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This article originally was published by THE AMERICAN ENTERPRISE, MAY/JUNE 1998 THE PROBLEM WITH DAYCARE

by Karl Zinsmeister

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Meryl Frank is an expert on child care. For five years she ran a Yale University program that studied parental leave.... Frank went back to work part time when her son, Isaac, was 5 months old, and in the two years since then she has changed childcare arrangements nine times. Her travails began with a well-regarded day care center near her suburban New Jersey home. On the surface, it was great. One staff member for every three babies, a sensitive administrator, clean facilities. "But when I went in," Frank recalls, "I saw this line of cribs and all these babies with their arms out crying, wanting to be picked up. I felt like crying myself." She walked out without signing Isaac up and went through a succession of other unsatisfactory situations -- a babysitter who couldn't speak English, a woman who cared for 10 children in her home at once -- before settling on a neighborhood woman who took Isaac into her home. "She was fabulous," Frank recalls wistfully. Three weeks after that babysitter started, she got sick and had to quit. Frank advertised for help in the newspaper and got 30 inquiries but no qualified babysitter. (When Frank asked one prospective nanny about her philosophy of discipline, the woman replied: "If he touched the stove, I'd punch him.") A few weeks later she finally hired her tenth babysitter. "She's a very nice young woman," Frank says. "Unfortunately, she has to leave in May. And I just found out I'm pregnant again and due in June." That's what happens when a pro tries to get help. So begins a story in a special issue of Newsweek on family trends. While this many day care problems in two years is probably not average, it is by no means unusual. Mismatches, repeated disappointments, and occasional horror stories are the rule, not the exception, when it comes to hiring parental substitutes today -- as you'll quickly discover once you start interviewing a cross-section of day care users about their actual experiences. In a perfect world, there would be an abundance of intelligent, well-balanced, devoted individuals willing to attend lavishly and patiently to the demands of strangers' children -- enough so that every family who wanted could have their own full-time loving surrogate. These dream workers would all be willing to provide their services so cheaply that there would be little or no strain on family finances. And they would remain with the same family year after year, meshing perfectly with child, parents, and surroundings. But there are no dream caretakers. There is very little that even comes close. In real life, purchased care is rarely more than a stopgap. That's not my verdict. It's the verdict of parents themselves. Take Joanie Colquitt, mother and holder of a master's degree in social psychology. In a long letter she wrote me a few years ago, Ms. Colquitt details a quite typical set of experiences: I can remember when I considered sending my own first child to day care. I had spent so long on my education and we did truly need the money. So I visited what was, at that time, the number-one day care chain in the country. What I saw there broke my heart. Babies were lined up, six in a row, crying, waiting for their meals. Toddlers were still in their cribs, some with tear-stained cheeks simply sitting there with no toys, no companionship, with looks of having given up any hope for personal attention a long time ago.... There was a bucket on the the floor next to the high chairs where several rags floated in dirty looking water. The helper pulled one out to wipe a baby's face. There were 15-month-old children who could not even walk, I believe because they had not been allowed out of their cribs enough to develop properly. I have visited other day care centers that were cleaner, and had academic programs and activities galore. However, the atmosphere, to me, was still negative. The children were not loved the way they needed to be and you could tell. They looked tired and kind of washed out. Author Linda Burton is another person who has described in detail what she came across while scouring her hometown (the Washington, D.C. area) for day care: In one instance, I found the "absolutely marvelous" family day care provider, recommended by trusted friends, sleeping on her sofa while 11 children (she had informed me that she only cared for five) wandered aimlessly around in front of the blaring TV. Another time, on an unannounced visit, I found that the "highly recommended" licensed day care provider confined seven preschoolers to her tiny dining room. I found them huddled together, leaning over a barricade to watch a TV program showing in the adjacent room. These are not isolated anecdotes. Anyone investigating the world of full-time day care quickly amasses files of such testimony. A few years ago the Metropolitan Toronto Social Planning Council investigated a sample of 281 day care homes. They reported that a small number were genuinely stimulating, and another small number were out-and-out abusive. The large majority, however, provided care that was merely indifferent. Only a few of the caregivers studied were able to make themselves genuinely interested in each of their individual enrollees. In a significant minority of cases, youngsters were simply ignored most of the time. How do parents react to the disappointing standards of most hired care? Very often, by lowering their expectations. I was struck by a conversation my wife and I once had with three of our Washington, D.C. neighbors who used significant amounts of substitute care for their children. We asked them how they liked their current sitters. "This one's good with children," replied the first. "She's always proselytizing for the Jehovah's Witnesses, though, and sometimes that annoys me." Another volunteered about her sitter: "She's great. Except that she's really incredibly lazy." " -- -- -- is nice, and we're happy with her," answered the third, "but she smokes all the time, and never has the TV off." Day care-using parents make minor compromises like these by the millions. And some end up facing much larger worries. Like the dual-career Washington, D.C. couple (the mother actually worked as a child care researcher at one of the local universities) who discovered that the Spanish-speaking woman they were dropping their nine-month-old off with was taking in several other babies without their knowledge, and regularly leaving them with her 12-year-old daughter while she went out to clean houses. (They discovered this only when one of the infants swallowed 30 aspirin tablets and ended up in a hospital.) A telling example of how difficult it can be to accurately judge a hired caregiver involves professor Sandra Scarr. Scarr is one of the most zealous academic defenders of day care in the country. She argues regularly and vociferously in her writing and in media interviews that "day care can actually be good for children." Yet when Scarr employed babysitters for her own children, her day care expertise and enthusiasm were not enough to avoid problems. One day she returned from work to find her 18-month-old weeping. "Kathy hit me! Kathy hit me!," the toddler cried simply. Scarr found large, red welts on her daughter's body -- "the sitter had beaten her badly." She expressed great frustration when told by police that there could be no prosecution without witnesses. Apparently without any sense of irony, Scarr complained bitterly that "no one was there to prevent the abuse or to testify about it." But physical dangers and out-andout abuse are not the major problems associated with substitute parenting. Despite the screaming headlines, these are fairly unusual occurrences, thank goodness. The commoner, deeper drawback is simply that it is an emotionally unsatisfying substitute for the natural attentions of mother and father. From a youngster's perspective, the typical day care arrangement is a puzzling, often chilly, slightly sad arrangement. Unfortunately, very few discussions of day care look at things from that angle. "We could do with another Charles Dickens," suggests family historian John Sommerville, "to give us a child's-eye view" of the world of day care. DAY CARE AS IT REALLY IS There's no need for anyone to write a book on what children encounter in a typical day care setting -- because a writer named Deborah Fallows has already done that. Fallows (a Radcliffe graduate, linguist, and former assistant dean at Georgetown University who is married to U.S. News editor James Fallows) is not Charles Dickens. But in A Mother's Work she describes one-and-a-half years' worth of close observation in dozens of diverse day care centers scattered across Maryland, Washington, D.C., Texas, and Massachusetts. While Fallows discovered no abuse, relatively little dirt, and adequate physical conditions in most centers, she nonetheless found the average child's experience frighteningly empty. This was a fairly typical visit: I settled into an inconspicuous corner of the room and began to watch the children.... Often, one child would attach himself to me -- maybe going off for a few minutes but always coming back to say a few words...point to a shoe that need tying...or show me his tummy. The teacher watching the children tried her hardest, ad-libbing her way from one activity to the next. She put on a record and started to dance. One little blond boy started dancing along with her. A few others joined the group. Five or six gathered by some swinging cabinet doors that formed the partition between the play area and the rest of the room. One little girl sat by herself, crying softly in the corner. The rest wandered around.... Then a fight erupted between two little boys, and the teacher had to stop dancing to break it up. Without her example, the dancing died off. She tried again a few minutes later but was interrupted this time by a small couple who tripped over each other.... She gave up records then and tried reading a story. The same few eager dancers moved right in to listen, while the rest kept on swinging on the cabinet doors or aimlessly wandering. The little girl was still crying in her corner. After a short story, the teacher opened the large cabinet and pulled out some puppets. This immediately attracted the largest crowd of the morning. All but a few rushed right over to watch the show. But the brilliance of the idea dimmed after several moments. As her impromptu story line weakened, the toddlers drifted back to their swinging doors and wandering, shuffling their feet, chasing back and forth.... Here as at other centers I visited, you could almost feel the morning driving itself toward the grand finale -- lunch. Fallows gives wrenching descriptions of children referred to by their teachers as "little boy" or "hey little girl," of activities that cater to the group average but leave quiet toddlers behind, of desperate notes pinned to youngsters' coats in which parents plead for extra attention or special comforts. She tells of caretakers who can't remember babies by name and description just a few months after they've graduated to an older group ("I'm not sure which one it was. They all do that after a while..."). There is much tedium, much bewilderment, many unconsoled tears. Children clamoring to go "to mommy's house," are quieted with small fibs ("yeah, mommy will be here soon"). In a situation that human biology guarantees no natural parent would ever have to face (four to ten same-aged youngsters per adult), tired teachers do what they can to get by. Fallows' testimony is cool, relentlessly detailed, and very convincing. For individuals who have never visited average day care centers or thought much about