Skip to Main Content


With more women seeking employment outside the home, about 11 million children under the age of 5 years spend a significant amount of time in nonparental childcare (NPCC) arrangements.1 Political, cultural, and economic factors contribute to the increasing number of children in NPCC settings in the United States. In 2006, 67 million women were employed and 75% worked full-time.2 Changes in family structure influenced the economic needs of households. Currently, about 70% of children live with two married parents. Children living in mother-only households increased steadily to 23% and in father-only households to 5% in 2006.3 Preschool-age children of working mothers spend an average of 36 hours in childcare each week.1


Primary care clinicians need to understand NPCC options available to families, current research on the effect of NPCC on child development and behavior, how to counsel families on choosing quality childcare within the family budget, and how to advocate for quality childcare on a local and national level.4


Over 70% of children 5 years and younger with employed parents are in nonparental childcare (NPCC) arrangements.5 The primary types of care include (1) center-based care, such as childcare centers, daycare centers, preschools, prekindergarten, and Head Start programs; (2) home-based care, such as that provided in a nonrelative’s home or care provided by a nanny or babysitter who comes to the child’s home; and (3) school-age care, such as before- and after-school programs. NPCC can be for-profit or nonprofit, faith-based or nondenominational, private or public6 (Table 97-1).

Table Graphic Jump Location
Table 97-1. Types of Nonparental Childcare7

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.