This is the first post in a two-part series on day care.

By now we all know the importance of the first three years of a child’s life. Who cares for a baby or toddler and how they are cared for is everything. But what is optimal for the baby or toddler and what is possible for the parents may be two different things.

As a child psychologist and psychoanalyst, I can tell you that years of training, clinical experience, and tons of reading have convinced me that infants and toddlers do best with loving, responsive, one-on-one care. Parents, grandparents, aunts, uncles, babysitters, and well-trained day care staff at a high-quality day care center can provide this.

For many parents, staying at home is not an option, close relatives are not a possibility, and finding and paying for a babysitter is out of the question. For these parents, day care is a necessity. But what kind of day care is best? Figuring this out is made difficult by the lack of reliable research available in the popular media.

While it seems that everywhere you look, there is an article about something new that harms your baby, very little is said about what constitutes good early care.3

It’s confusing. To make matters worse, the discussion is highly politicized. And to make matters even worse, high-quality, low-cost day care is scarce.

It’s fraught.

For parents who must use day care, what is important to know is what constitutes high-quality day care. And for those parents who live in areas where high-quality day care does not exist or is too expensive, it is important to know what to advocate for in the day care centers they do use.

What High-Quality Day Care Looks Like
Licensing. The center should definitely be licensed—but don’t stop here. Licensing is not enough. Licensing standards do not cover many important aspects of a good day care center. Generally they provide a baseline of the fundamental necessities of operation, but do not include the most important thing: what happens between the babies and toddlers and their caregivers and teachers.1
Interpersonal Interactions. When you go to visit, check out how caregivers interact with the children they care for. Are they warm? Patient? Consistent? Do they respond to difficult behaviors with reasonable limit-setting? Do they talk to the babies and toddlers and provide a language-rich environment?1
Physical Environment. Make sure there are clean, age-appropriate, and engaging surroundings and materials including plenty of books and stimulating toys that babies and toddlers can create, build, and interact with. Make sure there is also well-kept outdoor space and daily opportunities for outside time.1
Curriculum. Age-appropriate activities and curricula should be available to all. Starting by age 1, this includes storytime, imaginative playtime, structured playtime, naptime, and snacktime.
Size matters. Small group sizes for babies, toddlers, and children are optimal. When you visit, observe how big the group sizes are and how many staff are available to children in each group.
Staff-to-child ratio. There should be a small staff to baby/toddler ratio. Ask about this.
Good communication between teachers and parents. Research has shown that parents, teachers, and children benefit from good, regular communication between home and center.2
One or two caregivers assigned to each baby to provide for her rather than having one of five or six staff members going to the baby when she is in need. Babies benefit when they get to know their caregiver and when they are cared for consistently by the same one or two people so that they recognize and know her voice, body and rhythms.
Low turnover rate among staff.
Good relationships between administration and staff, with staff treated well enough that they are incentivized to stay at the center.

In addition to the things I’ve mentioned, before you visit a day care center, think about what else matters to you. Make a list of what you want to see and ask about it.