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The Truth About Day Care

Exactly 12 weeks after my daughter was born, like many other American moms, I squeezed into a pre-pregnancy dress, kissed my baby’s tiny cheeks goodbye and headed back to work. Each morning, after I left, my husband dropped our daughter off—for the first few months with a neighbor’s nanny, then later at a nearby day care center.

I’ll admit that in the beginning, handing over my impossibly small, perfect baby to a relative stranger was, well, hell. “I don’t think I can do this,” I wept to my husband on my first day at the office. But what choice did I have? We relied on the income and health insurance my job provided.

“Trusting your child with someone else is one of the hardest things that a parent has to do, and in the United States, it’s harder still, because American day care is a mess,” writes Jonathan Cohn in “The Hell of American Day Care,” his recent cover story in the New Republic. Among the problems: Not enough quality care, little official oversight and often crippling costs to parents.

For our family, the expense of my daughter’s care was a huge financial burden, even though I was working full-time. According to a 2012 report issued by Child Care Aware of America, day care is more expensive than rent in 22 states, and that was nearly the case for us. Yet my husband and I counted ourselves lucky simply to find a center where we were comfortable sending our daughter that was even remotely affordable.

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In our New York City neighborhood, like in many other places across the country, the majority of day cares seem to fall into two extremes. On one end: idyllic centers that have two-year-long waiting lists and cost twice as much as our monthly mortgage bill. And on the other: loosely run facilities, often home-based, which seem to have little oversight and too many kids per adult.

Indeed, as Cohn points out, the quality of day care facilities is “wildly uneven.” A 2007 survey found that only 1 in 10 provides high-quality care. Perhaps it's not surprising when you consider that many states require minimal or no safety training, and in 2011 the median annual salary for day care workers was just $19,430—not exactly an attractive number for those with skills or experience. Compounding the problem is that there is little official monitoring of what goes on inside day cares: Inspections occur infrequently, and the standards are often so weak that even bad centers manage to stay open.

“Listening to the inspectors, the people whose job it was to oversee day cares, tell me about the places they had shut down—and the places they couldn’t shut down despite the fact that horrible things were going on—was very sobering,” said Cohn in a conversation earlier this week. Home-based centers seem to be particularly dicey, since they are less subject to regulation and tend to have fewer official inspections. As Cohn points out in his story, the death rate for infants in home settings is seven times higher than in centers.

“There are some great home-based day cares out there, but in general you’re more likely to find problems, partly because you’re more likely to get fly-by-night people who say, ‘I’m just going to open up my house and do this,’” said Cohn. “And partly because, in a home-based setting, there’s often just one caregiver running the show. If that person is irresponsible, there aren’t any other adults to report it, or to pick up the slack. And the kids are too young to go home and tell their parents about what’s happening.”

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When Kate* began thinking about child care arrangements after her son Josh was born in 2011, she found a nearby home day care using a state database. “It grabbed my attention because it was just around the corner from our apartment, and the woman who ran it seemed very warm and grandmotherly,” says Kate. “Looking back, I should have asked for and checked her references, but at the time, we decided to trust our gut,” she says. “That turned out to be a bad decision.”

After two incidents—one in which her 4-month-old son received a bad sunburn, and another in which she found him lying on a changing table alone while the caregiver was in another room—Kate pulled Josh out after just six weeks. “The second time around, we were much more selective in our search process—visiting lots of centers and calling other parents to hear their experiences.” Today, Josh attends a different, Montessori-style home-based day care, which Kate calls “a dream” and “much more structured and better organized than the first one we used.”

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In our conversation, Cohn said that until policy changes are put in place to increase oversight and tighten standards, parents need to take greater responsibility for investigating day care centers on their own. “One thing I heard over and over from inspectors was, ‘Some people will spend more time investigating a car than investigating a day care,’” he said. “You need to spend time there, and I don’t mean 10 minutes. It’s important to observe the interactions between the caregivers and the kids.” References are also important, and Cohn recommends getting additional information about the providers: How much training have they had, what’s their level of experience, how long have they been employed there? “Of course, there are cases in which doing all of that won’t ensure a quality experience for your child, and you can’t foresee everything,” he said. “But a little vigilance goes a long way.”

*Name has been changed

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