what group care of infants and toddlers comprises -- and how many adults, even prospective parents, have? -- her observations will come as an upsetting revelation. Another disturbingly realistic portrait of full-day hired childcare is provided by William and Wendy Dreskin in their book The Day Care Decision. For five years, the Dreskins co-directed their own non-profit nursery school and then day care center in the San Francisco area. Theirs was a very high quality program: teachers had a B.A. plus one year of graduate training, child to adult ratios were low, there was lots of educational equipment, and an intelligent curriculum. I know the Dreskins myself and can testify that they are extremely warm, wise, gentle individuals who have raised two great kids of their own -- the kind of people who are naturals with children. They started out with a half-day preschool, which was very successful. But with more and more dual-career parents demanding day-long care they found that a facility in use only three hours a day was becoming uneconomic. So they decided to expand into a full-day operation. "We were going to offer a quality program. We did not have the slightest suspicion that there might be a serious problem with even the best day care programs," they write. Then they began to notice changes in their children. "Some of the same boys and girls we had known as nursery schoolers became different children when they were subjected to the stress of full-time day care." The Dreskins cite numerous specific cases to illustrate the alterations in personality they observed. Three year-olds who had been happy in a morning program began to withdraw, lash out, or cry for hours at a time. In the individual journals that were a standard part of the Dreskin's program, they began to dictate poignant pleas for more time with their parents. Some children lost previously acquired skills. Others began to refuse to take their toys home at night. ("What's the use? I'm here more than at home."). The parents changed too. As they subconsciously transferred more and more of the responsibility for their child to the center, they gradually stopped coming to school meetings. They didn't check books out of the lending library. They asked fewer questions and dropped in on classes less. They showed up after work badly over-stressed. "We typically saw scenes like this," the Dreskins write: Carl's mother arrives at 6:00 p.m., tired and frazzled. Carl tries to show her a picture he has painted. 'Show me later. Get your lunch box. Come on.' She is already halfway out the door. Carl trails after her, crying at the rebuff and at the effort of trying to balance his painting, his lunch box, his fire engine, and the cup of fruit salad he made in a cooking project that afternoon. We can tell from his mother's mood what sort of evening Carl will have. So much for the precious two hours he will get to spend with his mother between leaving day care and going to bed. "For two years we watched day care children respond to the stresses of eight to ten hours a day of separation from their parents with tears, anger, withdrawal, or profound sadness," the Dreskins write, "and we found, to our dismay, that nothing in our own affection and caring for these children would erase this sense of loss and abandonment." They found themselves in a dilemma: "The problem was not with our facility.... It was obvious that there was a problem inherent in day care itself, a problem that hung like a dark storm over 'good' and 'bad' day care centers alike. The children were too young to be spending so much time away from their parents. They were like young birds being forced out of the nest and abandoned by their parents before they could fly, their wings undeveloped, unready to carry them out into the world." "We were so distressed by our observations," the Dreskins conclude, "that we closed the center." ARTICLE CONTINUED BELOW The Importance of Early Childhood Attachment Numerous studies conducted in varied settings show clearly that the only way to build strong independence in children is to indulge their strong needs for dependence when they are very young. As Margaret Mead put it, "we do not know -- man has never known -- how else to give a human being a sense of selfhood and identity, a sense of the worth of the world." The path to the sturdy self lies directly across the lap of mother and father. There is no other route. Parents who push their children out into the world before they are ready do them no favors. In my years of working in parent-cooperative play groups and nursery schools I myself have seen a number of strikingly disturbed and protestful children in this situation. I remember one two-year-old in Washington, D.C., for instance, who would shake and whimper, frantically clutch her stuffed animal, and finally curl herself on the floor in a tight crouch, refusing to be comforted, on many mornings when she was dropped off. Usually it was her babysitter who delivered her, only occasionally her mother, never her father. "Human attachment" research has demonstrated that the early relationship between infants and preschoolers and their parents is the "foundation stone" of all subsequent personality development. It has also shown that even very marginal parental care is better for a young child than institutional care. As John Bowlby, the only psychiatrist who has twice received the American Psychiatric Association's highest award, warned, "a home must be very bad before it is bettered by a good institution." A classic investigation by psychiatrist Rene Spitz, for instance, compared the development of infants raised by nurses in children's homes with infants raised by mothers confined to prison. He found that the infants in institutional child care exhibited evidence of depression and were stunted in their development, while the mother-raised children developed normally, despite the inhospitable setting and the fact that every one of the mothers was either mentally retarded or emotionally disturbed. In groundbreaking mid-1950s research, Yale professors Sally Provence and Rose Lipton examined infants who spent a considerable part of their first year in superior institutions. They found that these youngsters suffered incapacities in all areas of physical and mental development compared to home-reared children, and their deficits did not disappear when they were moved into home settings by age one. Follow-up work showed that these parent-deprived children never fully overcame their physical, cognitive, and emotional impairments. When it became clear how much these youngsters had withered, most of the group homes were shut down. Another telling result came from the work of child analysts Anna Freud and Dorothy Burlingham. After arriving in London with her father Sigmund in 1938, Anna Freud helped set up the Hampstead Nurseries. During the war, the Nurseries provided care for infants and children who could not be looked after at home because their parents were working in the war effort, or because a parent had been lost, or because their homes were thought unsafe due to the German bombing blitz. Both Freud and Burlingham were already world-renowned child analysts at the time, and strong believers in the importance of good early relationships. They chose their staff carefully and set up child care practices based on the very latest knowledge of child psychology. Conditions, all in all, were about as good as modern science and social concern could create. What, then, were the results for their young charges? The truly crippling effects produced by average institutions were mostly eliminated. But in several vital areas children reared under these prime group conditions fared less well than children tended by average families. In speech, for example, the typical Hampstead two-year-old was six-months retarded compared with typical children looked after in their own homes. The Hampstead children were more aggressive and had less control of their impulses. They were late in achieving their toilet training. They were less cooperative. Many became listless. In an attempt to soften these effects the nursery eventually grouped children into artificial "families," small groups of infants and toddlers with one or two adults serving as the exclusive "parents." "The result of this arrangement was astonishing in its force and immediacy. The need for individual attachment...which had been lying dormant, came out of a rush," wrote Freud and Burlingham. "The violent attachment to the mother substitutes...was anything but peaceful." Eventually, however, there was a positive effect on speech development and on toilet training. Overall, results were better but still far from optimal. So here we had a model institution, directed by two international experts in child development as their contribution to the nation in a time of emergency. And the outcomes were literally less successful than those produced by a statistically average family with an average baby. This, incidentally, did not come as a surprise to Freud or Burlingham. They had long recognized that professional wisdom, for all its usefulness, could never supplant intimate family ties as the spur to human development. Results like those from the Hampstead Nurseries stand not as criticisms of the techniques of the child development profession but rather as, in psychoanalyst Selma Fraiberg's words, "an appreciation of the family as the point of departure for all sound psychological thinking." -- KZ The Dreskins may be more sensitive and braver than most day care practitioners, but their experiences are not unusual. A vast body of skeptical testimony on hired child care is available from individuals right inside the profession. Several years ago, after I'd written a number of scholarly articles about day care, Reader's Digest reprinted a review of day care research I'd put together. That brought me an outpouring of more than 100 personal letters. The thing that stunned me most in this correspondence was the number of responses critical of day care that I received from current or former day care workers. A single mother from Spokane, Washington wrote: "I know that the abdication of parents' responsibility to raise their children begins at a very young age in this country. I know that parents abdicate this right even in the first few weeks after birth, during the critical bonding stage for infants. I know this because I am a nanny recruiter. I send nannies to the East Coast states and to Florida. I like my job, mostly because I deal with the really fine people we send, who are truly nurturing people, but I am alarmed by what I see happening at the end of my job placements, in the family itself. I am seriously thinking about altering my profession." A woman named Cherie Johnson sent a note saying, "I am the Assistant Director of Rainbow Corners Child Care Center in Papillion, Nebraska. This one job I would cheerfully give up if all these kids could stay at home with Mom or Dad. We really try to give them warm personal care but with so many I know most of our full-timers do not get the attention they really need." Judy Hodges, a college-educated mother of two from Columbus, Ohio, wrote to report that after working in a day care center and keeping children in her home while her own daughters were young, she felt very uncomfortable with the idea of extended separations of young children from their parents. A woman who had worked at the Siemens Corporation day care center in Oslo wrote me from Norway to describe a "survival of the fittest environment" characterized by "fresh talk, aggressive behavior, a feed 'em and get 'em out to play" attitude. Along these same lines, a different article I wrote on day care for the Washington Post produced a response from an intelligent 33-year-old mother of two living in Falls Church, Virginia. "I am a home day care provider," she