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Making It Work

Choosing a Caregiver

From New Beginnings, Vol. 26 No. 2, 2009, pp. 34-35

"Making It Work" is a regular feature of the magazine New Beginnings, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of New Beginnings to help mothers who wish to combine breastfeeding and working. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.

Mother's Situation

My mother has been looking after my son since I went back to work, but now that he is crawling, she is finding it difficult to keep up with him. Soon he'll be walking, and I think it will be too much for her, so I need to find someone new to watch him. I have a number of leads, some through referrals, but I'm terrified of leaving my baby with a stranger. How can I make sure I pick the best possible caregiver?

Mother's Response

Trust your judgment. You are very lucky to have been able to have your mother looking after your son. Even if my mom were retired and living closer to me, child care would have been quite a drain for her.

The older your son gets, the easier it is to trust others, mostly because your baby becomes more able to communicate with you (even indirectly, by what he says and does with his toys) so you get a flavor of what happens at the daycare in your absence. I have been very fortunate to have a home daycare provider, whom my husband and I trust completely. This woman loves children and has had a home daycare for 20 years. She started this job after her kids were grown, so there is no issue of my child playing second fiddle to hers.

She looks after four other children, and she has a rule that she has no more than two infants. My daughter, Karen, now 21 months, has been going there since six weeks of age and is now the second youngest. It's basically like a big family with children spanning the ages between nine months and four years. Karen learns from the older ones (both good and bad habits) and the daycare provider is able to instruct in a positive way. In fact, she has given my husband and me lots of helpful advice, most recently about potty training, and Karen, after only two weeks, has used the potty twice!

However, I've heard about other home daycares, where children are left in front of the TV all day, so clearly each situation needs to be evaluated on its own merits. I was definitely nervous about leaving Karen at first. I was concerned that she wasn't being held often enough -- though with the amount I was still nursing her, I can't imagine how that possibly could have been! Now that Karen can communicate her basic wishes, it's very clear the many positives she has gotten from daycare, such as saying "please" and "thank you" almost all the time and calling us "Daddy Sam" and "Mommy Edie." We won't have to worry about her not knowing our real names if we ever get separated from her! My friends all have their children at one of two daycares in our area. The big difference from our local public daycare is that the children there all take a two-hour nap so they won't go to sleep as early in the evening. My home daycare lets the babies sleep more according to their own needs, and doesn't mandate a two-hour down time. Karen tends to nap for no more than an hour anyway. I'm just starting to back up her bedtime from 7.30 pm to 8 pm, so that she'll go down more readily at nap time. And she sleeps in until I wake her at 7 am, and until as late as 9 am on the weekends, which is absolutely great so we can all get a bit of extra sleep!

Overall, just keep in mind how you feel when you visit the different places, and go with the one that feels best. And then, stop by. I started out with a noon to 3 pm schedule, nursing at home while I worked on the computer in the morning. My colleagues didn't even realize I wasn't at work when I was on a phone conference until Karen got older and wouldn't nurse through a full hour's meeting. Then I worked some more in the evening after my husband got home.

So there may be some options to use, even taking some vacation to make shorter days during a one or two week transition period, or having your mother drop your son off from 10 am to 3 pm until everyone is comfortable. There are many different ways to make it work, and the right solution is the one that works out best for your family. Good luck!

