Choosing Child Care

Reviewed by Dan Brennan, MD on August 09, 2022

If you're planning to go back to work at some point after having your baby, the time to start thinking about finding good child care is now, while you're still pregnant. It can take a long time to research child care options, and the best and most trusted caregivers often have a waiting list.

If you will not have a stay-at-home partner or other family member caring for your child, your three main child care options include:

  • Center-based day care
  • A home-based day care
  • A nanny or au pair

There are a wide variety of center-based day cares available, some privately owned and others operated by churches, corporations, national or regional franchises, and schools and universities.

Two good sources for finding day care centers are:

  • Child Care Aware (
  • The National Association for the Education of Young Children (

Also, ask your friends with children for recommendations.

At a minimum, your day care center should be accredited by the state you live in. But you want more than just the minimum for your child. Look for a center that:

  • Meets the American Academy of Pediatrics' recommendations for infant-to-caregiver ratio (no more than three babies under the supervision of one caregiver).
  • Allows and even encourages drop-in visits by parents.
  • Has clearly stated, written policies on things such as discipline and what happens when a child is ill.
  • Has a strict policy about cleanliness, hand washing, and hygiene. When you visit, observe whether workers wear gloves when changing diapers.
  • Employs staff members who are trained in CPR and in early childhood development, and who have gone through criminal background checks.

You should also find out about their vaccination policy, how they accommodate special diets or food allergies, and what the operating hours and fees are.

If you have twins, be prepared to pay tuition for two, although some centers may offer a sibling discount.  Some parents prefer to have their twins in separate day care or preschool classrooms so each can establish their own identity as an individual person. This would be easier to do in a day care center than with either a nanny or a home-based day care.

Home-based day cares are smaller, run out of an individual caregiver's home. Often, the person running a home-based day care has children of their own whom they care for at the same time. There are many more of these centers than day care centers, they are usually less expensive, and they can be easier for finding an opening.

On the other hand, their hours are often less convenient than center-based care -- for example, a home-based day care provider may close for a week in the middle of the summer for their own family's vacation. Or they may have to close at the last minute if they get sick -- something that doesn't happen in a center.

In a home-based day care, you should look for:

  • Licensure by the state, criminal background check, CPR certification, and experience caring for young children and infants
  • No more than six children per adult caregiver, including any of the caregivers' own children, with no more than two of these children under age 2.
  • Clear policies about hygiene, discipline, and illness
  • Information about what sort of daily program is offered. Does the caregiver take the children for walks? Provide specific things like music time, art time, and story time? How often is the television on?
  • Information about other adults or older children in the home. Centers are usually stricter about who comes in and out of their buildings; you may not be comfortable with a lot of unscreened, unrelated people visiting the home where your child is cared for.

Many parents of infants and very young children prefer to have their child cared for in their own home, by a nanny or au pair. This is probably the most expensive of the three main approaches to child care, but it might make more financial sense if you have twins. Nannies may ask for a slightly higher salary to care for twins rather than a single child, but it's usually not the double tuition you might pay at a day care.

Keep in mind that having a nanny also requires backup for any time your nanny is sick, on vacation, or needs personal time.

On the other hand, having a nanny gives your child much more one-on-one attention, and being cared for in your home means less exposure to germs -- which may be particularly important to you if your child was in the NICU or is otherwise fragile. You can also set a specific schedule with your nanny; many centers and home-based day cares close at 6:30 p.m., but if you can't leave work until that time, a nanny may be best for you.

One good source for finding a nanny is the International Nanny Association (

Things to ask a prospective nanny (besides checking their references thoroughly):

  • Why are you interested in working with young children?
  • Have you worked with young infants or newborns before?
  • Why did you leave your last position?
  • Are you certified in CPR and willing to undergo a criminal background check?
  • How would you handle discipline? Temper tantrums? Toilet issues?
  • What would a typical day with you be like for my baby?

No matter which type of child care you think is right for you, be sure to visit each center or home-based day care center on multiple occasions, or meet with each nanny candidate you're seriously considering more than once.

Observe the children. Do they seem happy? Is this a place you could see your child thriving? If something just doesn't feel right to you, move on. But if the answer is yes, then you've probably found the right child care.

Show Sources

SOURCES: "Making Child Care Choices Count for Your Family," "Family Life," "Preparing Twins for Preschool."

The National Association for the Education of Young Children.

KidsHealth from Nemours: "Choosing Child Care."

American Academy of Pediatrics: "Choosing a Childcare Center."

National Association of Child Care Resource & Referral Agencies: "Is This the Right Place for My Child?"

American Academy of Family Physicians: "Day Care: Choosing a Good Center." 

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