Preparing your infant for child care

Starting an infant in child care can be stressful for everyone involved. Parents want to be able to spend time with their little one, but have to go to work or school. Infants need specialized, consistent quality care. Child care providers want to provide high quality, loving care while balancing the needs of multiple children and licensing requirements.

The care your infant receives at child care will be similar to what you provide at home, but there will be unavoidable differences. Many of the differences are part of the regulations for licensed* child care providers. These may include things like safe sleep practices, safe and/or healthy nutrition guidelines, curriculum and activity requirements, and illness policies. Additionally, care givers strive to provide a caring transition that makes your little one feel secure and loved.

*If you didn't know, most states require some level of licensing for caring for children. This includes people who regularly care for children in their home. If you are unsure of your state's requirements for child care, check with the Department of Early Childhood Education to get more information. 

I surveyed family child care providers in Massachusetts to find out what parents can do to help them give the highest quality care to infants. Here is what they said:

What can parents do to help ease the transition from home to child care?

Safe Sleep Practices

Massachusetts has very strict guidelines for safe sleep practices in child care. The American Academy of Pediatrics also issued an updated list of recommendations for safe sleep recently. These guidelines and recommendations are intended to help reduce the risk of things like SIDS, strangulation, and choking.
What do caregivers need to do?
Caregivers must place infants on their back to sleep (unless prescribed differently by a doctor) in a bed designed for sleeping: crib, porta-a-crib, play pen, bassinet. Bed must have a firm, flat mattress and a tight fitting, clean sheet. Bed may not have anything in it other than the baby and what the baby is wearing, including a sleeper or sleep sack. Pacifier can be used while the baby is awake and will removed if it falls out of their mouth. Car seats, swings, or vibrating chairs cannot be used while an infant is sleeping. Items like blankets, pillows, wedges (unless prescribed by a doctor), or toys will not be allowed at child care. Infants younger than 6 months will be on constant visual supervision of infants, even during sleep. Provide safe sleep information to parents. Take regular training on safe sleep practices.
What can parents do?
At least once a day, have your child lay by themselves on their back on a flat surface intended for sleep during nap time. Allow time for the baby to sleep while on the flat surface. Occasionally lay the baby down while they are awake. Make sure the bed is clear from anything that is not the baby, his pacifier (with no stuffed animal, string, or clip attached), and a nap sack. Practicing at home helps baby to be comfortable with this sleeping arrangement.

Safe & Healthy Nutrition

Infant's food intake can be different from one child to another. Breast milk, formula, purees, and finger foods all have to be served to the right child, at the right time, using the right method. On top of the regulations, care givers have to do regular training in CPR, first aid, and choking prevention.
What do caregivers need to do?
It is recommended that bottles are given cold or at room temperature. There are guidelines to follow for warming bottles, including things like: the bottle should be held under warm running water, the baby cannot be held while caregiver is removing the bottle from warm water, bottle warmer appliances are not allowed. Caregivers must hold infants while giving them a bottle. Although it is not a regulation, care givers may have policies to send infants home that refuse to eat for extended periods of time.
Care givers are required to follow USDA guidelines for nutrition. Care givers must follow a feeding schedule, document feedings, and document newly introduced foods. Your caregiver may share information on developmentally appropriate feeding practices as your child reaches milestones.
What can parents do?
If the baby is nursing, make time for someone other than the mother to feed the baby on a regular basis for 2-3 weeks before child care begins. The baby may need time to adjust to using a bottle or may reject certain types of bottles. Hold infants while giving them bottles. Give bottles that are cold or at room temperature.
Follow a regular schedule for feedings for a few days before child care begins and follow that schedule on weekends after child care begins. Share that routine with the child care provider and inform them if the routine changes. Tell your child's care giver when your child last ate, what they ate, and if there were any changes since they were last in care. Tell your child's care giver if they tried a new food since last in care.

Curriculum & Activities

What do caregivers need to do?
Tummy time is required daily for infants. While in child care, babies will likely have to be laid down while they are awake. All children are required to be allowed gross motor and outdoor time on a daily basis. In a family child care, it is likely that there are children of multiple ages in the group. There will be times that the care giver is not giving 100% of their attention to your infant, because they are expected to provide developmentally appropriate activities for all of the children in their care.
What can parents do?
Trust infants to spend time on their own. Allow them time to lay independently on the floor, play mat, or in a play pen.  Outdoor clothing is needed starting on day one and every day after that, even for the youngest infants. Child care can be a loud, busy place. Don't be afraid to make noise at home that would normally occur if the infant weren't home, especially while they are sleeping.

Illness Policies

What do caregivers need to do?
Licensed providers are required to keep records of illness and injury, which includes reporting serious illness and injury to DEEC. There will be times where your infant will not be able to attend child care because they are suspected to have a contagious illness or are too sick to participate. A mindful caregiver will notify parents when one of the children in the program has symptoms that could be spread. Medication has to be documented and provided by the parent in the original container with the directions. Care givers also have to follow hand washing, diapering, sanitizing, and disinfecting policies.
What can parents do?
Have a plan for illnesses. Babies will get sick. It is important to fully understand your caregivers illness policy and to follow it accurately. Illness policies are designed to reduce the spread of illness and reduce how long those illnesses last.  Typically, illness policies include: sending home children with fever/vomit/diarrhea and excluding children for 24+ hours following their symptoms. You can help prevent the spread of illness by regularly washing your hands with warm, soapy water and helping your infant wash their hands with baby wipes or at the sink once they are strong enough. It is important to keep your emergency contact information up to date. Many providers require pick up within 30-60 minutes of notification of illness.

Loving Relationships & Secure Attachment

What do caregivers need to do?
Care givers are expected to support and encourage positive relationships with the families they work with. Providers should have open communication with the families and consider parent input for programming. High quality care givers will have an "open door policy," which means parents are allowed to come into program space at any time their child is present. Care givers are expected to have responsive relationships with the families and children they provide care for. This includes attentive, consistent, and comforting interactions.
What can parents do?
Follow a routine at home that is similar to what will followed at child care. Begin this routine 2-3 weeks before child care begins, then try to match it loosely on weekends until the child is well adjusted to the change. To help your infant feel secure at child care, sleep with a t-shirt, stuffed animal, or the sheet to be used when they are trying to settle for nap.
Have a plan for drop off. Dropping off and then leaving your child can be difficult. Demonstrate trust and confidence by following a quick, predictable routine at drop off. This will likely include putting your child's things away, updating the care giver of the last time they ate/slept/diaper change, and saying good bye followed immediately by leaving. Drop off is not a good time for in depth conversations.  If you need to have a longer conversation, send an email or ask when a good time to call would be.
Any child care that does not have an open door policy or refuses to allow parents to enter or see the child care space during operating hours is not a high quality program. High quality programs may ask you to call or text before coming at an irregularly scheduled time or to be mindful of the busier times in the routine (prepping for lunch, nap time), so that the program is able to run smoothly.

Keep in mind that each child care will be different. Do your research and find what is best for your family.

Note: Items listed under "What do caregivers need to do?" are not a complete summary of the regulations and policies that licensed providers in Massachusetts are required to follow. Child care providers should refer to the DEEC's website or their licensor for current and complete regulations and policies.