began. I care for a 19-month-old girl, the daughter of close friends of mine, who I've cared for since she was four months old. I normally have her four days a week, 8:30 a.m. to 4:30 p.m.... For many months this child cried and held her arms out to me every time her mother came to pick her up. I know her parents very well and feel certain that nothing resembling abuse or neglect was going on. After ruling that out it seemed that the child had made a conscious choice and preferred me to her mother. This has been difficult for both me and my friend.... This baby, unlike a child at home full time with his mother, was given another option and chose not to bond with her mother, to instead bond with me. I think this is an awful situation to put an infant in. To deprive a baby of the close, intense relationship with one caring, loving person, which I believe is critical in infancy, both for the child and the adult, negates the very basis from which emotional security derives. One of the most compelling letters I've received on this subject came from a former day care worker from Wisconsin named Donna Briesemeister. She wrote as follows: I am a public school music teacher, and the mother of two nearly grown sons.... In 1983, when I was between teaching positions, I took a job as a day care worker in Deerfield, Illinois. Baxter Laboratories made us nationally famous, and made history for themselves, by becoming the first corporation in the country to subsidize their employees's use of child care at an approved facility. We were housed in an unused public school building, and had in our care approximately 280 children between the ages of 6 weeks and 6 years. I was assigned to a room for infants, and for nine hours a day I, and three wonderful young women, tried to give "mother's care" to 12 precious souls. This experience was one of the most poignant of my life, because it was impossible for us even to approach the level of care we believed a child needed.... I watched children being traumatized as workers came and went. I observed the disenchantment they suffered, and the hostility they developed. [Noted psychologist] Burton White even came to visit us, and to speak to us of his belief that children, if they are to grow up healthy and happy, need to be under the care of their own mothers, at least until they are three years of age. I couldn't agree more.... I could go on and on, because I have been haunted these past several years by the images I carry from this "best of all possible" institutional day care centers.... I can tell you that before my year in day care work was over, my co-workers and I were able to convince five of the 12 mothers whose children we cared for that they would be happier, and that their parent-child relationships would be healthier, if they would quit their jobs and would stay at home with their children. Our "babies" are five years old now, and we still stay in touch with their parents. That early bonding -- unfortunately between us and the babies, instead of between the babies and their parents -- is such a powerful human emotion that it never goes away, no matter how many years pass or how circumstances change. No parent or child should miss out on that experience. Though it is obviously very difficult for workers to speak frankly on this charged subject, a great deal of uneasiness of this sort exists on day care's front lines today. There is a strong tendency in the popular press to censor such testimony for fear of "offending" some listeners. Nonetheless, warnings have worked their way into some established media outlets. In a feature article in the politically left magazine The Progressive, Dorothy Conniff, head of city day care programs in Madison, Wisconsin, describes day care as "mostly crowd control," and "a troubling social experiment." The Washington Post has quoted Jeree Pawl, director of the infant-parent program at the University of California-San Francisco, saying, "in most day cares, it's a pecking order; it's like a bunch of wild chickens in a hen yard." The loudest, most obnoxious behavior is what gets rewarded with attention from overloaded adult caretakers and intimidated peers both, stated Pawl. The Wall Street Journal ran an interview in which the head of an Illinois day care center serving 300 children -- 250 from families where both parents work, 50 from single-parent families -- worried aloud about her mission. An excerpt: Demand is so great that Elaine Lombardo, the center's founder and executive director, could sign up many more parents for care ranging up to $120 a week if she wanted to. She doesn't want to. Mrs. Lombardo has ambivalent feelings about her job. She knows she is providing a valuable and necessary service, but she worries about the family life and future of her charges. Many children are dropped off at 6:15 a.m. and don't see their parents again until 6 at night -- even later, sometimes. One parent, a model, left her four-year-old until 8 p.m. It's not unheard of, either, for parents to drop off children who are obviously ill. Under the circumstances, it's not surprising that the children come to look upon their teachers and Mrs. Lombardo as mother figures. "The kids kiss me good night," she says. "I'm torn. I want them to feel safe and secure, but this is not their home. Parents think we can substitute for family, but we can't." In one of her books, bestselling child care author Penelope Leach also reports hearing such reservations among day care workers. At a recent talk I gave to a group of nursery worker trainees, one girl recounted her worries about the lack of individual attention received by children in her unit. She finished with these words: "I suppose it's true that they are better off with us. We are taught and we do know what we are doing. But when I have children of my own I will use everything I know to look after them myself. I'd die rather than put a child of mine in the place where I work. Coming as they do from talented and well-intentioned individuals right within the substitute-care industry itself, statements like these reflect much more than occasional dissatisfactions. They grow out of fundamental problems that exist at the very core of the childrearing-by-proxy experiment. In the sections that follow we'll look at some of those inherent problems. MUSICAL CAREGIVERS Remember Meryl Frank? She of the ten babysitters in two years, whose story started this article? Well, Meryl Frank has lots of company. The Washington Post Magazine ran an admiring profile of a fine day care teacher working in a Maryland Kinder-Care center. In the body of the article, as part of a short description of the teacher's first weeks adjusting to her job, the reporter described how one mother angrily approached the new teacher with the news that "she was the ninth woman to work in her son's room in eight months." The mother demanded to know, "How long are you gonna be here?" An article from New York magazine provides a snapshot of this same, central problem hitting a different part of the socio-economic spectrum. It chronicles the experiences of a "mergers-and-acquisitions specialist at Paine Webber" who went through six nannies in the first six months of her child's life. Nanny Number One was arrogant, while Number Two was overfanatic about housekeeping, and Number Three didn't stimulate the child. Nanny Number Four was great but left abruptly without notice. Number Five was an au pair whose inability to speak English led to nutritional problems for the infant, and nanny Number Six was a Haitian who turned out to be paranoid and a baby disliker. Number Seven was doing fine. As of the story's writing, anyway. In the interview grapevine and the statistical studies alike, caretaker turnover turns out to be a very serious problem for hired day care. A pair of investigations by UCLA psychologist Carollee Howes of 18- to 24-month-olds in good quality home-based day care found that most of the children had already experienced two or three changes in caregivers, and some had had as many as six. By its very nature, day care produces instability and discontinuities in a baby's life. A child in purchased care, Penelope Leach points out, must regularly rely on "somebody who, even if she was there yesterday because it wasn't her day off, doesn't know what happened to that child in the 12 hours previous." This can have negative effects: When a child is growing and changing and developing and working very hard at particular areas of his development, even 12 hours can put you totally out of step. Caring for a baby non-continuously is a constant process of experiment.... It may not hurt the baby for one afternoon, but it's awful bad for babies if all of their infant lives they are having to communicate with people to whom their language is foreign. Yet this is what day care children are required to do all the time, as Leach notes: Split shifts to cover the long nursery day double the number of people with whom babies must interact. Lunch breaks, sick leave, vacations and in-service training courses produce such constant staff movement that case studies suggest an average of seven different people a day and 15 a week (some of them strangers "filling in") handle each child. This is the built-in churning, Leach notes. On top of that you must add all the turnover that occurs whenever there is a change of center or arrangements. There is widespread agreement among child development experts that instability in caretaking can seriously interfere with a young child's development. Howes' studies showed that the more changes a youngster had experienced, the more trouble he had adjusting to first grade. Other research shows that caregiver departures can cause breakdowns in toilet training and speech skills. Repeated disappointments will cause some youngsters to withdraw from adult contact. Other children will act out their resentment and disappointment by disrupting the classroom. "The child is thrust into the care of some strange person, disrupting the bonds established with the mother. And just when he sends out some tender, new shoots of affection, he gets a new sitter," explains child psychiatrist Jack Raskin. "The child can't shout, 'My heavens, every attempt I'm making to get the closeness I need is sabotaged. What the hell is being done here?' But you'll see the results, perhaps five years later when he's disruptive in school, or ten years later when he's on drugs." A baby who "is cared for by many well-meaning strangers in turn, or one who is cared for sketchily and without concentration, sharing his caretaker with other needful small people, is like an adult who moves from country to country, knowing the language of none," writes psychologist Leach. Some youngsters learn not to attach themselves to any caregiver. They lose the ability to feel or express warmth, and develop a shallow and indiscriminate emotional life. Certain such children end up without any sense of personal connectedness, and thus lack concern for winning any other person's approval. This leaves them unaccountable, and sometimes socially dangerous. To understand why shifting parent-surrogates can be so disruptive to a youngster, consider that a child's feelings "acquire the strength and variety of adult love" by the age of two, according to experts. Take this fully-developed capacity to feel the thrills and pangs of love and then overlay it with a child's fundamental uncertainty about the larger world and you can see where the potential for hurt and insecurity comes from. As one mother I know asked when facing her own daughter's separation from her day care provider: How do I explain to Susannah that very soon she will leave the woman she has known and loved for three-fourths of her life? That she will be taken away from what has become her second family? That the children who are closer to her than her