by Emily Oster
Finally, there is a set of observations about what the children are doing. Do they seem physically well (not hungry, not wearing a poopy diaper, etc.)? Are they getting some time interacting with adults? Are they, heaven forbid, watching TV?
At the end of the observation, the observer is also supposed to record some general feelings. Is the day care child-centered? That is, do the adults seem like they are really focused on what the kids want to do, listening to them and responding to them? Or are the adults just going through the motions, mostly focused on each other and not on the kids? Do the children and adults seem to have a positive and loving relationship? Do the children seem well-adjusted and happy, or do they seem afraid and cringe at the sight of the adult?
You are (presumably) not a trained day-care observer. On the other hand, many of these characteristics are things you could look for on your own. It is very unlikely a caregiver would hit a child in front of you, but negative affect and a lack of warmth aren’t actually very hard to pick up on. And it’s hard to fake the opposite.
A reasonable question to ask is whether this is all just a way to say you should pick the most expensive day care you can afford. It is true that quality and price are correlated: more expensive day cares are going to be, on average, higher quality. But the main component of quality—how the care providers interact with the children—is not about price.
THE NANNY OPTION
Okay, so we’ve solved the day-care node (or at least done our best). We’ve done our clipboard evaluations and found the best possible day-care option.
Now, what about the nanny?
The NICHD study evaluates the quality of at-home (i.e., nanny or other non-mom family member) childcare, with the same results: higher-quality childcare, as determined by the metrics they can measure, is better. However, quality in this case is even harder to evaluate than for day care.
The study uses a similar evaluation period and checklist to see if the caregiver is responsive to the child, if there are toys and books around, if there is yelling or hitting (both bad). Unfortunately, it is likely to be much harder to do a reliable evaluation of a single adult–child interaction, where it will be obvious the researcher is there, watching the caregiver, than at a day care, where you can more easily fade into the background.
In addition, even more so than in the case of day care, the quality ratings are likely to be related to socioeconomic status in a way that overstates the importance of caregiver quality. One of the questions—for example—is whether the child has at least three books. But this is a feature of the family, not the nanny.
Beyond this, there is simply very little concrete guidance about how to find and evaluate a nanny. Perhaps the most useful piece of advice I got in doing this was to talk to references (of course) and try to evaluate not only whether they liked the person but also whether the person doing the referring seemed like me. Were we people with similar needs?
It can also be useful to have candidates answer some basic questions in writing. When you’re interviewing someone, it can be hard to remember everything you wanted to ask. If you use an agency, they’ll often provide a suggested questionnaire. If not, you can find some online.
Hiring a nanny is a bit of a leap of faith, and you may have to trust your gut. When my daughter was three, we moved, pretty abruptly, from Chicago to Providence. We left our beloved nanny, Madu, in Chicago, and had to look for someone else on a tight time frame. We ended up hiring Becky without ever having met her in person, after just two phone calls and having her meet my brother. It just felt right—which it was—although this is hard to square with my ever-eager desire for data.
DAY CARE VS. NANNY
At this stage of the decision tree, you should have chosen your optimal day care and nanny structure. Now to compare them. Is one necessarily better?
One problem with the data is that many studies that look at day care, in particular, implicitly or explicitly compare it to the option of being home with Mom. This is an interesting comparison—see the previous chapter—but it isn’t exactly the same as comparing day care with a nanny.
The NICHD study is our best option here. This study does explicitly compare nanny-type arrangements to “center-based childcare,” and makes an attempt, although it is, of course, imperfect, to adjust for differences in family background.
The paper that summarizes the effects on children through age four and a half looks at cognitive and language development, and at behavior problems.3 On the cognitive side, the results are mixed. More months in day care before eighteen months are associated with slightly lower cognitive scores by four and a half years old, but more time in care after that is associated with higher cognitive outcomes.
It is hard to know why this is. It could be that very early on the one-on-one attention enhances early language development, but at older ages, children in day care are likely to spend more time on skills like letters, numbers, and social integration than children cared for by nannies or stay-at-home parents. But this is speculation. It is also possible that these are just correlations—that they are not causal at all.
Studies that combine this suggest that, overall, the effect is positive—that kids who are in day care for more time over this entire period have better language and cognitive outcomes at four and a half.4
On the behavior side, there are small associations between behavior problems and more time in day care at all ages, although the authors caution that these effects are fairly minimal and all the children were in the “normal” behavior range.
These effects—both the (slightly) positive cognitive effects and the (slightly) negative behavior effects—seem to persist through the early grades at school, although they fade substantially by third or fifth grade.5
This is only one study, but the effects are mimicked in other contexts. Day care is associated with better cognitive outcomes6 and slightly worse behavior.7 The cognitive-outcome effects seem to be concentrated in care that occurs at slightly older ages. There is a variety of evidence for this last point—for example, the evidence for the effectiveness of the federal Head Start program is based on studies showing that preschool hours enhance school readiness.
