Choosing Child Care: What to Know and What to Look For   

The American Academy of Pediatrics is offering a few tips when choosing a child care provider for your child.


AAP experts suggest you start by making a list. What characteristics would your ideal childcare provider have? Consider qualities such as experience, religious background, disciplinary beliefs, cost, location, reputation, and flexibility.


It’s important to do your research and know what options are available to you.

  • In-Home Care: Some parents prefer the one-on-one contact an in-home care provider can offer, especially for an infant. Parents or couples with full-time careers may find their work schedules require them to hire an in-home care provider. Trying to juggle overtime, business trips and child care demands can be impossible without live-in help. Consider seeking the services of licensed agencies with experience when hiring a nanny or au pair.
  • Out-of-Home Care: Out-of-home care includes day care centers (usually affiliated with a public or private agency such as a religious organization, corporation or community center); family day care programs held in the caregiver’s home; part-time child care programs such as preschools or play groups; and publicly funded preschool programs such as Head Start. These programs usually care for kids from birth to age 5.

The American Academy of Pediatrics recommends that one adult should have the primary responsibility for no more than one baby under 12 months of age in any care setting. Babies need positive, consistent caregivers who learn to recognize their unique cues for hunger, distress, and play. This kind of nurturing interaction contributes significantly to an infant’s social and emotional growth.

For overall infant care, the AAP recommends a child to staff ratio of 3:1.

The AAP guidelines for child care are:

Age                                         Child: Staff                                         Max Group Size

Birth – 24 months                3:1                                                       6

25-30 months                       4:1                                                       8

31 months – 5 years            5:1                                                       10


The AAP and the National Association for the Education of Young Children (NAEYC) recommend that any child care setting, whether in-home or out, be licensed and regularly inspected. Caregivers should have basic training in CPR and early childhood development. There should be clearly written policies on sick children and discipline. Voluntary accreditation with the NAEYC or the National Association for Family Child Care (NAFCC) usually indicates that the center is committed to providing quality care and must participate in ongoing child development programs.

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Health, safety, and hygiene must be given priority in all settings. All kids and staff should have current immunizations; staff should have clear criminal background checks. The facility must be childproofed, and all staff should wear disposable gloves when changing diapers. Toys should be disinfected regularly, and frequent hand washing should be promoted among the staff and kids to minimize the spread of infection.

In larger child care settings, you should also expect that your child will be assigned to the same caregiver to promote a sense of security and consistency. Inquire about the rate of staff resignations; low staff turnover minimizes the need for young children to repeatedly adjust to new caregivers.


According to the AAP, federal law guarantees special education and related services to kids with disabilities from birth through age 5. Special services such as speech and physical and occupational therapy can now be brought into daycare centers or preschools so that children with special needs can be included in “regular” care settings.

Early intervention services can be coordinated through your local Office of Mental Health for kids up to age 3 and through your state’s Department of Education for ages 3 to 5.


After all your research, interviewing and observing, you may need to reassure yourself that leaving your child in the care of someone else is what works best for your family.

Daily reports about your child’s day and frequent onsite visits can help reassure you that he is being nurtured and having fun.

Just as you need to feel confident in your child’s caregivers, kids need time to adjust. Young infants up to 7 months old generally adapt quickly to caring adults; older infants may suffer from “stranger anxiety” and need extra time and parental reassurance. Many toddlers and preschoolers go through adjustment periods involving tears, pouting and tantrums s they settle in. Visits with you, favorite objects, (a familiar blanket or teddy bear, for example) in the child’s backpack and the reassurance that you will return at the end of the day can help the adjustment

2 thoughts on “Choosing Child Care: What to Know and What to Look For   ”

  1. I’m glad you showed us the chart that displays the recommended child-to-staff ratio for childcare centers depending on their ages, as provided by the AAP. I’m going back to office work next month, so I need a childcare center to watch over my 3-year-old while I’m working. I’ll be sure to consider this chart while I look for nearby child daycare centers I might consider.

  2. I agree that you should prioritize health and safety when looking for a childcare service. My older sister is hoping to find a reputable childcare center for her 3-year-old daughter so she can add more hours to her work schedule. This week, I’ll help her look for a center that has a good reputation for safety and health.

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