Choosing Child Care

What to Think About

Paying for high-quality child care

Budgeting for child care takes work. Plan ahead and think about your future child care expenses as far in advance as possible. Keep in mind that it may take time to process applications or there may be a waiting list, especially if you are trying to qualify for financial assistance.

Child care referral agencies or other experts (such as some state or federal government agencies) can help you research your options for child care financial assistance. Some of the general options usually available are:²

• State child care subsidies. Guidelines vary by state, but generally low-income families who are working or in school may be eligible for assistance.
• Local programs. United Way, local government, community groups, or faith-based organizations are all potential sources of financial help.
• Employer/college support. Some employers and colleges offer child care scholarships, child care discounts, or reduced rates at on-site facilities.
• Child care program assistance. Some group child care providers offer scholarships, discounts, or pricing according to your income.
• Pre-kindergarten (Pre-K) programs. Many school districts now offer free or low-cost educational programs for 3- and 4-year-olds.
• Head Start and Early Start programs. Federal and state-funded programs are available that offer part-time or full-time free child care and other services for families who meet federal poverty guidelines.
• Tax credits. You may be allowed state and federal tax credits for child care expenses. Specific programs and amounts depend on your household earnings, family size, and other factors.
• Dependent Care Assistance Programs. This is a program offered by employers that allows you to have up to $5,000 a year taken out of your paycheck tax-free. The money is put in a special account for you to be reimbursed for child care expenses as they are billed.

Also, it may help to think creatively about affording child care and thinking about your options. Brainstorm ideas about ways you might be able to reduce the number of hours of child care you need or about ways to pay for it, such as:

• Sharing a nanny with a neighbor or a friend.
• Pursuing a flexible schedule at work that allows you to juggle child care and spend less. For example, you may ask if you can work 4 days a week for 10 hours and have an extra day off.
• Child care cooperatives. If you need only part-time child care, you may be able to work some hours caring for other children at the same time as you care for your own.

Changing or ending child care

Child care changes are inevitable and require careful planning. As children grow, their needs change. Also, personal preferences, a move, or other life events may require a different arrangement. Allow time for both you and your child to adjust by talking about it ahead of time. You may want to plan something special for your child's last day at the child care center, such as bringing treats and taking pictures.

Evaluate and plan for how you will accommodate a new routine, such as different hours of care. Talk with your child about what to expect. Stress the positive parts of the change, but acknowledge the challenges. Devise strategies about how to overcome some of the expected difficulties.

Effects of child care

Many parents worry that the relationship with their child will suffer for having another caregiver. Current research on the mother-child relationship shows that its quality is mainly determined by family characteristics such as the mother's interaction with the child, her educational background, and family income level.³

Another common concern of parents is whether children will develop and learn to their potential in a child care setting. Research shows that the quality of the parent's (in this study, the mother's) relationship with the child best supports a child's mental and behavioral growth.³ The more sensitive, responsive, attentive, and mind stimulating the mother is, the better the child will do in child care.

Help prevent illness

Your child is more likely to become ill when he or she is frequently with other children. One recent study shows that children in child care with more than 6 other children and who are between 3 and 4½ years of age have more episodes of upper respiratory infections (such as a cold) than those in nonparental care with fewer children or who are cared for at home.⁴ The spread of many contagious diseases can be reduced by practicing healthy hygiene habits regardless of what type of child care arrangement you have. Hand sanitizers (such as Purell) can work as well as or better than soap and water.

Establish a backup plan

Plan what you will do if your regular provider cannot keep your child or if your child is sick. Children with mild upper respiratory illnesses such as minor colds usually can attend child care. (Usually, mild upper respiratory illnesses are transmitted before symptoms developed.) Keep your child at home if he or she has a condition that prevents attending child care, such as a fever or a rash.

Know your responsibilities

If you use an individual care provider for your family on a regular basis, you may be obligated to comply with employer rules and regulations of the federal, state, and local governments. Call the United States Department of Labor (1-866-4-USA-DOL [1-866-487-2365]) for information about your responsibilities.

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Author:	Debby Golonka, MPH	Last Updated: September 26, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Michael J. Sexton, MD - Pediatrics
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