Finding the Best Day Care for Your Child

Day care for your children may be a fact of life if both parents work. But not all day-care options are good for your child. If you're just starting to look, first, decide which type of child care best suits your situation.

Hiring a baby sitter in your home or taking your child to the home of someone who watches a few children may be convenient or more economical, but your best bet may be a group or center setting.

Things to think about

Before you make a decision on a day-care center (or another day-care situation), here are a few things to consider:

• Be sure the center has a state license, and ask about accreditation. Ensure they are CPR certified.

• Look for a ratio of one adult per three children under 1 year old, one adult per seven children 3 years old, and one adult per eight children 4 and 5 years old. Ask if caregivers are certified.

• Be sure discipline doesn't involve isolation, humiliation or intimidation—make sure the center's policies agree with yours.

• Be certain the center has a designated diaper-changing area, with a sink, separated from the rest of the facility. Watch to see that staff members wash their hands at appropriate times, such as after diaper changes and before snacks or meals.

• Be sure the center was designed with children's safety in mind. Outdoor play areas should be protected with impact-absorbing material.

• Make sure the center's food and drink meet your child's dietary needs. Snacks and naps should be on a schedule. If your child has any food allergies, make sure the staff members know how to keep your child's snacks separate and free from contamination with foods that could make your child sick.

• Ask about policies for special situations, such as when your child is sick or when you're stuck at work late.

• Ask if they have current parent references you can contact.

• Ensure the center follows guidelines to reduce the risk of SIDS and sleep related deaths as detailed below.

Reducing the risk for SIDS and sleep-related deaths

Here are recommendations from the American Academy of Pediatrics on how to reduce the risk for sudden infant death syndrome (SIDS) and sleep-related deaths from birth to age 1:

• Place your infant on his or her back for sleep or naps. This can decrease the risk for SIDS, aspiration, and choking. Never place your baby on his or her side or stomach for sleep or naps. If your baby is awake, allow your child time on his or her tummy as long as you are supervising, to help your child develop strong trunk and neck muscles. This also may prevent flattening of the back of the head..

• Always talk with your baby's doctor if he or she has been diagnosed with gastroesophageal reflux. Do not raise the head of the crib.

• Offer your baby a pacifier for sleeping or naps, if he or she isn't breastfed. If breastfeeding, delay introducing a pacifier until breastfeeding has been firmly established, usually within 3 to 4 weeks..

• Use a firm mattress (covered by a tightly fitted sheet) to prevent gaps between the mattress and the sides of a crib, a play yard, or a bassinet. This can decrease the risk for entrapment, suffocation, and SIDS.

• Avoid using infant seats, car seats, strollers, infant carriers, and infant swings for routine sleep and daily naps. These may lead to obstruction of an infant's airway or suffocation.

• Avoid overbundling, overdressing, or covering an infant's face or head. This will prevent him or her from getting overheated, reducing the risks for SIDS.

• Avoid using loose bedding or soft objects—bumper pads, pillows, comforters, blankets—in an infant's crib or bassinet to help prevent suffocation, strangulation, entrapment, or SIDS.

• Avoid using cardiorespiratory monitors and commercial devices—wedges, positioners, and special mattresses—to help decrease the risk for SIDS and sleep-related infant deaths. Special devices that are sold to prevent SIDS, such as wedges or positioners, are not proven to work and may increase the risk of suffocation.

• Always place cribs, bassinets, and play yards in hazard-free areas—those with no dangling cords or wires—to reduce the risk for strangulation.