There are various other things evaluated in these studies. One is “infant attachment.” Are kids in day care less attached to their moms? No, they are not. Quality of parenting matters for this, but day-care time makes no difference.8
A final data-driven comparison is with illness. Kids who are in day care are more likely to get sick.9 These are not serious illnesses, more like colds and fevers, stomach flu, and so on. On the plus side, these early exposures seem to confer some immunity, with children who were in day care for more years as toddlers having fewer colds in early elementary school.10
In all this we come back again and again to two things: First, parenting matters. Much more consistent than any of the associations in these studies is the association between parenting and child outcomes. Having books in your house and reading them to your kid is going to matter much more than what books they have at day care. This seems to be true even though your child probably spends as many waking hours with their care providers as with you. I don’t think we know precisely why this is the case, although it may be that you as the parent are the most consistent influence your child has. Second, childcare quality matters much more than which type of childcare you have. A high-quality day care is likely to be better than a low-quality nanny, and vice versa.
The choice of childcare arrangement is also not just about your child. Ultimately, you have to figure out what works for your family. This introduces considerations beyond the cognitive development ones.
First, there is cost. On average, a nanny is more expensive than day care (although this may not always be true). An arrangement where you share a nanny with another family may be a way to offset some of the nanny costs. This is a question for your budget.
What i
s the right share of your budget to spend on childcare? There is no one answer. The way we thought about it—this is really getting into the weeds of economist parenting, a place where no one may want to be—is back to the “marginal utility of money.” Let’s say that the difference between a nanny share and having your own nanny is $10,000 a year for 3 years, so $30,000 total. Obviously, if you prefer the nanny share, it’s an easy choice.
But if you prefer not to share the nanny, you want to think about how much that money is worth to you. The key is to think about its marginal value. Yes, this is a lot of money (childcare is SO EXPENSIVE). But that’s not the relevant question. The question is what would you do if you had that money? What is the next best, non-childcare, use of these funds? This is the same question I encouraged you to ask about having a parent stay home.
It may be that the difference is in how nice a house or apartment you have. It may mean a difference in some vacation choices. It may mean less savings—you’re then trading your retirement plans for something now. There isn’t an easy choice. But by being explicit about what else you’d do with the money, you can at least frame the decision a bit more concretely: Would you rather have your own nanny, or two vacations a year, or more retirement savings?
Beyond budget, there is the question of convenience. Is there a day care close by (either to home or work), or will you have to drive far out of your way for drop-off? And what are your options if your child gets sick? At home, care can still work with a sick kid (also, kids get sick less at home), but day care cannot. What are your backup options?
One of the best pieces of parenting advice I got from my friend Nancy was this: Regardless of what childcare you choose, have a plan for who is in charge when the nanny or the kid is sick. Fighting about who will miss work in the moment is a bad idea.
Finally, you might simply feel more comfortable with one of these options or the other. That is a good reason to choose that option! Many people express discomfort at the idea of one person being with their child, in their house, all day. Your relationship with an in-home caregiver can be complex. If you have a nanny, one day your child will call you by their name. Will this make you feel bad? There is no uniform answer to this, but it is something to think about in advance.
This is a family decision. If all the adults in the household choose to work outside the home, you need to be happy with your childcare. You’ll spend enough time thinking about your children while you’re at work anyway, and if you are worried about them all day, you won’t get anything done. Finding an arrangement that works for you is nearly as important as finding one that works for your child.
As a final point, I should say that the dichotomy at the heart of the decision tree is perhaps misleading. The choice of childcare doesn’t have to be either-or. Looking over the data, to the extent we have any evidence day care is worse, it seems to be worse early on in life—say, in the first year or eighteen months. To the extent day care is better, that seems to be truer later in life—say, after a year or eighteen months. Putting this together could argue for a nanny-type arrangement (or a helpful grandparent, or some combination of the two) early on, followed by day care at a slightly older age.
The Bottom Line
With any childcare arrangement, quality matters. For day care, in particular, you can use some simple tools to try to do your own quality evaluation.
On average, more time in day-care centers seems to be associated with slightly better cognitive outcomes and slightly worse behavior outcomes.
The positive effects of day care present more at older ages, the negative ones more at younger ages.
Kids in day care get sick more, but develop more immunity.
Parenting quality swamps childcare choices in its importance, so make sure you pick something that works for you as a parent as well.
11
Sleep Training
Sleep. The elusive, mystical dream of new (and old) parents alike.
