Child care

Each day in the United States, millions of children, ranging from infants topreteens, are in the care of someone who isn't their parent. Child care is nolonger a luxury; it is a necessity when two incomes are needed for familiesto make ends meet. Parents have a variety of options to choose from for childcare. Their decision is influenced by cost, convenience, and what they and the child feel comfortable with. They can select from child care in a home setting or out-of-home day care.

The history of the daytime care of infants and young children, also known asthe day nursery, day-care center, or nursery school, dates back to 1840 in France with the use of institutions called the creáche (French for "crib"). The establishment of child care institutions in most European cities andindustrial centers took place during the second half of the 19th century, with the first in Great Britain created in 1860. These types of services to young children and their families have an established history in European and Asian countries with infant care and preschool education included in the regularpublic school systems of France and Italy. Day care programs in the United States are private industries that did not become common until late in the 20th century. As American social reformers tended to the needs of immigrant families adjusting to the new world at the beginning of the 20th century, this time was declared "the century of the child" with most children not starting school until the age seven. With the "century of the child" at its end, it is not unusual for children to be placed in a child care setting at the age of one or two months.

Changes in the United States regarding child care throughout the end of the 20th century have been dramatic for families with children. In 1960, only 19 percent of married women with children were in the work force. In 1970, the figure rose to 28 percent. By 1980, 54 percent of married women with children were working, with this number increasing to 64 percent in 1988. Of those withpreschool aged children, by 1987, more than 50 percent of married women withnewborn children rejoined the work force before the infants were one year old. With the reorganization of the "traditional family" as it was once known,their has been an increase in the variety of child care to meet these demands.

Home-setting day care can take place at either the child's home or the caregiver's. In the former case, the in-home caregiver either comes to the child'shome to stay with the child all day, or may actually be a live-in employee. Such caregivers are called babysitters, nannies, or au pairs. A babysitter isoften a relative (such as a grandparent) or a neighbor. Nannies generally have extensive formal training. Au pairs usually have less formal training thannannies, and are often young women from other countries. If the child is brought to another person's home for day care, this is called family day care. The caregiver takes care of a small group of children at his or her home. Groupfamily day care is similar to family day care, except that a larger number of children to care for requires the presence of additional caregivers.

Many families choose out-of-home day care. In this type of care, children attend child care centers for all or part of each day. These centers may be operated independently, or may be part of a chain of day care centers, or run bya school, community center, or religious group. These centers may also offerpart time or occasional care, such as play groups.

Whatever the child care setting, most caregivers (except for babysitting family members) are usually required to be licensed by the state. Cities and towns may have additional certification requirements.

When considering a child care situation, certain standards should be looked for and met. In 1992, The Journal of the American Medical Association reportedthat children under the age of 2 years who attend day-care centers are morelikely to acquire respiratory infections at an earlier age than those cared for at home. Those in day care are also about one and one half times as likelyto get acute respiratory illness as children at home and have up to three and one half times more outbreaks of acute diarrhea. A March 1997 study in Pediatrics indicates that the proportion of preschoolers with ear infections between 1981 and 1988 jumped from 18.7 percent to 26 percent, due to the increased number of children in group care. While day care settings are oftenseen as a breeding ground for infectious diseases, those that meet or exceedcertain standards can minimize these health risks. Among the standards that should be met include:

  • Staff members should have training in early childhood education as well as training in first aid and CPR.
  • Both centerstaff members and children who are cared for at the center should have proofof up-to-date immunizations.
  • Snacks and meals, if provided, should be nutritious.
  • Steps must be taken to minimize the spread of infectious diseases (for example, toys and tables should be disinfected with bleach solutions, rubber gloves are worn when changing diapers, and children who become ill are isolated, cared for, and/or sent home as soon as possible).
  • Children must never be left unattended or allowed to leave the facility with someone other than a parent without the parent's written permission.
  • A variety of age-appropriate toys, games, activities and books should be available for children.
  • Electrical outlets must be covered.
  • Smoking is not allowed in the facility.
  • Caregivers interact with the children.
  • Children look happy and active, and the setting has a warm, comfortable atmosphere for both children and adults.
  • Parents are welcome to drop in without prior notice.

The cost of child care varies, depending on the location and type of programand the age of the child. In general, infant care is more expensive than carefor an older child (up to $100 a day is not unheard of), because infants aremore labor intensive and the teacher-child ratio is lower (three infants perteacher is ideal for an infant up to one year of age, as opposed to four children per teacher at age two). Some facilities will not accept children underthe age of two years nine months, or children who have not yet been toilet trained.

It is important to choose a child care giver with whom both the parent and the child feel comfortable and secure. For some families, that caregiver is a family member; for others, it is a teacher at a for-profit center. Choosing achild care option takes time, and sometimes the least expensive option isn'talways the best. In 1999, researchers affiliated with the National Instituteof Child Health and Human Development (NICHD) found that children who attendchild care centers that meet established standards of quality have fewer behavioral problems and score higher on school readiness and language tests.

For more information, contact the National Association for the Education of Young Children, the organization that accredits child care facilities. They can be reached at 1509 16th St. NW, Washington, DC, 20036 (800-424-2460). The state department of child-care licensing can also provide valuable informationabout child care facilities.

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