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Choosing the right child care is one of the most fraught decisions modern parents face: Should one of us stay home and forgo a salary? Should we choose the government-stamped daycare or the family-run one around the corner? Can we afford a nanny?

Now, British parenting guru Penelope Leach steps into the breach with her recently published book, Child Care Today: Getting It Right for Everyone. But despite her reputation for offering comforting advice to freaked-out new parents, don't look to her for easy answers here. The revered psychologist puts all the options under a ruthless microscope and exposes many uncomfortable truths in her examination of care in Canada, the United States, Britain and Europe, including the fact that much of the child care parents pay for in North America is dismal. The Globe and Mail talked to Dr. Leach about her findings.

In North America we're so entrenched in debates on what's best: being a stay-at-home mother, using a nanny or using a daycare.

There are a lot of things wrong with that debate. One is that idea that the only alternative to poor child care is no child care. In other words, if you can't find child care that is absolutely perfect for your child then you ought to stay home. To me the debate is, if you can't find child care that you reckon is good for your child, how can we make it good? We're still looking backwards, with rose-tinted spectacles, back to the postwar years. An awful lot of people still believe, sometimes rather secretly, that in an ideal world mothers would stay home with their children until they went to school. I don't think we live in that world any more.

Two things make me angry.

One, for a parent, usually a mother, who positively wants to stay home, whether indefinitely or right now or for a bit longer, to have to go back to the workplace is disgraceful. Because it doesn't actually save society any money. And it doesn't actually save the couple any money, and the evidence is women do infinitely better in the business of balancing child care and home if they're able to do what feels right to them. The other thing that makes me cross is that we know quite a lot about what high-quality child care is for different children at different ages. And we don't do it because it costs money.

We know that a high ratio of adults to children is good for them. What else do we know?

It's not as if any old adult will do. By the time you're 2½ you can do with fewer people, but they have to be trained. It isn't as good by then just to have someone who is warm and cuddly and well-meaning. If you're going to be in a group, you need to be in a group that, if not run by a teacher, that's very closely supervised by a teacher. Being assigned to a key worker is crucial. Again, it isn't enough to just have a lot of adults looking after everybody. ... If you treat children like cans of baked beans, they'll feel they're cans of baked beans.

So, continuity is crucial?

The staff replacement rate in child care is 30, even 50, per cent, which means that a child will be lucky to have some key person even for a year in one room, let alone his (whole) time in a nursery. Why? These terribly important people who are so very vital to our children are paid less than a housekeeper, less than a gardener. It's crazy how contradictory we are in what we say matters and what we actually do.

So, how do we raise those standards?

We really need to fund it the way we fund every other kind of education. We couldn't get quality kindergarten if we said, 'Well, parents who want it will have to pay for it.' In the same way, group child care and early education needs to be at least partly funded by the taxpayer. And if North Americans are going to get on their high horses and say, 'Why should I pay for other people's children?' one has to look them in the eye and say, 'Why should other people's children fund your pension?'

We're talking about institutional child care more than we're talking family or home-based daycare, nannies.

I would very much like to see the quality of family daycare increased. Family child care is often a better solution for very young children. When it really works, it's almost an extended-family feeling. It's in the community. What worries me about formal child care is that the toys may be wonderful, the equipment will be wonderful, but many of those children will be in one big room all day. That doesn't seem a stimulating idea for a small human being who doesn't know about the seasons, who hasn't been out in the rain to meet the neighbourhood cat.

And nannies come out extremely well in all the studies. While they are monstrously expensive for one child, the minute you have two children and are looking at two daycare places, let alone three, it becomes very different. It works because it's home-based. It means that the environment they're in is one that the parents have chosen and set up. You're getting one-on-one care, probably more than you get from your mother. If you're a nanny you don't do much in the way of chores or local community work.

Normally speaking - I have to be careful because the U.K. does better than the U.S. on this - you've got to be trained or experienced. It's obviously not the same everywhere. But you can be a woman who crosses the border from Mexico and she can call herself a nanny.

You strongly suggest parents not just choose a daycare that's conveniently located on their commute.

I make such a song and dance about going to look at any daycare you may be considering. On one occasion, we turned up to a baby room that was supposed to have a ratio of one adult to three babies and a group size of six babies. There were six infants and no adults. It happened to be nap time, and it was true that four of the infants were sleeping. One was sucking its thumb and one was crying. But this was naptime and there was nothing more the adults felt they had to do.

A lot of parents are very afraid about upsetting the staff when they visit these places: They think staff might take it out on their child, or they might not save them a place. So when staff say, "It's very difficult for us to talk to parents during the day when the children are here, so please come at going-home time," we forget it's perfectly the opposite to go at going-home time, because what we want to see is what goes on during the day.

So, what is your advice for parents pondering their options right now?

It hugely depends on what you want as individuals, what your family set-up is. And a little bit what your child is like. I'd be wondering how much I could get my family and acquaintances to think of this baby as something that had to do with all of them. Grandparent care - and there's a huge amount of it - is a fantastically good start for infants. But some of it is more reluctant than people like to know. You're not going to damage even a very small baby by having him cared for eight hours a week in a centre. So I'd be looking at whether there were compromises I could strike - both parents going three-quarter time, for instance. And/or the possibility I could find one-on-one care of some kind at least for the first few months if I couldn't be home at the start.

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