Most people are prepared for the first couple of sleepless weeks with a baby; maybe your family is around, or at least you aren’t working off a base of exhaustion. But then month 2 comes, and still the baby is sleeping only two hours at a stretch. At some point, the pediatrician tells you, “A baby of this size can sleep for up to six hours at a time.” You want to poke them in the eye with a pen.
Now it’s month 4. There was one amazing night when the baby slept for four hours, but this has never been repeated. It takes two hours to get her to sleep since you can’t put her down in the crib until she has been sleeping for at least an hour in your arms. That’s one hour of potential sleep for you, gone. Now it’s month 6. Now it’s month 8. Now it’s starting to seem like your baby just wants to hang out in the middle of the night. And it really does seem like you’ll never be rested again.
Of course, this is not everyone’s experience. There are people who will tell you their baby slept through the night from three weeks on. In my experienced opinion, most of these people are liars, but I guess it is possible a few are not. And certainly some babies sleep better than others. But the fact is that most babies get up a lot at night, and most parents would prefer not to.
This issue has not gone unnoticed by the marketplace. There are a tremendous number of books on strategies to get your child to sleep better. One academic article on parental approaches to sleep lists forty different books, from Ready, Set, Sleep: 50 Ways to Get Your Child to Sleep to Winning Bedtime Battles.1 Even a short Amazon perusal reveals at least twenty, including:
Weissbluth, Healthy Sleep Habits, Happy Child
Ferber, Solve Your Child’s Sleep Problems
Ezzo and Bucknam, On Becoming Baby Wise
Pantley, The No-Cry Sleep Solution
Hogg, Secrets of the Baby Whisperer
Waldburger and Spivack, The Sleepeasy Solution
Mindell, Sleeping Through the Night
Giordano, The Baby Sleep Solution
Turgeon and Wright, The Happy Sleeper
These books can be quite compelling. They follow a similar formula: describe some science of sleep (some do this better than others), provide a suggested procedure for increasing sleep, describe many anecdotes from successful users. These anecdotes can be very persuasive. The people in the stories typically have problems way worse than yours. And look at them! A few days into the new system and they’re sleeping for twelve hours and waking up refreshed!
For the most part, these books each have a particular approach. For example, Healthy Sleep Habits, Happy Child outlines a system that involves making sure the baby is fed, diapered, and comfortable before leaving them in their crib, but then allowing them to cry it out. The book contains a lot of details—if you plan to sleep train, you’ll want to read at least one of these—and a good portion of it describes the research on why this is a good idea.
Some of the systems are more complex than others. With Finn I briefly attempted one that involved picking him up when he cried, then waiting until he stopped, then immediately putting him back down. Then repeat. I abandoned this after three days; I definitely did not achieve the success of the people in the book. I was so tired, I was probably doing it wrong.
The major distinction among these books is whether they advocate a form of “cry it out.” Broadly, “cry it out” refers to any system where you leave the baby in his crib on his own at the start of the night, and sometimes let him fall back to sleep on his own if he wakes at some point during the night. The name refers to the fact that if you do this, your baby will cry some at the start. Modifications include varying whether you check on the baby, the length of time you’re willing to let them cry, the length of sleep you are trying to achieve, whether you stay in the room with them (without picking them up), etc.
Ferber is the most well-known advocate of these systems—the word F
erberize is sometimes used as a verb to refer to this behavior (i.e., “I am going to Ferberize my baby”), although Weissbluth is increasingly popular and also advocates crying it out.
Alternatives like The No-Cry Sleep Solution largely avoid “cry it out,” opting instead for systems in which the infant is taught to sleep alone without as much crying. Usually there is some crying anyway (it’s a baby, after all).
Of course, there is yet a third solution, advocated more strongly in the attachment-parenting community, that you should not be doing this at all. This philosophy is often linked with William Sears, a Californian doctor with more than thirty parenting books to his name.
Proponents of this philosophy argue, basically, that your infant cries because he needs you, and to let him cry is barbaric. But it goes further than this: attachment parenting advocates co-sleeping as well, meaning there is no need for sleep training of any type since there is no goal of getting the child to sleep alone. Proponents of this point out that if your child is in the bed, you don’t really have to get up to deal with them—you just roll over and stick a boob in their mouth and go back to sleep.
If you have decided to keep your infant in the bed with you (see the discussion of co-sleeping in chapter 6), then sleep training (at least early on) is probably not a feasible option. People do try to sleep train older toddlers who share a bed with them, but this is a discussion for another day. But if you are not doing this and your baby is in another room, after getting up every two hours to feed/rock/beg them to sleep, sleep training may begin to seem appealing.