July 2009

The Child Care Challenge

By Julie Bindeman, Psy-D

Becoming a parent means becoming a decision-maker. From the onset of pregnancy, the choices that parents make can feel overwhelming and flood even the most confident people with self-doubt. For some, even the most seemingly minuscule of choices can become an exercise in uncertainty. No wonder many of us are wracked with guilt over the bigger choices: Should I stay home or go back to work (and when)? Should I breastfeed? Should I supplement with formula? Do I pick up my baby whenever she cries? Should I go out with my spouse and leave my child with a babysitter? What kind of preschool should my child attend?

Today in America, some of these choices are made for us, especially those concerning child care. For parents who need to work full-time outside of the home in order to have an economically viable household, these are very real stressors. And for parents who want to work outside of the home, there are mixed feelings associated with the luxury of having a non-parental caretaker minding the children. One thing is certain: Children need adults to care for them. In the past, the child’s mother traditionally played this role, and the need for outside child care was rare. However, with more women involved in pursuing careers or other types of work outside of the home, finding an adult to watch their children is a necessity for many.

The Family and Medical Leave Act

Announcing to an employer that you are pregnant can be dicey, despite protections ensured by the Family and Medical Leave Act (FMLA) passed by Congress in 1993. (As recently as 2008 and 2009, FMLA was amended to include members of the armed forces.) FMLA ensures that an employee can take up to 12 weeks of leave from work for the birth, adoption or foster care of a child; the care of a spouse, parent or child with a serious health condition; or the employee’s own serious health condition. FMLA only guarantees employees leave during this time and protects their positions, as they cannot be fired for handling one of the above situations. But FMLA does not provide wages for this time taken off, and it is only valid for employees who work in a company with more than 50 workers; no protection is provided for parents who are employed by a small business or work for themselves. Many women expecting a child are able to be creative in terms of taking time off. They cobble together saved sick and vacation days, as well as short-term disability, so the financial reality of having a child is not so difficult. But what about those who work as hourly employees or for minimum wage? How do they balance needing to take care of an infant with the economic needs of everyday living?

Choices for Parents

For some, the solution is simple--forego rejoining the work force once the child is born. This takes care of the economic setback of paying for child care, as the two-parent income might barely offset the additional expense of this care. For these parents, looking at this from a purely economic standpoint would make the whole idea of outside child care an unpractical option, and the model of a single-wage earner often prevails. An alternative would be to have child care accessible to either parents who need to work or those who have discretionary income, which allows parents more freedom to choose how they spend their time.

It is also important to take into consideration the emotional health of mothers. Taking care of an infant is taxing, yet at the same time, it is very rewarding. Minding ones own child may not be suited for everyone. There is a certain collegiality associated with being part of a workforce. Commiserating over lunch about workloads, directives from superiors or long hours helps co-workers bond. Some stay-at-home parents miss this feeling of being a part of a larger whole. Others feel isolated and cut off from the world that does not include infant care. Their time is their own, spending habits may drastically change, life as they knew it might turn on its side and jealousy over the fact that their partner gets to go out and work can cause rifts between the parents. Still others thrive in this situation and make new connections in this role. They form new social circles by way of playgroups and “Mommy and Me” classes. Bonds like these can last a lifetime.

Child Care Today

In her new book, Child Care Today: Getting It Right for Everyone, Dr. Penelope Leach analyzes this conundrum on an international level, examining the social, cultural, emotional and economic factors that go into deciding whether to stay home or continue working. Leach breaks down the different forms of child care, which range from parental care (either having one parent stay with the child or arranging schedules to accommodate each parent’s staying with the child while the other works), familial care (having a grandparent or another family member watch the child) or noncustodial care (which can range from a nanny, in-home day care or center care.) She analyzes the factors that determine what is “good quality” care.

What makes this book such a compelling read, in addition to the fact that Leach prepares her argument succinctly and clearly, is that she works from the premise that other caregivers, besides the biological mother, are just as suited to bring about the outcome of a happy child, and in some cases, even more so. Leach begins by reviewing attachment theory. It is through this perspective that the myth referring to mothers, preferably biological ones, are the ideal candidates to raise their own children, becomes perpetuated. She points out that it is commonly overlooked in attachment studies that there are reports that fathers and other caregivers, as long as they are consistent, provide as equally competent care as the mother figure.

