Picking Child Care-Daycare versus Nanny

This isn’t something they pull you aside during peds residency and teach you. Not at all. This is something I’ve learned the hard way w/ trial & error. I get questions weekly from parents taking the leap into child care-Nanny vs. Daycare, especially at the two month well check, when moms are planning return to work.

Let’s focus on daycare first.
Daycare’s a great option if hours of care are well defined & you feel strongly abt your child being in a group environment with other kids. KNOW THIS-it’s not until 13 mos that kids begin solitary play & after 18 mos that they engage in pretend play w/ other kids. There’s no rush to have children “socialize.”

If Daycare is the best option for you, consider your criteria:

  • Hours & days you need care
  • Budget
  • Location

Determine what you’re looking for & what matters most. Maybe that means you have to be flexible with distance if you find the right price point….or maybe you’re ok splurging if the daycare has hours after 5pm that work for your work schedule

…Wait, what? Once you know what you want, head to www.winnie.com/childcare & put in your zip. You can view daycares near you in list format, sort by criteria, and best of all, learn if they have immediate openings. Don’t forget to check their license! Thank me later.

You wouldn’t pick your house w/out a walk through. Same goes for your child care! Trust your eyes, ears, and most importantly, your parental instincts!

This is a tough one. Child care trust is based on two types of trust, in my opinion: trust of character and trust of competency, ie integrity & work capability. It takes time to check both boxes-to know if someone’s behavior is consistent, honest, ethical, caring. You’re the expert on your child, but this step takes patience. Deep breaths.

This is a huge step for you & your child. If you can, try not to go back to work and begin the daycare routine the same week. Both you and baby will be out of whack. Take time to adjust. Plan for extra cuddles. Expect sleep routines to be off because naps didn’t go well. Take a week to roll with these transitions.

Many parents ask me what I prefer. The decision is totally dependent on you and your spouse or support system. In a dual physician marriage especially during residency, daycare hours weren’t going to work for me and my husband. Some days, I was out the door by 5:30am. Other days, my husband wasn’t home until 8pm. We needed in-home flexibility. Which meant a nanny for our household.

So, how do you go about finding a nanny? Ask for referrals! Mommy Facebook groups & nanny websites like www.care.com or Seeking Sitters are a good start and have really streamlined the process of finding in home childcare. I also recommend asking among friends if any participate in nanny-shares and are open to adding another family.

Consider your criteria:

  • Age of caregiver
  • Distance from your home
  • Certifications (CPR, First Aid)

This is a very broad list. Your list can look very different. You can add or cut back on depending on your preferences.


After you list your initial criteria, plan for an in-person interview. I like to narrow this down based on references. Some nannies prefer to provide references after an interview. I recommend meeting at a neutral location like a coffee shop. That way a stranger doesn’t know where you live. This is also a good time to learn about the candidate’s punctuality.

Ask the right questions.

There are a lot of great resources on what questions to ask. I used care.com’s list for a rough outline & tailored it to what really mattered for me & my husband. For example, important points for me were up to date on vaccinations like the flu shot (as my daughter was born during cold and flu season and was too young to receive the vaccine), no transportation reliability issues, and fluent in English so no language barriers. 


Don’t expect your future nanny to read your mind! Be very clear about what the duties are, the weekly schedule, if and how you need flexibility, holidays, & of course, compensation. 

Verify Information.

Just because someone is referred by a friend doesn’t mean you don’t check the references & work experience. Confirm certifications. Do a background check. If you haven’t, speak to references. Don’t overlook this step! Follow your instincts when interviewing someone.


Just like with daycare, trust is going to be huge-especially because this person is in your house. Again, this step takes time & patience. It is 100% okay to have nanny cams but I do think it’s only right to disclose you have them to your nanny.

Think of a back up. 

Nannies are humans who get sick and have emergencies just like everyone else. You as an employer need to recognize that. Make sure you have a good back up plan-whether it’s using a sick day at work, bringing your child to work, or calling in a family member!

It does get easier-I promise. My personal advice is when it comes to the daycare drop off or leaving your little one at home, try not to linger. Don’t let mom guilt get you. Personally, I think picking the right childcare is one of the hardest choices we have to make as parents. The right daycare today, may not be the 1 a year from now, and that’s ok. The right nanny right now may not be the right one as your child gets older or your family’s needs change. That’s also ok. As a pediatrician, I’m always hear to help parents and advocate for their thoughts during this time of transition. These are big decisions to undertake and first and foremost, it’s important to trust your instincts.

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