"In Spring 1997, 12.4 million (63 percent) of the 19.6 million children under 5 years of age were in some form of regular child care arrangement during a typical week.

...About one-fifth of preschoolers were cared for in organized facilities, with day care centers (12 percent) being more commonly used than nursery schools or preschools (6 percent). Overall, other nonrelatives provided home-based care to17 percent of preschoolers, with 7 percent being cared for by family day care providers.

...Organized child care facilities also were important sources of child care arrangements for employed mothers with preschool-age children.  Employed mothers relied on day care centers (19 percent) more than nursery or preschools (7 percent) or Head Start programs or school (4 percent)."

(Source: Kristin Smith, "Who's Minding the Kids? Child Care Arrangements: Spring 1997, Household Economic Studies," Current Population Reports, P70-86, United States Census Bureau, July 2002, p. 2-3; http://www.census.gov/prod/2002pubs/p70-86.pdf.) 

"In a devastating new book, Day Care Deception, Brian C. Robertson marshals the overwhelming evidence about the risks of day care and explains why much of academia and the media try to cover it up. Any negative information about the effects of day care is considered out of bounds because it will upset one of liberalism's most sainted groups: working mothers, whom feminists adore as the vanguard of their assault on the "patriarchy."

The drum roll of day care's negative effects on kids includes higher rates of illness, including acute respiratory illness, ear infections and diarrhea; insecure attachment to their mothers; more aggressive behavior; and in the case of children of well-educated mothers placed in poor-quality care, slowed cognitive development.

Burton White, former director of the Harvard Preschool Project, writes, '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, especially a center-based program.'"

(Source: Rich Lowry, "Day Care Deception: Stay-at-home moms are undervalued," New Republic Online, August 12, 2003; http://www.nationalreview.com/lowry/lowry081203.asp.)

American pediatricians well understand that the day care center makes their job much harder by spreading various diseases among young children and by incubating tougher antibiotic-resistant germs as the carriers of those diseases. They also well understand that despite these very real medical problems, American mothers are not likely to reduce their reliance on day care as a surrogate parent any time soon.

To see both pediatricians' deep concern about how day care spreads disease and their pessimistic resignation to a future dominated by day care, readers need only turn to a recent special issue of Pediatric Annals devoted to acute otitis media (AOM), an ear infection that has become alarmingly common among young children in the day-care era.

In one of the feature articles, Stan L. Block, professor of pediatrics at the University of Louisville, points out that "rates of AOM in younger children have nearly doubled since the 1970s; AOM thus accounts for nearly 25 million antibiotic prescriptions annually." The problem with such a high number of antibiotic prescriptions, Block worries, is that it "exacerbates the growing rates of antibiotic-resistant bacterial strains." Indeed, in a complementary article, Elizabeth D. Barnett of the Boston Medical Center reports that a growing number of strains of Streptococcus pneumoniae - the bacteria most commonly identified as the cause of AOM - have grown resistant to penicillin and other antibiotics: "The proportion of [Streptococcus pneumoniae] isolates that are nonsusceptible to penicillin...has been increasing steadily worldwide in the last 2 decades. ...[B]y the late 1990s up to 50% of isolates in some regions were no longer susceptible to penicillin."

This special issue of Pediatric Annals naturally surveys new strategies for diagnosing and treating AOM. However, Jerome O. Klein-the guest editor-predicts that "during the next few years, otitis media will continue to be a major complication of respiratory infections of children." This almost fatalistic prediction reflects, in large part, Klein's assessment of how day care spreads - and will continue to spread - AOM. "Attendance in group child daycare," Klein stresses, "is one of the most important risk factors for otitis media," adding that "the number of American children who receive some form of daycare is large." "The more children in the daycare group," Klein reasons, "the more exposure to respiratory pathogens and the higher the rate of respiratory tract infections, including otitis media." Unfortunately, Klein sees little likelihood of any social change that will soon break the links in this pathogenic chain: "There is," he writes, "no reason to believe that daycare attendance will diminish in the near future." "Use of group day care," he even ventures, "is unlikely to change in spite of [any] family leave initiative."

(Sources: Stan L. Block, "Therapeutic Nihilists: Lend Me Your Ears, or the Witches Cauldron of Acute Otitis Media," Pediatric Annals 31(2002): 784-791; Elizabeth D. Barnett, "Antibiotic Resistance and Choice of Antimicrobial Agents for Acute Otitis Media," Pediatric Annals 31(2002): 794-799; Jerome O. Klein, "What's New in the Diagnosis and Management of Otitis Media?" and "Changes in Management of Otitis Media: 2003 and Beyond," Pediatric Annals 31(2002): 777-778 and 824-826.)