What concerns some parents about dropping off their child with a non-family member during the daytime hours is that the child will attach to the caregiver and not the parent. For example, they are afraid their child will start to prefer the caregiver rather than the parent. Additionally, the parents worry that they might miss out on early developmental milestones, such as the child’s first steps or words. This is not the case. While during the week, the child might be with an outside caregiver, attachment is formed over time, and the stability of a home environment has the longest effect regarding with whom the child feels secure. In fact, it is only through developing early secure attachment with parental figures that a child is able to feel secure with non-familial people. Allowing a child to feel the love of multiple caregivers can be a gift: it shows the child that the world can be a safe place outside of the immediate family.

What Is Good Quality Child Care?

Discerning what is good quality child care is a perplexing task at the very least. The ones who would be the “experts” (infants and young children) seldom are able to communicate their thoughts on the quality of care they are receiving.Of course, child care is not just limited to this age range. For working parents, finding appropriate arrangements for after-school care is another struggle. As children grow, their needs change, and what is deemed as acceptable also changes. No longer can parents rely on a caretaker to be attentive. As children grow, their socialization and stimulation needs vary.

Measuring “good quality” is also challenging, as the factors are not necessarily stable from one center to another. For example, one factor is the small ratio between caretakers and children. Ideally, there should be one caretaker per two infants at a maximum. However, just because there is an appropriate ratio, it does not mean that the caretaker is able to form a connection with her charges. Rapport is another nebulous factor. Ideally, the caretaker should have a good rapport not only with the children being cared for, but also with the parents. This chemistry can be measured subjectively only over time. It can be difficult to predict whether or not a rapport is apparent when you are interviewing for a child-care placement.

Paying for Child Care

Leach’s book goes beyond simply what to look for in quality child care, whether it be from a family member, a nanny, a family day care setting or a child care center. She also examines the problem of paying for child care and with whom the burden should rest. In the United States, this burden lies mostly with the parents. Some employers offer a benefit to their workers that allows for a portion of child care expenses to be reimbursed prior to taxes. However, for many, most of the second wage earner’s income becomes absorbed by the burden of the cost of child care. Additionally, quality child care is important, and yet what we pay those that work in these settings is paltry compared to other professionals.

Leach makes some suggestions on how to bridge our priorities with our spending and points out how some countries have successfully done so. Basically, Americans need to change their priorities. Choosing child care should not be a function of a family’s wealth. Frequently, this is a decision based upon the affordability of whether or not both parents can work. Thus, our priority is adult-centered rather than child-centered. Leach details the need for making the best quality child care available to all families, not just the wealthy. She suggests integrating child care with our educational system. After all, isn’t this the earliest type of intervention? Secondly, Leach suggests that our caregivers should receive proper educational training and have a nationalized system of best practices that can be used as markers.
A big consideration is who is paying for the child care. This can either be a cost that the government partially or mostly subsidizes,as in other developed countries, or, as our system mainly is now, parents pay for the majority of the cost. As a country, we should think about our Family and Medical Leave Act. As it currently stands, FMLA does not go far enough in providing a caretaking option for families. FMLA should include a longer period away from work, as well as paid or partially paid time off. The law sends the subliminal message that raising a family isn’t a worthy undertaking.Only minimal time off is granted (typically just enough time for a woman’s body to heal from the ordeal of child birth).

Child Care Today raises and addresses the myriad issues that go into the politics, economics and emotions of starting a family. The United States seems to fall short in many categories compared to our international counterparts. While we have a good start in FMLA, there is still much work to be done. Whatever child care decision you make, it is important that it is the right one for your family.

Julie Bindeman is a licensed psychologist in private practice and co-director of Integrative Therapy of Greater Washington. She works exclusively with adults and adolescents relating to identity formation and transition issues. She can be reached at jbindeman@greaterwashingtontherapy.com or you can view her website: GreaterWashingtonTherapy.com.

How to pick a caretaker for your child: