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  • Instead of promoting universal day care, we should be advocating for paid maternity leave for mothers and primary caregivers to remain with their babies for the first year. Tweet This
  • In my practice, I see many parents who are struggling with their children’s emotional dysregulation after their child has been exposed to excessive amounts of stress in understaffed group-care situations. Tweet This

Most families view one stay-at-home parent as the ideal arrangement for raising children, and most parenting-age Americans would prefer direct cash assistance over subsidized day care, according to a recent national survey. Moreover, decades of psychological research and my own personal 30 years of experience as a psychotherapist confirm that institutionalized child care is a less-than-ideal option for very young children in their formative years of development. In spite of this, the recently passed American Rescue Plan lays the groundwork for a permanent prioritization of government-sponsored nonparental care over direct cash assistance for families. American Enterprise Institute scholar Katharine B. Stevens correctly asserts that the funds provided by this plan “are not targeted to either the providers or the families who are truly struggling, disproportionately benefit affluent families, and aim to create new, state-level entities focused on childcare providers, rather than families and children.” Indeed, the plan provides the child care industry with more money than ever before, but does not make it much easier for parents to stay at home to raise their children in the early years (despite some beneficial tax credit adjustments).

“Universal Child Care” plans, most recently popularized by Senator Elizabeth Warren in 2019, advocate for government-sponsored child care for children up to age five. Like the American Rescue Plan, these types of proposals subsidize the child care industry rather than new parents directly. Instead of making it easier for one parent to stay at home, these plans make it easier to go back to work quickly after childbirth, despite the fact that most parents do not want this and it is unhealthy for kids.    

Wouldn’t it be better to provide support that helps parents stay at home in the early years, since that’s what parents want and what children need?  

It is abundantly clear that day care is not an ideal environment for children ages zero to three. During these early years, children need a primary caregiver who is consistent, focused on their emotional needs, and able to both buffer them from stress and soothe their distress.  If children are forced to prematurely separate from their main source of emotional security, and placed into a relatively chaotic and over-stimulating day care environment, they will become stressed. Among other things, psychological stress is associated with elevated cortisol levels, attachment disorders, and other behavioral issues. 

There will be many unintended consequences to the long-term mental health of children if we forge forward on the path towards institutional child care without considering other options for governmental and private sector support.

In my practice, I see many parents who are struggling with their children’s emotional dysregulation after their child has been exposed to excessive amounts of stress in understaffed group-care situations with too many children and too few caregivers. Children who are separated from their parents before they have developed a deep feeling of emotional security will seek such care from indiscriminate strangers, which is not normal and often a sign of an attachment disorder. They may also show signs of fear or disinterest in their interactions with adults, and finally they may show signs of aggression. The fight or flight response is our instinctual evolutionary way of protecting ourselves in stressful and threatening situations. All of these responses are signs of stress in children.

If we are going to make day care a healthier option for families, then it must meet certain criteria. These conditions include a 1-to-1 ratio of caregiver to child in the first year so that surrogate caregiver may become an alternative attachment figure, and a ratio of no more than three children to one caregiver between the ages of 2 to 3 years of age. Consistency of care is also critical: the child should be cared by the same person everyday with no last-minute substitutions. Furthermore, the caregivers should be provided with training in how to best handle the attachment, separation, and emotional requirements for children’s development. 

Advocates for universal day care like to assure skeptics that everything will be fine because government sponsored child care options will be “high-quality” and meet these described standards. But such high standards are a longshot for government-funded programs. In Sweden, a nation with “high-quality” subsidized daycare, a group of 17 children under three can have only two adult supervisors for several hours. Their day care system is so overwhelming and overcrowded that caregivers are often stressed out and out sick, and children are juggled between different caregivers frequently. 

Instead of promoting universal day care, we should be advocating for other types of governmental support, such as real paid maternity leave for mothers and primary caregivers to remain with their children for the first year without the financial stress of having to leave their vulnerable children to go out to work. Another option is to provide families with a stipend for caregiving (provided through a caregiver or social security tax), which can be used to allow a mother to remain home for longer or to hire an extended family member, a single-surrogate caregiver, or even a shared caregiver with another family (sensitive and empathic babysitters are far better than group day care settings for children under age 3). A third option is to provide tax credits to businesses to offer part-time and flexible working schedules to parents who are the primary caregivers of their children so they may spend as much time as possible with them in the first three years.  

As Katharine Stevens laments: “There will be unintended consequences to children’s mental health if we implement universal childcare in this country and no one is really asking how this will affect the children.” Indeed, there will be many unintended consequences to the long-term mental health of children if we forge forward on the path towards institutional child care without considering other options for governmental and private sector support. Instead of asking how to get more women into the workforce as quickly as possible after giving birth, we should be considering how to keep mothers or primary caregivers with their babies longer to ensure the emotional well-being and mental health of our children for generations to come. 

Erica Komisar, LCSW is a psychoanalyst, parent guidance expert and author of Being There: Why Prioritizing Motherhood in the First Three Years Matters. Ms. Komisar is a Contributing Editor for The Institute for Family Studies.