cousins, whose names were among the first words she learned, will be gone from her world? Fear of abandonment is a primal human worry. There are fairy tales and ballads and novels aplenty to attest to that. The oldest theme in literature is that people can't simply be interchanged one for another in affairs of the heart. So is it really so hard to understand why children might suffer from being disconnected from the people they love most? And as wrenching as lost loyalty and love are for grown-ups, they are even harder for children -- because children are forming their very first attachments and have no other bonds or sense of worth to fall back on. ARTICLE CONTINUED BELOW Longstanding Warnings from Experts "It's very hard to become a sensitively responsive mother if you're away from your child ten hours a day," says distinguished child developmentalist Mary Ainsworth. "It really is." Margaret Mead, the scholar and champion of progressive causes, emphasized the same point. "A little baby needs continuity of care; all our studies suggest that too frequent changes of the mothering person are hard on children. If a woman works full time, it is very difficult for her to provide this continuity." Toward the end of her life, Mead argued explicitly that thoughtful women shouldn't be having children with the idea of placing them in someone else's care all day. From her experience of recent years, Princeton, N.J. child therapist Isabel Paret concludes that "there's no question that infants don't do well in daycare, no matter how much modern families would like to think they do." Eleanor Galenson, a prominent New York child psychiatrist, states unequivocally that "putting infants into full-time daycare is a dangerous practice. Psychiatrists have been afraid to come out and tell the public this, but many of us certainly believe it to be true." Stanford psychologist Bryna Siegel concurs, noting that "clinician colleagues are reporting an increase in the number of children with unstable, extensive daycare histories in their practices." An article in the Journal of the American Psychoanalytic Association reports that among "patients with an early history of surrogate mothering," "estrangement from biological mothers, and intolerance of intimate relationships" is a significant problem. Many teachers, physicians, and youth workers likewise report seeing more and more disturbance traceable to early non-parental care. Lillian Katz, the 1994 president of the National Association for the Education of Young Children, describes this decade's findings on daycare effects as "very frightening." "Children under three don't belong in institutions," she states straightforwardly. Samuel Sava, executive director of the National Association of Elementary School Principals, likewise urges that "each child deserves at least three good years at home with a full-time parent." Penelope Leach, the British psychologist and author of today's most influential childraising manuals, is an opponent of the trans-Atlantic trend toward viewing childraising as a sideline practiced by parents busy at jobs. She insists that newborns need the concentrated attention of their parents for at least their first couple years, and she speaks with passion against group care for children under two. Someone caring for a child out of love will do a far better job than someone doing it for pay, she argues, and it should be a major aim of modern society to make full-time parenting easier. Another child advocate who refuses to pull his punches on the daycare issue is the prominent pediatrician William Sears. He insists that "when mother and baby are separated, both of them miss out on the full benefits of a continuous mother-infant attachment." A baby in substitute care, he says, is "required to bounce his cues and affections back and forth between various caregivers. His needs may not be consistently met, and his developing sense of trust may be compromised." The granddaddy of parent counselors, of course, is the recently deceased Benjamin Spock. Dr. Spock had for years opposed infant daycare, arguing that "a day nursery...is no good for an infant. There's nowhere near enough attention or affection to go around." Spock has argued that children need responsive, full-time parental love in their first years, and that it makes no sense for parents to "pay other people to do a poorer job of bringing up their children." Despite a good deal of backtracking in successive editions of his book to placate feminist criticisms, Spock still pointed out in recent years that "even at six months babies will become seriously depressed, losing their smile, their appetite, their interest in things and people, if the parent who has cared for them disappears.... Small children...may lose some of their capacity to love or trust deeply, as if it's too painful to be disappointed again and again." He adds that "it is stressful to children to have to cope with groups, with strangers, with people outside the family. That has emotional effects, and, if the deprivation of security is at all marked, it will have intellectual effects, too." For the first three years of his life, Spock argued, a child needs individualized care from the same person. Only in the small number of cases where a childcare arrangement fits that description can it substitute "pretty well" for parental care. He registered his urgent hope that "there will always be men and women who feel that the care of children...is at least as important and soul satisfying as any other activity." And he insisted that no parent should ever "feel the need to apologize for deciding to make that their main career." Burton White, former director of the Harvard Preschool Project and one of the world's leading authorities on the first three years of life, has also written explicitly on the subject of nonparental care. "After more than 30 years of research on how children develop well, I would not think of putting an infant or toddler of my own into any substitute care program on a full-time basis," he reports, "especially a center-based program." White suggests that except for occasional baby-sitting, parents ought not use substitute care at all during the first six months of a child's life. A newborn "has to be responded to intensely in this period." From six months to three years of age, he says, the parent can use some part-time child-care, but the youngster should spend most of his waking time with a parent or grandparent. White concludes, "Unless you have a very good reason, I urge you not to delegate the primary child-rearing task to anyone else during your child's first three years of life.... Babies form their first human attachment only once. Babies begin to learn language only once.... The outcomes of these processes play a major role in shaping the future of each new child." After studying hired child care in depth, in both its non-profit and for-profit forms, White pronounces it "a total disaster area," with "no feasible way of turning it into a model industry." Most families will find only "pretty poor substitutes" for parental care when they look outside the home, he warns. Therefore, "government should resist the cries for free full-time substitute baby care for all who want it." If you are surprised to learn of this consensus against early full-time daycare, there is a good reason: Political fashions have made criticisms of daycare so off-limits that unfavorable evidence has been muted, downplayed, or ignored, in academic circles and mass media both. Michael Meyerhoff, director of the Center for Parent Education, explains that "over 90 percent of the professionals we deal with would agree with our basic position -- that full-time substitute care for children under age three is not ordinarily in the best interests of the child. But many of these professionals are involved in situations where it's economically or politically unrealistic to maintain that position. Because of the strong attacks they'd be likely to get, many people are not saying anything." Penelope Leach warns parents "there is a cover-up going on." The deep need of young children for individual care is seldom stated publicly and unequivocally for "fear of upsetting the parents who don't provide it." This, says Leach, is a serious error on the part of responsible authorities. I am sorry for mothers who cannot look after their babies themselves, but I do not believe that it is helpful to conceal from them the fact that group care is a bad alternative. They are entitled to the facts as we understand them.... I am sympathetic, too, with mothers who could provide full-time care themselves but do not wish to. But they too are entitled to a true picture of the conflict between what they want and what their children need. Rather than dispense information which could ruffle feathers, many pediatricians, psychologists, and other public advice-givers have fallen scandalously silent on this touchy subject. The result is that knowledgeable criticism of daycare is fading from popular view. And fewer and fewer parents are even aware that there exists a large body of research and clinical experience associating serious problems with early daycare. But if public warnings on this subject have been muffled, the reservations of experts nonetheless remain strong. A 1990 poll of U.S. pediatricians conducted by the Thomas Jefferson School of Medicine in Philadelphia, for example, showed that 77 percent believe infants six months or younger ought to be cared for only at home. A different survey of 1,100 baby doctors carried out that same year by the American Academy of Pediatricians reported that a substantial majority of physicians consider full-time daycare harmful for children under age 4. -- KZ Though most parents are aware that harm can come from day care instability, it is not at all uncommon for children to be regularly moved to new settings. Census Bureau figures show that about one child out of every five in day care has changed programs within the last four months. Other studies show that fully half of all day care arrangements change over the course of a year. There are dozens of reasons for rapid day care turnover. The child or parent may have had a bad experience. There may have been a sickness. The child may have gotten too old for a particular group. The location may have turned out to be inconvenient. The cost may have been too high. Someone may have come to dislike someone else. Perhaps the family moved, or changed jobs. And even when the parent and child stay put, providers very often move out from underneath them. The National Child Care Staffing Study, which examined a sample of 227 childcare centers in five regions of the country, reported that fully 41 percent of all caregivers quit their position each year. (Other studies show comparable results.) "To give you an idea of how bad it is," stated the director of the project, "during our study, we had tiny children coming up to our researchers and asking them, 'Are you my teacher?'