To Daycare or Not to Daycare

I find it so ironic that American culture communicates what can feel like judgment for those of us placing our infants and toddlers in daycare, along with maternal leave policies that mostly undercut the financial freedom to stay home with our children past 6-12 weeks old. Not that irony or contradiction is a new part of our cultural fabric, but this can be especially emotionally triggering for mothers. In the postpartum haze of hormones and sleep deprivation, the idea of separating from our infants is almost universally devastating.

Personally, that feeling of grieving our togetherness worsened with each one of my maternity leaves. It felt more and more “unnatural” to not be physically near my infant in these early months of growth, bonding, and getting to know each other. On the other hand, I greatly value my career and professional identity apart from my role as mother, and I did enjoy spending more intellectually meaningful time with adults. For my own personal fulfillment, I need both, even if balancing them is impossible and I’m constantly running back and forth to find “balance” while paradoxically always tipping the scale one way or another. The point is using daycare is a highly personal choice that often does not feel like a true choice, but one that can leave us grappling with guilt, doubt, and fear for our child’s well-being.

An online article by Psychology Today compiled a summary of findings from research, including the most notable and extensive Study of Early Child Care (SECC) funded by the National Institute of Child Health and Human Development, examining multiple long-term outcomes comparing children across different types of childcare (center-based daycare, daycare in a home, at-home care [including maternal care and nanny care], grandparent care, father care (I do not know why maternal care is considered “at-home care” while father care is not). Had I read this article originally posted in 2007, I would have shed even more tears in my anticipation of returning to work.

The findings certainly sounded dire: the kids showed more behavior problems, more conflict with parents and teachers, worse work habits in the classroom, and poorer social functioning; the positive outcomes included better short-term memory and higher math and reading scores.

Some important caveats, however, that are not as attention-grabbing as these grim predictions, were that many results were correlational and not causal (for example, results showed an association between more hours in child care centers and behavior problems later, but not that the more hours CAUSED behavior problems). What is important about this caveat is it means that other potential factors could have contributed to the outcome (eg, parent and family factors like stressed out, financially strapped caregivers, may have related to more hours in childcare, which then associated with behavior problems). There is also an acknowledgement of the “small effect” behind some significant findings. In statistics, this means that although it is mathematically “significant,” the actual real-world difference is small (see IQ point differences for breastfeeding in previous blog post).

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In fact, I ran into several doom-and-gloom headlines about daycare that seemed to draw on these very findings, using phrases that misrepresent the data (eg, "placing children in daycare can LEAD TO a number of negative effects"). Skewed and misleading phrases about the study results -- even suggesting my children are less likely to have a secure attachment (don't get me started again) -- exemplify the danger of relying on non-scientific outlets to communicate scientific information. 

Another review published in 2007 by the Journal of the American Medical Association (JAMA) examined the findings of the SECC study in combination with other recent research. Although they reported some similarities to the results outlined by Psychology Today, they also included some persuasive findings about how higher quality childcare predicts multiple positive outcomes (eg, high social competence, cognitive and learning gains, fewer behavior problems, lower stress). Also, the SECC study found that “family factors” (eg, parenting characteristics, income, attitudes and beliefs about parenting and child care, quality of parenting) had 2-3 times the influence of childcare on child outcomes.

Examining these studies in depth leads to the following common-sense conclusion to the question of how daycare affects children: It depends.

What does it depend on? The type and quality of childcare, the child’s personal characteristics, and parenting practices at home combined with what kids are exposed to in childcare. A major take-home point is that it is definitely worth the time to research childcare options, pay attention to the daycare environment, and absolutely follow any instinctual red flags. The American Academy of Pediatrics has a great summary of what to look for in "high quality childcare" (including the statistic that we are paying an average of 27% of our income instead of the recommended 7%!!!!).

In our family’s history of sending three children to daycare from the ages of 12 weeks on, there was one time when our child’s mood and behavior seemed to be affected by the daycare situation. We paid a little more money and drove a bit farther for a different daycare, and the new problems at home resolved. We were not 100% certain that the mood and behavior changes were caused by daycare, but went with instinct and had no regrets. It’s important to note that this was a poor fit between my child’s age/development and the classroom; our other two children actually did quite well in different classrooms at the same daycare.

I can’t count the number of times I have heard women offer reasons/disclaimers/apologies for either "choice" of going to a job outside of the house or staying home. I have made these comments and harbored that limitless guilt that I might be harming my children, and the person to whom I’m speaking is making that judgment. The truth I have garnered from listening to parents from my personal social circles, online social media groups, and reading endless blogs, tweets, and parenting articles, is that this choice (in the case of having a choice) is not just hugely personal, but also fluid, changing depending on circumstances. As always, we do our best each step of the way. 

That's exactly why we need to tread carefully with how we read and respond to headlines about the effects of daycare. We don't need the already-present flames of guilt to be fanned by click-bait headlines preying on our fears. Do we have a personal responsibility to do our research for the best option for our child? Yes. Do we need better choices? YES. If we choose daycare, should we be kind to ourselves about it, trusting our mama instinct ? Absolutely yes.