Daycare and the Prematurity Factor

August 20, 2014

Your preemie has been home from the NICU for some time now. You’ve watched your baby grow from a tiny preemie that could fit in the palm of your hand to a toddling one or two year old. You might have to consider daycare… or should it be a nanny? This is a big question that many parents will need to consider and might lose a bit of sleep over.

Daycare or Nanny?Your preemie has a story and may have a list of needs and a team of specialists routing for your child. This list of instructions and team is invisible to those who meet only the child and have yet to understand your child’s early start in life. Depending on the number and type of needs your child has you might experience some anxiety about putting someone else in control of the majority of your child’s day while you are at work. You’ll need to have an open and honest conversation with your partner or those who help your family and identify any wishes you have for the type of setting your child is put in during the day, identify any special needs your child may require throughout the day, and figure out what kind of setting will meet your child’s and your family’s needs best.

Our family went both routes for different reasons and periods of time. The following are some pros and cons for the options of daycare and hiring a nanny.


Pro: Many licenced daycares will often have 2 adults to about 8 children in a setting.  Having two or more adults making rotations through a daycare room can be a great benefit to children who require greater attention and support with navigating a classroom. For example, a child who is two, but has global developmental delay, may need a bit more instruction, information and guidance to get around the classroom to different play stations, circle time, and washrooms. They might need a bit more patience and guidance and many daycares have early childhood educators who are trained and understand how to manage differing needs of their charges. If a child is having a particular rough day and one daycare provider is having difficulty helping the child through it, then there is at least one other staff person available to provide additional support.

Con: Your young child may still be a bit more prone to catching viruses or illnesses and may be more likely to pick up things when in a larger group setting with other children and adults. If your child does get ill, you will likely not be able to send your child to the daycare for at least 24 hours after feeling better again.

Pro: If you choose to send your child to a daycare and your child is receiving therapy such as occupational therapy, speech therapy or others, then the service providers who help your child will likely be able to schedule times to go to the centre to meet with your child. This will take some of the pressure off your own schedule by not having to book time off work for each appointment; rather you can pick and choose which ones you will show up for. Many therapists will visit the centre, carry out their assessments or therapy and send the parent a quick written report about how the day’s interaction went. You will be able to meet your need of being at work, while at the same time your child’s developmental needs will be attended to by the therapist and everyone will be kept in the loop of your child’s progress. Plans can be discussed and implemented by the early childhood educators.


Pro: Having a nanny will mean you do not need to do a morning routine of packing up and dropping off your child at a daycare site. If you live in an area that experiences cold, snowy winters, skipping this step each day is a big pro. Coming from Canada, trust me when I say this is a huge sanity saver, especially in the winter! Your nanny can either come to you or live-in and you will know that your child is growing up and learning in the comfort of your own home. Your nanny and child can familiarize themselves with the parks, libraries and services in the area that meet the needs of a toddler.

Con: If you have a child with particular developmental needs, your nanny may not have the expertise to support or recognize such needs. To hire a nanny with specialized training means you will pay more out of pocket, which is not always feasible for a family. Most therapists will not be able to attend a home without a parent present, therefore it might be more challenging to obtain the therapy your child needs, unless you book appointments at the therapists’ office and take time off work to attend them.

Pro: Your child(ren) will likely develop a strong, trusting bond with the nanny you hire. A nanny will get to know your child very well and be able to provide a kind of comfort that a formal daycare provider may not be able to give. During times of illness (especially sudden onset), a nanny will be there to care for your child until you get home and likely continue to provide care through the illness; giving you a little more flexibility with your work responsibilities.

A final tip to deciding on a daycare option is to ask lots of questions of the people you are considering taking on the important job of caring for your child when you are away for the day. In order to be confident in your choice, provide scenarios and ask how they would respond to specific situations. Remember if you choose one option and it turns out not to work out as you hoped, you can always make some changes.