10 Things Your Child Care Provider Won't Tell You

This case helped spur Georgia to add a regulation requiring that infants be placed on their backs at group and family day care centers. But that's not the case everywhere — even though it's been estimated that 20% of Sudden Infant Death Syndrome (SIDS) cases occur in day care centers. A 2000 study by Rachel Moon, a pediatrician at Children's National Medical Center in Washington, D.C., found that 25% of licensed child care centers in the Washington metro area were unaware of the American Academy of Pediatrics' 1992 recommendation that infants be placed in the nonprone position while sleeping. Moon's study also showed that 28% still positioned infants prone. "You'd think it would be common knowledge by now, [but] we're bumping up against a lot of tradition," Moon says.

2. "We'll make your kid really sick..."
Day care centers are supposed to give working parents a chance to do just that — work. Pat Murphy wishes she were that lucky. The Oradell, N.J., mother missed so much office time — a full week out of the month sometimes — caring for her two sons who were sickened by germs picked up at day care centers, that her absences started to raise her boss's eyebrows. Both boys, Liam (now age three) and Conor (now two), contracted their first ear infections before they were three months old, and both needed tubes put in their ears by nine months. The family's doctor classified the infections as day care-related. "They were sick constantly," says Murphy, who finally pulled her sons out of the center and hired a nanny.

There's no getting around it: Day care centers are germ depositories. Get a large group of kids together and your child can expect a marked increase in colds, ear infections and upper respiratory infections. Says pediatrician Cathryn Tobin, author of The Parent's Problem Solver, "I see some day care kids twice as much as other children not in day care." How come? Blame poor sanitation, plus toy-sharing. Nicole Queen, a child care consultant and former day care director, says that at the Maryland centers where she was employed caregivers were required to clean toys with bleach and air dry them every two weeks. "Only a couple of centers I worked at did that," she says. What can you do? Be scrupulous about sanitation. Pay attention to how caregivers handle toys and bottles, change diapers and clean the facility.

3. "...especially during chicken pox season."
With the warmer weather, it's not just earaches your kids — and you — have to worry about. It's chicken pox time, and day care centers can help pass the virus along faster than you can say tic-tac-toe. A 2001 chicken pox outbreak that infected 23 kids in a Philadelphia preschool was attributed to a child whose parents had chosen not to vaccinate. While immunization rates are generally rising, "it's an increasing concern that some parents are choosing not to have their kids vaccinated," says Karl Heath, a registered nurse with the Philadelphia Department of Public Health.

For day care providers, it's not a simple issue when it comes to vaccinations. Day care owner Gale Walker, who oversees more than 300 kids at her Children of the Rainbow centers in San Diego, has just one child who isn't fully immunized. Walker allows him because he is the child of an employee who chose a religious exemption. Still, she's hesitant to allow more exempted children in her care because "some childhood diseases can be very detrimental, not just to children but to everybody."

4. "We have safety issues."
Day care centers may be fun for kids — but they're dangerous, too. The hazards range from the simple — recalled toys or unsafe playground surfacing — to the flagrant. Don Keenan, an Atlanta lawyer who specializes in negligence cases involving children, says he's seen cases dealing with day care injuries more than double in the past decade. Keenan is most troubled by the "alarming increase in intentional injuries; that is, sexual predators or child abuse."

Case in point: In March 2002, a Nevada district court sentenced Gary Hanneman, a former day care worker at the Children City Learning Center in Reno, to multiple prison terms for molesting nine children at the center. Videotapes of his acts were included as evidence. Several of the victims' families have filed civil suits against both Hanneman, who is appealing the original verdict, and the day care center. "He had access to more than 200 children," says Sherry Bowers, an attorney for several of the families. "There were many red flags that should have put [the center] on notice that it had a problem." Brian Brown, an attorney representing the center, says, "At this point we've denied responsibility."

5. "Our employees come and go..."
Ann Douglas, author of The Unofficial Guide to Childcare, puts the turnover rate at day care centers at "a mind-boggling 30% per year." You can blame low salaries for part of the problem. The U.S. Bureau of Labor Statistics tags the average hourly wage for child care workers at just $7.86, or $16,350 a year.

Unfortunately, your kid may pay the price for such haphazard treatment long after he has moved out of day care. According to a 1999 study by a team of researchers from the University of North Carolina at Chapel Hill, the University of Colorado at Denver, UCLA and Yale, children who had closer relationships with their child care teachers had better classroom behavior and social skills through early elementary school. That's one reason Douglas recommends that you seek out a center known for retaining top employees.