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Ask a Paediatrician

Choosing child care is a big decision. You will want to ensure your child is looked after in a safe, caring and stimulating environment.

What should I know about looking for child care for my son?

By Dr. Alyson Shaw

Whether you work full time, a few hours a week or have other outside commitments, choosing child care is a big decision. You will want to ensure your child is looked after in a safe, caring and stimulating environment, with plenty of opportunities to learn and grow. It is also important to have an open, positive relationship with your child’s caregiver(s). This article discusses out-of-home child care, but in-home caregivers (such as nannies or au pairs, who will look after your child in your own house) are another option with lots to consider.

Provinces and territories regulate and license centre- and home-based (i.e., within the caregiver’s home) child care programs in Canada. Centre-based programs must be licensed and, depending on the province/territory, employ trained, qualified staff. Centres are required to meet health and safety criteria and standards set by the province/territory.

Home-based programs do not need to be licensed. Some home-based providers do, however, choose to be licensed and supervised by provincial/territorial home child care agencies (which are often run by local municipalities). Unlicensed home-based programs are often just as good as licensed ones, but your child will not be protected by provincial regulations such as those related to fire safety and playground equipment standards. Home-based programs tend to provide a more flexible, less structured environment than centre-based facilities.

Whichever option you prefer, the best way to ensure your child will receive quality care is to visit during operating hours and talk with parents whose children are already enrolled.

Starting your search
Start your search early, months before you go back to work or (in some places) even before your baby is born. Here are some questions to get you started.
• What kind of care do you think will best suit your child’s age and temperament?
• What hours of the day do you require care?
• Do you have more than one child who needs care?
• What fee can you afford? Are you eligible for a government subsidy?
• Do you prefer a centre- or a home-based setting, and licensed or unlicensed care?
• Would it be more convenient to find care near your home or close to work?

To help you find child care listings in your community, check:
• provincial/territorial government websites for child care centres;
• directories under ‘child care’ or ‘day care’;
• your municipality’s website;
• local child or family service offices;
• local not-for-profit agencies and community information centres; and
• with friends in your area.

Once you have found a few potential caregivers or centres, phone them or check out their websites to answer some basic questions. Plan to visit the ones that fit your criteria.
Visiting your short-list

When you visit, do the following.
• Look carefully to see if the centre or home is clean and safe.
• Pay attention to how comfortable the children seem in the environment.
• Watch how the caregivers interact with the children.
• Ask to see the spaces where the children eat, play and sleep.
• Ask to see the outdoor play spaces. Assess any potential hazards such as busy streets or backyard pools.
• If the provider is home-based, ask to meet any other family members who may have contact with the children, including pets.
• Ask about the staff-turnover rate.

Final steps
Before making a decision, check references and talk to parents whose children have been enrolled for a while. When you have made your choice, ask for a contract to clarify fees, receipts and method/frequency of payment, hours of care, vacation and illness policies, and any other issues that might be relevant.

Once your child has settled down, continue to monitor the placement on an ongoing basis to ensure it is meeting his needs. Stay in regular contact with your child care provider.

A good child care setting:
• is clean, safe and has a small number of children per staff member;
• has staff who are professionally qualified, fully immunized and have had security checks and training in CPR and first aid;
• has areas for indoor and outdoor play;
• has a quiet space for rest or naps that follows current SIDS prevention recommendations.
• is smoke-free, both outside and inside;
• has regular but flexible routines that include a variety of activities appropriate for your child’s age and development;
• has an assortment of toys and equipment;
• serves nutritious meals and snacks; and
• allows you to drop in, unannounced, for short periods of time.

Dr. Alyson Shaw is a paediatrician in Ottawa.

For more information on your child’s growth and development, get answers from Canada’s paediatric experts at or

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