." And that's just in centers. Among home day care workers, the average turnover is even higher. Nationwide, 62 percent of all in-home workers flip over in the course of a year. What's more, the situation is getting worse. Surveys show that as the demand for day care and the size of the industry have risen, staff turnover has accelerated sharply over the last decade. Anyone who does any research on day care today hears repeated stories of nomadism. "While Mrs. Freebing says she's had good luck with the two nannies she's hired, one from Utah and one from Montana, she's in the process of hiring her third nanny in 18 months. The first two are going back to school," reads a typical history. Parents finally find an acceptable childcare provider after a long ordeal, only to lose her. Left for a better position. Got married. Going to school to learn computers. Deported by the immigration service. These are experiences I've come across over and over. Hardly any family relying on day care is safe from this sudden turmoil, not even those who pay for the costliest forms of care. An interview printed by Fredelle Maynard in her book on day care tells a representative story. Maynard quotes a Canadian mother describing an in-home day care arrangement she is satisfied with: They have a routine, the two of them. Victoria comes in the mornings and does toast and eggs for the baby; we leave while she's eating. Then they both watch "Polka Dot Door." Peggy recognizes the music, skips to the living room. After that the baby plays in her room, with the gate hooked, while Victoria cleans. Nap is from 11 to 1, lunch at one. Afternoons they go for a walk, shop, visit friends, watch some more TV (There's probably too much TV, but that's something I have to accept). Sometimes Peggy has a second nap while Victoria makes supper; they eat together, not with us (Victoria's choice). Peggy cries when she leaves. Everything considered, it's an ideal arrangement. I'm free to concentrate on my job, my child has a mother-substitute who's absolutely conscientious and devoted. Let me tell you I wake every morning and pray she won't leave us. Not that I really worry. The young nannies from Jamaica or the British Isles often don't take their jobs seriously; they meet a man, or get a better job, often, and they're off. For Victoria, stability is a central value. She regards this as her home. One week after this interview, Victoria left without giving Riva, the mother, any notice. Her immigrant papers had come through. And "in the three months since," Maynard reveals, "Riva (pregnant again) has had one nanny who lasted two weeks and a series of makeshift arrangements. Now she and her husband are sponsoring a nanny from Hong Kong." LOST IN A GROUP For all of the problems associated with nannydom, it is still probably the least harmful form of hired caretaking in most cases, because it at least allows lots of one-on-one attention. Relatively few children, however, have their own nanny. And few ever will -- because the average parent with average earning potential simply can't afford to hire someone to stand in for them full time. Professionalized childcare, as Penelope Leach points out, "depends for its viability on economies of scale, because if one professional cares for only one baby then she is a direct swap for the mother." There is no great supply of willing and qualified workers making themselves available for such a swap, and even if there were, this wouldn't "free up" any adults overall. Parents would be released, as Leach puts it, "only by leaving babies with less-skilled, or at least less well paid, adults -- an uncomfortably colonialist thought." In order to be affordable, mainstream day care will always require several children to share a single caretaker. Which brings us to the next inherent flaw that plagues paid childrearing -- the problem of lack of individual attention. Fredelle Maynard reminds us that "a mother of twins is hard pressed to give two babies all the cuddling they want. What can be expected of a caretaker who's in charge of four infants -- or six? With the best will in the world, that caretaker will be obliged to give some infants a propped-up bottle, to let others cry while she performs essential tasks." Consider that the birth of triplets is literally considered an emergency situation which automatically qualifies two parents for caretaking assistance and special social aid. Yet in hired day care, the very best institutional situations involve three or four infants assigned to a single caretaker. This is what gets called "high quality care." In average cases, things are worse yet. The government's National Child Care Survey showed that among centers caring for one-year-olds, the average group size is currently ten, and the child/staff ratio is nearly 7:1. Even this is probably an underestimate, since the survey was based on voluntary responses from day care centers and the worst institutions usually don't cooperate. For many readers, those dry numbers may seem unexceptional. They give no hint of what it's really like to be responsible for several infants or toddlers at once. I suggest anyone who thinks 7:1, or even 4:1, sounds like a reasonable ratio ought to try it someday with real babies. I can promise that you'll experience chaos and practice neglect. You will be lucky just to keep up with diaper changing. Very little real fostering will take place under such conditions. ARTICLE CONTINUED BELOW Day Care and Big Brother "By virtue of its privacy, the family is the primary shelter of human variety. In the very process of preparing its newborn for the world the family can...see to it that the world's standards do not impinge too closely upon the defenseless young and so do not mold them too precisely to the world's imperious demands.... In this lies the human potentiality for freedom." So writes author Walter Karp, one of many observers (from various parts of the political spectrum) troubled by the standardizing effects of mass day care. The contrast between a family upbringing and "collective professionalized care of the young" is stark, Karp notes. "Instead of protecting the young from the world, such administrative child care would fasten the world's ways on the newborn with a strangler's grip." And "in a society where cash is too often the link between people," daycare makes "the child's primary experience of life the experience of being someone's job." When the infant-mother-father relationship is changed, the very institution that forms human personality is altered. Eventually, society itself may be reoriented. Some years ago, a Smithsonian Institution project attempted to determine the early childhood sources of human creativity and leadership, and eventually concluded that a consistently close parental connection was the most critical factor. Two other important influences were minimizing the time a child spent with peers, and providing opportunities for free exploration of the world under parental encouragement. None of these conditions, chief investigator Harold McCurdy pointed out, are advanced by group socialization. Sociologist David Popenoe asserts that "childrearing is one of those aspects of human society that is not subject to improvement through modern techniques of efficiency and rationalization." It is, he says, a "cottage industry." What is required -- an abundance of time, patience, and love on the part of caring parents -- "has no substitute in the technological realm." Despite claiming to serve and speak on behalf of the family, the hired child care industry "actually weakens its authority at every point," suggests left-wing critic Christopher Lasch. Author George Gilder sees the professionalization of childrearing as a tragic extension of earlier errors in American public policy. "The same people who paved the road to hell in America's inner cities," he says, now "want to take care of your small children." New York State teacher of the year John Taylor Gatto warns that any standardized process which has children as its product will eventually yield bitter results. "Lives can be controlled by machine education, but they will always fight back with weapons of social pathology -- drugs, violence, self-destruction, indifference." These, he says, are already "symptoms I see in the children I teach." -- KZ Dorothy Conniff, the Wisconsin day care chief, did some calculations back in 1988 of how much time it took to provide an infant with just the barest maintenance. She then translated that into the very best day care settings: Consider the amount of physical care and attention a baby needs -- 20 minutes for feeding every three hours or so, and ten minutes for diapering every two hours or so, and time for the caregiver to wash her hands thoroughly and sanitize the area after changing each baby. In an 81/2 hour day, then, a caregiver working under the most stringent regulation -- the 4:1 ratio -- will have 16 diapers to change and 12 feedings to give. Four diaper-changes and three feedings apiece is not an inordinate amount of care over a long day from the baby's point of view. But think about the caregiver's day: Four hours to feed the babies, two hours and 40 minutes to change them. If you allow an extra two-and-a-half minutes at each changing to put them down, clean up the area, and thoroughly wash your hands...that makes seven hours and 20 minutes of the day spent just on physical care -- if you're lucky and the infants stay conveniently on schedule. Since feeding and diaper-changing are necessarily one-on-one activities, each infant is bound to be largely unattended during the five-plus hours that the other three babies are being attended to. So if there's to be any stimulation at all for the child, the caregiver had better chat and play up a storm while she's feeding and changing. While older preschoolers in day care require somewhat less maintenance, they also get crowded into larger groups -- typically from eight to 15 youngsters per adult. This also results in inadequate care. The average toddler makes 10 overtures an hour to his primary caretaker, according to studies. A day care worker responsible for 10 toddlers would thus be faced with an overture every 35 seconds. Obviously most will be ignored or bluntly cut off. The assistance, praise, rule-teaching, discipline, and reinforcement that one- to three-years-olds need will often be unavailable. The problem is not that day care workers are thoughtless, but rather that they work within a structure where fine-tuning and sensitivity are simply not possible. I have helped mind eight preschoolers many times in morning cooperative playschools, and I know that all you can usually aim for is to keep basic order, to avoid accidents, to survive. The life's lessons come few and far between in such settings. If children are gathered in such groups a couple times a week for two or three hours of play, this is not a serious problem. But when such a group becomes the child's primary residence all day long, not even the most conscientious caretaker can rescue the situation. The plain result is neglect. Many observers say all that's needed is some new laws requiring higher adult-to-child ratios. But they overlook day care's basic nature. Getting the ratios up to a humane level would amount to recreating families artificially, and the reason day care exists to begin with is because there aren't enough adults currently willing to spend their days in families. Even if you could provide enough adult bodies in every day care setting, you would, as Penelope Leach points out, "have lost your economies of scale." Only a comparatively small number of rich families can afford to hire one parent surrogate for every child or two. In any mass form of day care, basic financial considerations and the limited number of substitute parents available make the kind of personal attention children crave impossible. Childrearing of adequate quality is inherently resistant to streamlining. "Raising several children is a project that exacts a constant alertness and attention," comments writer George Gilder, something social engineers "don't remotely understand when they urge that 'society' do it." Pediatrician Herbert Ratner worries that "nature goes out of its way to give each baby a private tutor. We go out of our way to develop a litter situation." Substitution of group care for parent care is both unnatural and impractical, he argues, and it will eventually be regretted. CHILDREN OF INSTITUTIONS In recent years there has been a big shift toward institutional child care. If the Clintons have their way, even more of the future growth will be at institutions. Making institutionalization a common part of early childhood will have effects on American personality. As