Edie McKelvey
Lake Jackson, TX, USA

Mother's Response

On the practical side, it sounds like you may be interested in having a caregiver come to your home. Referrals from like-minded mothers are a good way to find a caregiver with whom you will likely work well. You might find it useful to make a list of what is important for your family in terms of hours, vacation, salary, meeting your baby's needs, activities in the areas your baby might enjoy, and how your family and caregiver will communicate. Then it might be helpful to call the caregiver's references with this list in hand to hear what their experiences were and compare them with your family's needs. Those conversations might help you narrow down the list of potential caregivers. Then certainly inviting likely candidates over to meet face to face to see how they interact with your baby would be important. It is relatively common to plan a trial run -- sometimes two weeks or a month -- to make sure that everyone can work together well. If the caregiver is working through a referral agency, that might offer some extra assurances of the caregiver's training and experience. On the more personal side, leaving our babies with someone else carries a whole bunch of potential stressors. Will the caregiver meet my baby's needs? Will the caregiver be confident on his or her own? Will we be able to communicate well? What will the caregiver expect from me? What if it doesn't work out? I think this takes an extra dose of strength and confidence in our ability to handle the unknown. That is especially hard when we are new parents or just getting to know a new baby. Some expect us to be the experts when we are just figuring it out, while others assume we know nothing and disregard what we do know about our babies.

There are many lovely, caring people doing the wonderful work of helping us care for our children. Sometimes we have the resources to make a good match, sometimes not. We need to have confidence that we can recognize when the fit is good and when it is time to change the caregiving situation. Already, you have shown the strength to do this when you recognized that an active toddler might be more than your mother could manage.

As your child gets older you might decide again to re-evaluate the caregiving situation. It might be a relief to know that the caregiving choice is not set in stone -- it can be changed if needed.

Perhaps the best caregiver is one who is loving to our children and with whom we can communicate in an open, honest way. This caregiver might not have the best education, or know all the best games, or serve perfectly nutritious food; but if it is someone with whom we can communicate openly and honestly then that might be the best possible partnership. I hope that helps. There's a lovely new book out, Mothers and Others* that talks about the importance of caregiving help across human ancestry and modern times.

*Hrdy, S. B., Belknap: Press of University of Harvard, 2009.

Lewisburg, PA, USA

Mother's Response

As we know, breastfeeding is so much more than food. It's mothering at your breast. Therefore, when returning to work, it's much more than the milk we leave behind, it's the separation as well. The baby's need to be with his mother is as intense as his need for food, as our La Leche League concepts tell us. It's important to get your baby comfortable with the caregiver. It's also important to ensure the caregiver knows how to care for breastmilk. Caregivers also need to learn to recognize your baby's hunger cues and differentiate when he just needs to be held and comforted.

Another point to keep in mind is that while mom is at work, pumping will serve three purposes: leaving milk for her baby, maintaining her supply, and relieving any engorgement. Try using a wide mouth and slow flow bottle nipple to minimize nipple confusion and be aware that there are more ways than using bottles to feed a baby. During your time together, you might want to continue breastfeeding your baby on demand, including nights. Do not be surprised if he nurses more at night when you are together, or what we call "reverse cycles." I, too, am a working and breastfeeding mother of two nurslings, so I hope this helps!

Karen McGratty
Brooklyn, NY, USA

Mother's Response

Finding the best possible caregiver is 50 percent instinct and 50 percent research. Start by asking other parents whom they use for childcare. Many states have a licensing board that can give you some good leads. Decide whether you want your child cared for in a childcare facility or in someone's home; regardless of what you choose, always check out the license with the state. You can find out if the provider has any complaints from former parents or from the state licensing board. If you chose in-home care I would also have a private investigator look into the person's criminal and financial background.

I would do a complete interview at the childcare location asking the following questions. How many children do you care for? What are their ages? What will a typical day be like for my child? How do you handle discipline? What is your experience with handling breastmilk and the needs of a breastfed baby? What will they eat/drink during the day? What is your sick/vacation policy? Do you take any continuing education classes on child development? Will you ever be transporting children from the center? Include, of course, any other questions that are important to your specific family needs.

I would also have your child do a few trial runs of a few hours each time to see how your child adjusts and reacts to the caregiver. If you are comfortable with the provider I would always drop in at unexpected times without calling to see what the child is doing and to ensure the promises made during the interview are carried out.

Always trust your maternal instincts and keep vigilant! Good luck.

Jenna Ellis
Long Beach, CA, USA

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