In the middle of seeing a clinic patient I see my caller ID and realize that the buzzing of my phone is coming from my children’s school.  The only reason the school would be calling me in the middle of the day would be the health and safety of my children.  So I take a breath, and in that brief pause before discovering what is going on, a million worse case scenarios run through my mind.  Did my child break a bone, get into an accident, need to go to the hospital?  Of course it was the most common reason, my child is sick.

One of the most challenging aspects about being a working mom is childcare during the sick times.  When my children were younger we chose to send them to a daycare center instead of using home daycare, babysitters, family/friends, an au pair, or nanny.  The benefit of the other four options was that often they would provide childcare even when your child was sick.  Any benefits of the other options were outweighed by the safety and reliability that a daycare center provided in our minds, which is why we went with it.

So, as was true then and is still true today, whenever my children are sick and both my husband and I are unable to take off of work we scramble to find sick friendly childcare.  We are extremely blessed to have parents who are willing to watch my kids when sick.  I often feel guilty for having to rely so heavily on them and they definitely have saved us on multiple occasions.  My parents live on Kauai and will fly up at a moments notice in order to care for my infected and infectious kids.  It helps with the guilt trip when the grandchild gets on the phone and asks grandma and grand-dad if they will be coming over to watch them, cough cough, in a cute sickly voice.  My mother even flew up weekly for 3 months to watch my son so he wouldn’t have to start daycare until he was 6 months of age.  My daughter was watched by my Aunt until she was older so she didn’t start at a daycare center until she was older as well.

The saying goes that it takes a village to raise children and my village definitely takes using grandparents in order to help with their care, especially sick care.  Both my husband, and I have difficulty taking off, even when we ourselves are sick, due to the commitment we both have to our patients and our professions.  We feel an ethical and moral obligation for patients who have scheduled up to a month in advance to keep the appointments they have made as their health care providers.

Childcare Options Pros and Cons

1. Daycare Center
   • Pros:
     • More affordable than a nanny/au pair (average cost in Hawaii infant $11,208, 4-year-old $7,452)
     • Reliable (no calling in sick)
     • Socialization/interaction with other children
     • Great visibility (lots of places have cameras, some you can remote in on your phone)
     • Multiple caregivers/providers
     • Certified and follow strict screening and training regulations
     • Scheduled holidays well in advance, no vacations, and in my case they were open way more than our current elementary school
     • Longer/extended hours – my daycare was open from 6 am to 6 pm
   • Cons:
     • Sick children are not allowed to attend
     • Caregivers care for more than 1 child
     • Infant care with long waiting lists
     • Kids initially get sick a lot because of exposure to other sick kids
     • Rigid drop-off and pick-up times
2. Home Daycare
   • Pros:
     • May have care option for sick children
     • Home atmosphere
     • Less expensive than most of the other paid childcare options
     • Socialization with other kids
     • Potential flexible drop-off and pick-up times
   • Cons:
     • Poor visibility, you won’t know what’s going on in the home or who else may be there
     • Some illness exposure, but less than daycare centers
     • No standards for education, potential certification
     • Can call in sick themselves
     • Vacations
3. Babysitter and Au pair/Nanny
   • Pros:
     • Personal care and attention
     • Conveniently in your own home
     • Flexibility for your needs and schedule
     • Will care for sick child
   • Cons:
     • Most expensive option
     • Poor visibility, unless you potentially get nanny spy cameras installed
     • Lack of socialization with other kids, unless specially planned/arranged
     • Extensive paperwork/taxes
     • Could call in sick or quit
     • Vacations
4. Family/Friends
   • Pros:
     • Often done out of love without payment expectation
     • Caregivers are vested in health, safety, well-being of child
     • Personal knowledge/experience of their caregiving abilities, trustworthiness, and values
     • Personalized attention
   • Cons:
     • If paying for care difficult to employ family/friends (the whole it’s always a bad idea to go into business with family/friends)
     • No supervision or regulation
     • Potential parenting philosophy/value conflicts
     • Possible lack of energy and experience caring for young children

Hawaii State Caregiver Ratios

For more information on childcare in Hawaii check out PATCH.

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