Deborah Fallows points out, Life for a child in a day care center, good or bad, is different in certain ways from other kinds of life. There is more rigidity to it. The sheer number of children that day care centers handle necessarily means organization, scheduling, and rules.... Life in day care centers is also more homogeneous than life elsewhere. The day's format is always the same. Most of the time is spent in the same building or room, on the same playground....The need to manage large numbers of young children...accounts for the centers' emphasis on standardization and routine. "Anyone who has spent time in a day care center knows that it is not a place where children can 'do their own thing,'" add Bill and Wendy Dreskin. Every aspect of the day is regulated. They must lie on the mats, whether tired of not, for the prescribed number of minutes. If they are tired, they must still wake up at the end of rest time.... They must eat by the clock, even if they are hungry earlier, and there is no allowance for individual taste.... In some infant centers, babies are "color coded." The "green" baby has the green pacifier, the green bottle, the green crib, and so on. The uniqueness of each little human person is lost.... While "better" quality centers avoid horrors like walking toddlers in groups on leashes and putting infants in stacking kennel-like cribs, day care centers, like hospitals, asylums, and the military, are...a total institution.... Children quickly get the message that they must go along with the group and not make waves. The Dreskins evoke hospitals and barracks. I suggest an even closer analogy for the typical day care atmosphere might be a nursing home. There is often the same well-intended but ultimately depressing air. As one mother described full-day centers, "you go in there, and all these children are clutching their little possessions, and they're looking around. They don't have any concept of time, so when a door opens, they all look up, and when they see you're not their mother, they look back." Day care centers even tend to have a uniform emotional environment. This is Fallows' characterization: The children live in an "on" atmosphere that differs from the tone of life at home. Even when caregivers are most gentle and children most mild-mannered, the pressure of numbers generates considerable noise, confusion, interruptions. Children have to respond, to react, to engage the social side of their personalities almost all day long. Time alone, to be quiet, to muse, to just be there, is minimal. Almost all day care observers eventually comment on the constant hubbub. "I couldn't stand the noise. From sun-up to sun-down, voices talking, talking," writes Anne Husted Burleigh. "People," she argues, "were not made for babble." "For ten hours a day, these kids have to interact with about 20 or 30 kids," says day care worker Katie Humes. "Imagine if we adults had to constantly be trying to get along with that many people." For lots of children, suggested author Vance Packard after making a series of day care visits, the daily experience "must be like enduring a nine-hour cocktail party." Perhaps the most undesirable aspect of the day care center is that, as child psychologist Arnold Samuels puts it, "the child must comply with the environment; the program doesn't always respond to the child." Dorothy Conniff characterizes this as "the most consistent drawback of day care centers." Staff resort to forcing children into the same boring activity all at the same time to maintain control. Whatever children can learn from pasting a picture of a pumpkin on a pumpkin outline is not enhanced the next day by pasting a paper feather on a turkey. This kind of solution to the problem of what to do with young children is a terrible waste....[a] kind of repressive control. Given the impossibility of true personal attention, the need to mark time, and the necessity of keeping control, even the most mundane activities on the day care schedule take on large significance. Fallows describes the discomfort she observed during hand-washing periods as lines of children had to wait for those in front of them to one at a time walk to the sink, wet their hands, grasp the soap, wash, replace the soap, rinse, pull out a towel, dry, throw the towel away, and then return to their seat -- all with the deliberate, painful slowness of a toddler. In the course of a nine-hour day, mass coat-donning, bathroom-using, grace-saying, line-forming and so forth can become trials in depersonalization for two-, three-and four-year-old children. For her book The Erosion of Childhood, Valerie Suransky observed several widely different day care settings and came away struck by the way each stressed time scheduling and the routinization of tasks. Suransky also noted the importance of containment in day care, and the role of locked doors, marching in line, and other measures used toward this end. Regimentation pops up wherever custodial care of children is substituted for family care -- even when the children involved are much older and more competent than infants and toddlers. When Time profiled some typical days of American children a few years ago, a third grader named Katie, the only child of a Seattle doctor and nurse practitioner, was included. "Katie is a day care child," began the profile. "To her generation of children, day care is as familiar a destination as Disneyland, if not nearly as magical." Katie still goes to day care before and after every school day. Until her teenaged half-sister recently moved into the house, Katie also "used to go to day care all summer. I didn't look forward to summer then." Behold a picture of upper-income early childhood at the end of the twentieth century: Katie spends ten hours away from home each day. After rising at 7 a.m. and downing a breakfast of Lucky Charms, she buckles herself into the front seat of her mother's Volkswagen Jetta for the two-minute ride [to] Montlake Elementary School. She stays for an hour in a kindergarten classroom where the Community Day School sets up shop each day before and after school. At 9 a.m. she joins her third-grade classmates at Montlake. When the school day finishes, Katie circles back to day care, where she stays until 6 p.m. Katie clearly does not like day care. "A lot of times it gets really boring just going there," she says. "It's the same setting and usually the same things to do." ...She cannot invite friends over to her house, nor can she go to theirs. Worst of all, she cannot disappear by herself into her bedroom and play with her toys or work on her next book. "I would love if I could just stay in the attic," she says. "There's a little room in my mom and dad's closet. There's this little door to get in. It is really fun in there. They have all these old literature books and poetry books and drawing books. It is like a big library, and I could just sit there and read all day." Sometimes when she's feeling unhappy at day care, Katie starts to imagine that the other children do not like her. She suffers from attacks of what she calls "aloneness," a feeling she rarely has when she is at home alone.... No matter how creative the entertainment, the children find it hard to keep going, going, going as they head into the final stretch late each afternoon.... Toward the end of the day, the slightest twist on the doorknob is enough to get a sea of tired eyes to look up. As parents arrive to pick up their kids, Katie quickly looks up to see if it is her mom or dad. Most kids have a pretty good feeling for what time their parents normally appear, so when a parent is late, a child becomes anxious. Institutionalization of this sort means several things for children, comments family researcher David Cayley. "It means separation from the day-to-day world of home and neighborhood, it means the loss of the opportunity to do what you want when you want to do it, including sometimes just doing nothing at all. And it means the loss of privacy and solitude." This is not an exclusively American problem. All industrial societies are pushing their children in the same direction. The Christian Science Monitor carried an interview with an educated Parisian couple who discussed family practices and childcare policies in France (which Mrs. Clinton and other liberals in the U.S. often laud). "I've never wanted to put children into these public systems," confessed Alexandra Doualle. "You can say what you want, but day care centers are collective institutions. The children are raised as a collective entity. The child will develop his collective self but will not necessarily develop his individual self." What happens, she asks, to a particularly sensitive child? To one who is easily influenced? To one who can be dominated? They suffer. "A little day care, a few hours a day, that's fine," suggests Mrs. Doualle. But spending more time than that in a group can damage a child's personality. One of the great cultural ironies of our era, Bill and Wendy Dreskin have argued, is that this trend toward institutionalization in childhood is being driven primarily by social liberals -- the great professed opponents of dehumanizing standardization. Progressives are dedicated to increasing the number of children who must lead these regimented lives. They are lobbying for the public schools to include day care programs for preschool children or even infants and toddlers, and in some states they are working toward lowering the age for compulsory entrance into the school system.... Progressives push for year-round schools which would shift the responsibility of summer care from parents to the government. The institutions produced by all this social activism have been characterized as "part-time orphanages" by worried skeptics. And like the full-time versions, they can wrench their charges poignantly. Writer Harry Stein illustrates this through the experiences of a friend. While wrestling with the decision of whether to have children, the friend -- a successful broadcasting executive -- decided to visit the best day care center in her neighborhood and draw some conclusions for herself. She came back with serious reservations. "I was quite taken aback when I saw them consoling a six-month-old with a photograph of his parents," the woman reported. "I don't know," she observed after a pause, "those people are betting a helluva lot on this experiment panning out." This snippet from one of Deborah Fallows' center visits provides another glimpse of the impersonality that prevails in so much hired childcare. The story line of the book was getting more complicated when the phone rang next door in the director's office. The teacher got up to answer it because the director was out. When she came back, Jason started complaining that he didn't feel well. She let the comment pass and went back to reading when the phone rang a second time. She went again to answer it. When she returned, [Jason] stumbled out of his seat and toward the bathroom, spitting up on me and a few children as he passed.... The teacher went off to clean up Jason, laid him down in the director's office, and tried unsuccessfully to call his mother. She pulled out coloring books and crayons to keep the children busy in her absence.... All but two of the children located their coloring books by their names on the covers. Andrew, the two-and-a-half-year-old, and Michele, a recently arrived five-year-old, didn't have books. They found some left over from children who were no longer at the center and started using them. Suddenly Andrea discovered that she in fact had the wrong book and little Andrew was scribbling in hers. She attempted a quick switch, which set Andrew off howling. When the teacher returned, Michele was pouting and complaining about not having her own book. The teacher, impatient by then, picked up the book Michele was using, scratched