You've made a work-through-your-emotions-when-you-go-back-to-work plan, you've thought about how you're going to feed your baby when you're back on the job. Now, who's going to watch your little one? What about child care?
If you're like most modern moms out there, the thought of leaving your baby in the arms of someone else, anyone else is pretty daunting. The good news? It doesn't have to be.
I had the world's best nanny for my kids for my first five years of parenthood. She was an amazing childcare provider. I didn't find her by luck, though (okay, there was probably a little luck). I found her by design. And, whatever childcare situation you're looking for -- in-home one-on-one care, a child care center, care from a family member -- you can do the same.
As a private practice pediatrician, new and expecting parents ask me often about what type of setting is best for children—child care, family care, or in-home nanny care. My answer is never black-and-white because, like almost all things in life, it depends.
I care most about quality, and in my book, quality child care provides a safe space where kids can build deep, one-on-one connections with their caregivers and peers and is a place where kids do not get sick all day, every day (very important for all working parents).
The program or person also needs to provide the level of flexibility you need. Finally, you want the adults caring for your child to have the same parenting goals and values you do, backed by a working knowledge of the core principles of successful caregiving.
You don’t want them to try too hard to focus on a set “curriculum” for your children. Instead, you want them to provide opportunities for exposure to lots of books, music, one-on-one communication, and exploration. This could be in the care of a child care center, an in-home child care setting, a nanny, a nanny share, a friend, or a relative.
My top picks are nannies, family members, and in-home child care settings for young kids. Once kids reach preschool age, the need for structure and social skill development outweighs the home care aspect. At that point, a mix of preschool and sitter/nanny is my top choice. Of course, budget often comes into play, and traditional child care settings with quality, reliable caregivers are a great option too.
Child Care Centers
When you set out to find a child care center, start by talking with other parents in your area. Chances are seasoned parents will start recommending child care centers once their own kids are ready to start the next level of school in the fall. Depending on your location, you may need to get onto waiting lists early (eg, as soon as you’re pregnant; I know, we live in a competitive world). It’s never too soon to start researching.
Look for child care centers that share these goals for your kids, giving care in a way that helps kids.
• Contribute to society.
• Find contentment in their work and play.
• Form healthy relationships.
• Build resilience.

Consider the possibility of increased risk of illness.
A child in child care will be exposed to more germs daily than a child in a one-on-one or nanny share setting just because of the sheer number of other children she’s around. Yes, over time that can contribute to a stronger immune system, but, for some families, it can mean a world of hurt every winter. Every child is different—some kids seem to skate by without a cold or rash—but it is a recurring theme.
Even though a nanny or smaller in-home setting can seem more expensive on the surface, your cost-benefit child care analysis should also account for potential days of work missed caused by your child’s illnesses if he’ll be in a group care setting. In my profession, it’s not impossible to take a day off, but it is a huge inconvenience to my patients and to my business partners. So that I can avoid missed workdays, I look for ways to avoid my kids catching major illnesses in the first place.
Nanny Care
Likely because I’ve had such a good child care experience personally, friends and patients ask me consistently where to find a good nanny.
The answer: there are a ton of places to look for quality caregiver suggestions—online caregiver search sites, friends, family, coworkers, social media groups, and even professional nanny companies. On the websites specifically designed for finding care, they’ll make it easy for you to go through all the steps—they’ll allow you to create a profile and a job posting where you then filter through applicants and set up in-person interviews.
From there, you can sign up for a paid trial during which the caregiver cares for your child for just an hour or so while you’re still in the house so that you can make sure you feel comfortable.
Here’s the secret, though: it’s not about where; it’s about how. It doesn’t matter what site you use or what friend makes an initial suggestion. It matters what process you go through to attract, evaluate
Click here for my best strategies for finding an amazing nanny.
Family and Friends
Friends and family can also be amazing pinch-hit caregivers or caregivers for extended trips. If you have an open, honest relationship with a family member you trust, that person can also work well as a full-time nanny. The obvious bonus? Free care (or at least significantly reduced cost). The downside? For many parents, establishing long-term care with a family member can be more complicated than a traditional child care arrangement because there is no formal employer-employee relationship. The best way to address this is to set up expectations for what your needs are and your kids’ needs are and to let the chips fall where they may (as long as there are no major safety violations) if things aren’t to your exact specifications.
Paid caregivers will also vary in their willingness or ability to meet your expectations, but it’s a little easier when dealing with an employee because you are paying employees. If it doesn’t work out, you can usually end or alter your relationship with significantly less dramatic fallout. If the caregiving prowess or style doesn’t quite measure up, you can choose to find someone new without the emotional considerations that come with personal relationship negotiations.
On the flip side, it can be difficult for friends and family to understand or respect your boundaries or your parenting style. Sometimes you have to make a hard decision—is it worth it financially to muddy the friend and family waters and if it is, will you be able to let go of the smaller things that irk you?

The Most Important Caregiver Consideration
Feeling stressed as you tackle this topic? Don't be! Focus on finding experienced, quality providers. Like most things in life, what really matters when it comes to child care is that you feel comfortable and confident with your choice. The exact location or setup—child care, nanny care, or family care—matters less. Child care centers and nannies can be great options, but just make sure you find quality caregivers who share your goals and values—that is most important. Finding a nanny or caregiver can be stressful, but it’s also very exciting. You’re building your village; you’re hiring the person who will be there for your kids alongside you, nurturing, guiding, and caring for the person or people you love best. You’ll find amazing people waiting in the wings to work with you.
I know first-hand that working mom life is hard, but I also know it doesn’t have to be impossible.
Trust me. The best way to get unstuck isn’t to work harder. It’s to use a framework that gets real results, no matter what area you need to tackle first.