Choosing the right childcare for your family can be exciting and overwhelming. Whether you're expecting your first child or transitioning your toddler to a new childcare, understanding your options and knowing what to look for can make the process smoother.

Theresa Rapstine, RN, a nurse on Children’s Hospital Colorado’s school health team, offers expert tips on how to navigate the world of childcare, from selecting the right type of care to preparing for your baby’s first day.  Rapstine is also part of Healthy Child Care Colorado, a nonprofit public-private partnership that includes Children’s Colorado, state agencies and other nonprofits, where she provided technical assistance and trains nurses and physicians who work in childcare.

Rapstine’s biggest advice for parents? Start your childcare search early. Along with planning for your birth, decorating the nursery and stocking up on diapers, determining your childcare should be part of the process.

What are my childcare options?

Choosing the best childcare for your family is a deeply personal decision. In some families, one parent stays home or a different family member helps with childcare. Other families hire a nanny or an au pair — a care provider who lives in your home and cares for your  child throughout the day.

One of the most common options is licensed childcare. This can include a center or in-home childcare. Rapstine notes that licensed childcare centers come with the benefit of state oversight, which sets standards for safe and healthy environments for kids. They are regulated for safety, proper cleaning, sanitation and staff-to-child ratios. They also have vaccination requirements by the state. Other factors to consider include convenience, cost and the center's policies on medications, safe sleep, inclusion of children with special health needs and other health and safety topics.

How do I know if I’m picking a quality daycare?

Colorado Shines is the state’s quality rating and improvement system for all of Colorado's licensed early learning programs serving children birth to 5 years old. It is a valuable resource for parents looking for quality childcare options. Using this tool, you can search for the locations you are considering and explore their rating and any violations or safety concerns reported to the state.

Programs rated level 1 or 2 are in good standing with the state, whereas programs rated level 3 to 5 are considered high quality, meaning they’ve demonstrated advanced practices in health and safety, staff education and training, learning environment and other areas.

It’s always a good idea to see a facility for yourself, too, rather than just relying on ratings. Schedule a tour early for the places you are interested in and request the program to let you observe the rooms while kids are present.

What should I look for when visiting a daycare?

Childcare.gov is a U.S. government website that offers guidance for families picking childcare. Their tip sheet has a list of prompts and questions to ask when you tour a childcare facility. It follows a “look, listen, ask” structure to help you evaluate if that location might be a good fit for your family.

Look at things like the layout of the classroom: Can the teacher always see the children? Are there a variety of toys? Is the room organized and clean?

Listen for the tone of voice the teachers use with the children. Do you hear laughter and play?

Ask questions to help you gauge if their care aligns with what you are wanting for your family. How many children and adults are in each classroom? How does the program handle challenging behavior? What is the sick policy? What’s being served for lunch and snacks? How often do they play outside? And how do they share details of your child’s day with you?

Any licensed childcare program meets curriculum standards that encourage children’s physical, cognitive and social-emotional development. What shape that takes may vary though, so ask questions about their daily agenda.

“It’s helpful to watch the interactions between the teachers and the kids,” Rapstine says. “That’s likely how they will support your child. You want to look for things like tone and how they address conflict. Pay attention to how you feel when you leave that environment.”

Some places provide lunch and snacks for children, and others require you to bring your own food. If your child has allergies or a special need when it comes to food, it’s important to ask questions on your tour about safety measures.

“If you’re breastfeeding your child, do they have a place that is breastfeeding friendly?” Rapstine asks. “Do they have a place where you can come in to pump or breastfeed during the day that has some privacy.”

Childcares are also required to provide reasonable accommodations for children with medical needs per the American Disabilities Act, so you can discuss with them what might be appropriate for your child

What advice do you have for parents preparing for their child's first day of daycare?

Be gentle with yourself — this is a big transition! Transitions are hard for both children and parents. It can be helpful to do a trial run before the first day where you wake up early and practice getting yourself and your baby ready and out the door in time. If possible, you could stagger your transition dates with your baby starting a week before your return to work. Another option is gradually easing into full-time childcare by starting with shorter days, then working up to full days.

How can parents support their child during transitions?

Visit your childcare provider before your baby starts and see if they will let you spend some time with your baby in their new room or chatting with the teachers to help your child get familiar. If your child is older, talk to them about this transition and new routine, and involve them in the preparation process. For example, you could start to pack their lunch at home in their lunchbox, so they are familiar with it when childcare starts.

When children move up rooms at their childcare facility, this is also a time of change and transition that can be difficult for some kids and parents. Ask your facility if they let children spend time in the next classroom to get familiar with it before they officially move up.

Are there resources available for parents struggling to find care for children with medical needs?

If your child has specific medical needs, childcare centers are required to provide reasonable accommodations and have necessary support in place. If you are in Colorado, you can call 311 for assistance with placement and questions you may have.