out the name "Carolyn" and wrote "Michele" over it. "Carolyn withdrew from school," she explained to me. But Michele did not look convinced. One leading edge in day care today is special centers that only accept sick children. All around the country, institutions with cutesy names like Sneezles and Chicken Soup and Teddy Bearacks have sprung up, solely as places to park youngsters too ill to attend their regular centers. But there is nothing cute, or healthy, about this practice. When a youngster who is already feeling bad goes to an ill child center he is faced with a totally unfamiliar environment, where all the adults and all the other children are strangers. Instead of bringing extra security and comfort, his illness thus brings him extra strangeness and uncertainty. Penelope Leach puts it bluntly: "To put a sick baby into a stranger's hands is cruelty." In many cases, it is employers who set up these centers. They then parade them as proof that the company is "family friendly." One cover story in Fortune chortled that "for sheer cost-effectiveness, nothing beats a facility for children too sick to go to school or day care centers. About 80 employers, up 50 percent from a year ago, have made some provision so that the mommies and daddies of sufferers can still report for work." Susan Wolfe, director of one Minneapolis ill-child center, does the math for Fortune. When a middle manager at First Bank, one of her supporting employers, misses a day of work to minister to a miserable child, it costs the company $154, Wolfe reports. If, on the other hand, the employee checks the child into her center at company expense, it costs the bank only about $20. Voila! An institution that "saves the company 87 percent, or almost $135 a day." The growing regimentation of childhood involves more than just day care institutions. It includes things like more and more young children having to brave rush hour each day. I have before me an Associated Press piece entitled "The Littlest Commuter" that is typical of several I've seen. It profiles a mother and toddler who spend four hours a day traveling from suburban New Jersey to work and day care, respectively, in lower Manhattan. This is Ashley's day: She gets up very early and is driven by her mother from Oakland, N.J. to the train station in Ramsey. They park. They board the 6:22 a.m. local to Hoboken. In Hoboken they jump a Trans-Hudson subway. From the top of the subway stairs they stroller several blocks to Ashley's day care center. She stays there all day, then reverses her commute. All told, Ashley's "workday" is 12 hours long. Welcome to the baby rat race, Ashley. HEALTH RISKS Doctors warn that day care centers have become troublesome sources of health problems. The American Pediatric Association reckons that infants under one in group care have eight times as many colds and other infections as babies cared for by their families. A baby's immune system is not well developed until about his third month of life, and it does not reach adult-level disease-fighting capability until around age two. Take this fact, plus the research finding that an average toddler puts a hand or object in his mouth every three minutes, and you can see why concentrating together groups of these drooling, toy-sucking, low-immune children creates an ideal environment for disease transmission. Add to this the reality of diapers and you have a recipe for recurring sickness. The U.S. Centers for Disease Control warn that "diaper changing is the highest risk procedure" associated with day care. Even in the highest-quality center with a 1:4 adult-to-child ratio, a worker taking care of babies will have to clean an average of 16 bottoms every day, supposedly sanitizing the changing area thoroughly each time. Dorothy Conniff comments that if you "think about thoroughly washing your hands 16 times a day, you may begin to understand why epidemics of diarrhea and related diseases regularly sweep through infant-care centers." A Memphis State University study of 800 children under age three found that compared to youngsters at home, children in day care centers suffered half-again as many infections and four-and-a-half-times as many hospitalizations. The American Journal of Public Health has reported that children in day care centers incur overall medical expenses that are two to three times as high as those of children cared for at home. This research showed them to be nearly three times as likely to require hospitalization. A rand Corporation study which analyzed data on 3,841 children age six months to five years showed that attending a day care center "increases bed days for young children by 30 percent," while youngsters attending home-based day care have 19 percent more bed days (both compared to parent-reared children). In the Journal of the American Medical Association, physician Stanley Schuman reports that day care transmission is responsible for recent "outbreaks of enteric illness -- diarrhea, dysentery, giardiasis, and epidemic jaundice -- reminiscent of the pre-sanitation days of the seventeenth century." Other serious day care hazards include cytomegalovirus, shigellosis, hepatitis, HiB, and ear infections. When we checked my son into Children's Hospital in Washington, D.C., to have a minor hernia repaired when he was young, I was struck to note that half of the children in the surgical ward were in for inner ear surgery, most to have mechanical drains installed to try to prevent eardrum ruptures. Increased day care transmission of disease is the major reason this has become a big problem among children today. Committees of the the American Academy of Pediatrics recommended in the 1980s that to avoid chronic infections and childhood epidemics, children under two should be cared for only in the company of their siblings if at all possible. When that is impossible, the doctors urge that a small group of no more than six children, from no more than three families be used. Large groupings and groups with turnover among the children ought to be avoided when children are young, they suggest. This, obviously, would exclude most day care centers. And there are public health issues associated with day care beyond just those of disease transmission. Phyllis Weikart, a University of Michigan professor of physical education, has implicated increased day care use in the sharp decline over the last generation in the physical motor skills of children. Today's children have fewer opportunities for unrestricted outdoor movement and play, she explained. And youngsters are considerably less likely to learn physical skills and games from older siblings, playmates, and role models than they once were. Day care creates single-age ghettos where there is less transmission of skills and information of all sorts across age boundaries. CAN GOVERNMENT MAKE DAY CARE GOOD? Now a brief word about daycare "quality." In the national research (including the latest nichd study that activists misrepresent as exonerating day care), two facts are clear. The first is that when you get right down to actual effects on individual children, the differences between "good" programs and "poor" programs are not large. The second reality is that in even the very best full-time day care situations, large numbers of children (often a majority, depending on what is being measured) end up showing some sign of maladjustment. Problems occur not just where the care is of low quality but also among children in the most careful and expensive forms of hired care -- one-on-one nannies, and university lab schools, for instance. This is quite clear in the research, and the best way to summarize it may be to say that excellent day care gets less disappointing results than crummy daycare. ARTICLE CONTINUED BELOW A Final Test of Surrogate Parenting: The Nanny If you think the lucky few families able to afford gold-standard day care -- a private nanny in one's own home -- can thereby avoid day care's problems, think again. From the later-1800s until the 1930s, placing one's children in the hands of a hired nanny was one of the hallmarks of upper-class existence in Britain and a few other European countries. This was gold-standard care if it ever existed. The nannies were with their children nearly round the clock, typically living right in the children's rooms, and giving their whole life to their charges. Nonetheless, these arrangements caused much human unhappiness. Among other problems, Jonathan Gathorne-Hardy notes in his book The Unnatural History of the Nanny, "the annals of nanny literature are filled with desperate descriptions of incomprehensible and brutal partings" when caretakers left their host families. And even where the connections between nanny and child were never severed, nanny life often brought suffering. Many writers suggest this peculiar institution left deep, raw marks on the entire British upper class. One famous graduate of a nanny upbringing was Winston Churchill. "If it worked for Churchill, it can't be so bad for others," intone defenders of nannying. And in truth, Churchill's early rearing did have a lot to do with making him the great public man he was. But that rearing also left him privately tormented, and desperately unhappy at the end of his life. Churchill's case is interesting because it illustrates the remarkable closeness of the very best nanny-child relationships while simultaneously demonstrating that, even under optimal conditions, parental surrogacy is ultimately inadequate. Churchill's father, Lord Randolph, was an ambitious and preoccupied politician, and his mother, Jennie Jerome, was a beautiful young woman caught up in the whirl of fashionable society. Winston's childhood letters show him pleading with his parents for attention. Rescuing Churchill from this sore neglect was his nanny Mrs. Everest. For the first eight years of his life, Churchill was virtually never separated from Nanny Everest. He slept in her room, had every need attended to by her, and soaked up her calm, loving warmth. From birth until his twentieth year, when she died, Mrs. Everest was "the principal confidante of his joys, his troubles, and his hopes," according to Churchill's son. She in turn adored Churchill. The depth of their mutual love shines forth in their correspondence. Some samples from her letters found among Churchill's papers when he died (having then been saved by him for more than 70 years): Winny dear, do try to keep the new suit expressly for visiting, the brown one will do for everyday wear, please do this to please me. Thank you so much dearest for getting me a present.... It is very kind of you but you know my Lamb I would rather you did not spend your money on me. My darling Precious Boy: I hope you will take care of yourself, my darling. I hear of your exploits at steeple-chasing. I do so dread to hear of it. Remember Count Kinsky broke his nose once at that.... Churchill was at Everest's deathbed when she succumbed to peritonitis at her sister's house in North London. He describes the day in My Early Life. She knew she was in danger, but her only anxiety was for me. There had been a heavy shower of rain. My jacket was wet. When she felt it with her hands she was greatly alarmed for fear I should catch cold. The jacket had to be taken off and thoroughly dried before she was calm again. Her only desire was to see my brother Jack, and this unhappily could not be arranged. I set out for London to get a good specialist.... I returned to her bedside. She still knew me, but she gradually became unconscious. Death came very easily to her. She had lived such an innocent and loving life...she had no fears at all.... She had been my dearest and most intimate friend during the whole of the 20 years I had lived. Churchill enjoyed, as one writer put it, "the total love and undiluted attention of this good woman concentrated entirely on his well-being." He was cared for with intense devotion -- far more than most substitute-parented children will ever know -- and this gave him an unshakeable base of self-assurance. Yet Churchill was haunted, in spite of everything he got from Mrs. Everest, by the absence of his mother and his father. His parents were in no way hostile -- "My mother shone for me like the Evening Star," Winston wrote in later life -- his problem was simply that they were not around much. The anxiety this ingrained into Churchill wasn't always debilitating. Indeed, Oxford University psychiatrist Anthony Storr argues that the parental indifference of his youth may actually have helped prepare Churchill for his inspired wartime leadership of Britain. The boy's early emotional pain crystallized as an extraordinary pugnacity, and in the midst of a national life-and -death struggle, this rage found a complete and legitimate outlet. The prime minister's famous cry that "We shall fight in France, we shall fight on the seas and oceans, we shall fight...in the air, we shall...fight on the beaches" exemplifies the survivor's spirit that stood him and his nation so well in the heat of battle. The fact that Churchill had been repeatedly forced to master his own despair left him perfectly suited to rouse the nation when all the odds seemed against it, Storr suggests. But the boy's upbringing eventually came back to bite him. A child who is rejected will lack "belief that the world is predominantly a happy place, and that he has a favored place in it," says Storr. Although such a child may experience periods of both success and happiness, these will neither convince him that he is lovable, nor finally prove to him that life is worthwhile.... No amount of external success can ultimately compensate him for this. That, alas, is precisely the circumstance Winston Churchill found himself in. All through his life he was plagued with moods of deep depression -- he referred to them famously as his "Black Dog." These he combatted with activity, and during the periods he was holding political office he mostly kept them in control. But in the end, the "Black Dog" conquered the great man. In his last years, Churchill would sit glumly for days and weeks, convinced of his failure and the uselessness of his life. Despite his magnificent achievements, he ultimately died unhappy. Separation from mother and father was something not even the generous love of Nanny Everest could save him from. -- KZ Certainly not all children who go into day care will end up with weak parental bonds, aggressive tendencies, academic problems, personal insecurities, difficulties in peer relations, or other evidence of emotional or cognitive damage. Lots will bounce through with few obvious effects. Individual circumstances like a youngster's temperament, sex, and the status of his home influence how he fares. Older children are better equipped to adapt than infants and toddlers. Part-time care is much less risky than full-time. It's a mistake, though, to assume that a child with nice concerned parents and a nice middle-class daycare arrangement will be immune from harm. What we've learned over the last decade or so is that all youngsters are vulnerable. Lasting effects will show up among some considerable portion of the youngsters who experience extensive out-of-home care in their first three years. Exactly how large a portion we can't say; long-term results aren't in, and in any case many of these effects will never be fully measurable. But the ominous findings that have piled up so far give us clear reason to hesitate in our headlong plunge toward more and more childraising by hire. Day care advocates often claim that the kinds of problems I've been discussing in this chapter can be eliminated via more licensing and regulation. The trouble is, there are already lots of fully regulated -- and fully disappointing -- day care homes and centers out there. That's because most of the things that really matter to young children, if we're honest about it, simply can't be covered by regulations. Linda Burton admits she "never found an accurate way to evaluate the merit of a day care situation. Despite my most painstaking investigations, many environments that appeared loving and constructive on initial (and sometimes repeated) examination, turned out later to be something quite different." Anyone who would have the state "guarantee good childcare" must explain how regulators can make these judgments that even cautious parents find so elusive. Since the things that are really wanted in a childcare provider are almost impossible to stipulate through rules, state regulations generally dwell uselessly, or obsessively on the material inputs that are easiest to measure. What good is the government regulation that reads (literally): "Infants and toddlers should be offered water at intervals"? What about "Infants shall not remain in cribs, baby beds or playpens all day"? It may or may not be useful to insist that every room in which day care is conducted have an 8-foot ceiling, and that there are covers on all the diaper pails. But none of those things have much to do with producing humane childhoods. A 1991 rand study of child care quality published in the Journal of Social Issues concludes that "the structural elements that are currently the focus of [child care] licensing are, in fact, largely irrelevant in terms of what parents demand." The same conclusion is spelled out in more popular language in the 1990 report Mothers Speak Out on Child Care. "Mothers do not believe that loving care can be created by legislative mandate, or bought with generous salaries and top-of-the-line play equipment," it reads. "When they demand 'quality care' they are not referring to adequate fire exits and teacher-to-child ratio." And there is another problem with proposed regulatory fixes for day care: More rules lead to higher expenses and fewer providers. William Gormley observes in a 1990 Brookings Institution study that because regulation will "decrease the supply and raise the costs" of care, it can "ironically, result in fewer regulated facilities." And what good is "better" care if it's unaffordable or unavailable? I've known several cases where warm-hearted people stopped providing care for neighbors because the paperwork became such a burden, because the windows in their playroom weren't as large as the specifications dictated, or for similar reasons. In a strictly regulated environment, the advantage goes to cookie-cutter chains and other mass providers. A few years ago, Maryland working mother Judy Kaplan Warner wrote me to describe how day care regulations can have perverse effects in this way. She included an article she had written for the Washington Post after her daughter's "grandmotherly" home day care provider was raided by a county inspector because she wasn't licensed. In it, Warner complained that "in the name of protecting children, the state law has thrown me back into the pool of anguished parents searching for good day care, while a superbly competent day care provider is forbidden to care for children." Warner argues that she and thousands of other parents who freely choose informal unlicensed care arrangements "believe we know better than anyone else -- the state, the county, the federal government -- what our children need to thrive." And surely she is right. Only parents can judge what qualities are essential for their sons and daughters. The effect of most government norms dictated in the name of "quality control" will simply be to drive informal caregivers out of business. Day care proponents have an almost blind faith in the ability of government to solve child care problems. One favorite tactic of American liberals is to point to Europe -- where they claim that excellent day care systems flourish because public will and public money have been applied. The truth, however, as I discovered when I did research in several European countries in the mid-1980s, is rather different. To begin, most of the European systems are not really day care structures but rather parts of a much larger apparatus of family allowances and tax breaks set up to encourage births and population growth in countries rapidly growing gray. The United States doesn't have a problem with too few births, and thus is not about to copy these programs. Particularly since these European "Family Policies" are incredibly costly -- setting up a U.S. equivalent to the French system, for instance, would cost around $300 billion. More to the point, European child care systems don't do what American promoters claim they do. In Europe, most day care is not excellent, it is mediocre -- just as day care is everywhere when practiced on a mass scale. More national effort and funding has been expended in France than anywhere else, and the average center for three-year-olds has one teacher and one half-time aide for every 22 children. Even if every teacher was unusually gifted, this would amount to mere custodialism. Three-year-olds are simply not built for herding in flocks. Belgium has a free government-run nursery school system for children aged three and over that is very similar to France's. It also has a network, like other European countries, for providing referrals and public subsidies to day care centers that cater to younger children. A typical Belgian center will be staffed by aides with the equivalent of a vocational high school diploma, and the average worker earns about $900 a month. The major source of day care workers is unemployed persons on the government dole, who are assigned to centers by state welfare agencies. On a normal day, a third of the teachers may be absent. "You understand the difference between theory and practice," explains the director of one Brussels child care center, acknowledging that morale among the country's hired caretakers is low. The really striking thing about European young-child care is not the quantity or quality of publicly-funded centers, but rather the clear preference of parents to take care of their own infants and toddlers at home. In the European Union as a whole, fewer than half of all mothers with children under 10 are currently employed. In the United States, half-again as many mothers of children in that age range are absent from the home. Fully seven out of ten infants and toddlers are raised in their own home in France. Even in Sweden, where tax rules and heavy social pressures make it extremely difficult for families to survive without two incomes, four out of every ten children age six or younger are cared for by a parent at home, and another two out of ten are looked after by a relative or neighbor. And if the Swedish public had its druthers there might be even less day care. A 1988 poll showed that 83 percent of all Swedes feel children should stay at home until age three. Even when European children do end up in non-parental care, public institutions are a distinct second choice. Of the Swedish children in subsidized day care, for instance, fully 40 percent are taken care of in family homes rather than centers. Even more popular among European parents are related caretakers. According to European Union figures, European children with employed mothers are more than twice as likely to be looked after by their grandmothers, for example, than are American children. The common claim that Europe is carpeted with day care institutions that are consistently wonderful and highly popular is simply not true. Europeans strongly prefer parental and family care to the alternatives. Most still provide such care to their own children. And the institutional care funded by the European governments tends to be mediocre and impersonal just like institutional care everywhere else. There is no easy way, public or private, to buy for individual children the kind of loving concern that has never been for sale.