I've used live-out nannies, mostly found through newspaper ads. There are no agencies where I live. My experiences have not been good, but there are people on this board who have had good experiences. I have had nannies who neglected my children, left them in dangerous situations, and bad-mouthed me to my neighbors when they didn't agree with me. Based on my experiences, if any of my children were ever to use a nanny to care for my grandchildren, I would strongly recommend the use of a nanny-cam.

Then again, I have also had bad experiences with day-care homes. (sent my kid to one where they didn't change his diaper ALL DAY). The best experience I had was with a large commercial child-care center, though I wouldn't recommend those for little babies. When there are other adults around to keep an eye on each other, I think there would be fewer problems.

also the larger day care centers follow rules to a T usually so that they can remain open. we've had a decent experiecne with home day cares luckily but my concern is when we move for residency.
Regarding APs what about the cultural aspect? I feel like crossing cultural and even racial lines might be even tougher for everyone involved. what have your experiences been along those lines?

We considered the possibility of an au pair for a little while. My sister-in-law works for Au Pair Care, an organization that pairs up Au Pairs with families. Lots of families are happy with their au pairs, but we had reservations.

The cultural differences didn't bother us that much, as long as English was fluent and we could communicate. Our concerns were that most of these girls that au pair are very young, early 20s, and chances are we would end up parenting a young adult, in addition to our new infants. Some have childcare experience, but not all the same levels. In addition, often it is the 1st time they are living away from home and they are in a new country. (remember when you got to move away for college for the first time??) Leaving 2 helpless newborn infants at home with essentially a young student who might easily get distracted with other things didn't seem like the right thing to do. Not to mention, with the 45 hours limit they are allowed to work per week, that isn't nearly enough help we need.

so tsunami what did you end up doing?

We're going to have to hire a nanny.

We decided that daycare would not work for us. Most of them only open from 8am-6pm and charge PER MINUTE that you are late picking them up. Since I have to be at work by 8am, I would not be able to drop them off in the morning, and my DH has to be the one to pick them up in the afternoon, so he can't leave later. It would be hard with traffic for him to get to daycare by 6pm to pick up the kids. Unfortunately, the daycare center on campus is impossible to get into with over 700 people on the waiting list.

So we are going to hire a nanny, most likely a live-out. However, it ends up being pretty expensive. Going rate is $15/hr for an experienced nanny where I live, and for twin infants, the nannies I am interviewing want $18-20/hr. I need 50-55 hr/wk in order for me to go back to fellowship, so it ends up being about $1000/wk. The nanny placement agencies charge a lot (15% of the 1st year of the nannny's salary) so if you will paying your nanny $52000, then the placement charge you pay the agency is over $6000! In addition, they advise that the salary is what nannies expect to take home, so if you want to do everything legit and pay SS, taxes, and disabilty, you have to back-calculate from a higher salary so that the nanny does take say $1000/wk home! I never realized childcare was this expensive.

As you know, even as a fellow, you don't even earn as much as a nanny! So essentially, we'll be taking out a 2nd mortgage to pay the nanny until I graduate from fellowship and get a job. I'm trying to find a nanny who has experience with infants on my own so I can avoid paying the extra nanny agency fee.

A live-in nanny would be great since we wouldn't have to worry about rushing home and it costs less, and she could help at night. But as I mentioned, we live in a 2 bedroom condo. Some people suggested putting the 2 cribs in the hallway or in our room, but I don't think it will work with twins. Also, my husband is uneasy with having a non-family member living with us.

We live in an area where people don't use trained professional nannies. We found an older lady in our community who comes to "housekeep" for us. She has already raised two children, doesn't have the distraction of grandchildren yet, and is pretty efficient at managing things. She does light housework, makes supper, and of course watches our children (three, all schoolage now). All of this for only $10/hour - granted we live in a rural community.

I feel for some of you who are struggling with the high cost of childcare. It is FRUSTRATING that it is so hard to find good help, and so costly too! :weeping: I envy couples who have family members nearby and willing to help with childcare - such a blessing!

Oh, the nannies I am looking at aren't officially "professional trained". Because the demand is so high for household help/nannies, there are hundreds of agencies in our city that help with placement and referrals... for a fee. I've been told that Craigslist is also a good place to look for nannies, but its too early for me to look there because nannies who list there want to start immediately, whereas my babies won't be born until end of September.

I was told that I had too many requirements and that is why my nanny would have to be paid more. I don't think my "requirements" are unreasonable.

1. Doesn't need to be fluent, but must be able to speak enough English so that I can communicate with her.
2. must have previous childcare experience with infants.
3. must be legal immigrant.
4. must be able to work about 50 hours per week.
5. must have reliable transportation so that they can arrive on time everyday.
6. must have references in childcare.
7. must agree to background check.
8. I didn't require infant/child first aid certification because we were planning to send the nanny we hired to a class.

Tsunami- i would actually expect a lot more requirements so i don't think that yours are unreasonable at all. I would want a driving record too since i assume that she might have to take them to dr appts, etc.
also, did you check into home daycares? The one my baby is going to was referred to me by my son's pediatrician because she sent her children there.She is a stickler so my research hard already been done thank God.
and where do you live where daycares open at 8? the ones i have been involved with open at 6:30 and the one associated with the medical center opens at 6 and stays open until past 8, i think 8:30. the only place i have seen that opens at 8 was a montessori school. i ended up having to take my son out because of it.
I will be applying to residency programs this year and was looking at the university child care centers in my top 3 places (as of right now) one place costs $1210 per month!!! That's $302 per week. Plus i would have to pay for after school care for my son. I might as well have a nanny for that price.

Also some of the places i am looking at had childcare referral lists. It would take a lot of research into these places but is that an option for you?

The childcare referral person at the University where I am doing my fellowship wouldn't even give me the childcare referral list. She said that the chaos of getting ready for work, getting the twin infants dressed and packing up all the supplies and milk (I plan to pump for the first year) in the morning would make me a bad candidate for daycare. Plus, if the kids get sick, I am trapped because I am using all my maternity, vacation, and sick leave for the next year and a half while I'm out on bedrest and maternity leave. We have no back-up. I would have to bring the kids to work.

The daycare on campus is impossible to get into, unless you are a faculty member who has a competing offer from another university in writing. They close at 5pm. They don't take infants under 4 months of age. They do have the most reasonable price, at $1175/infant/month and it gets cheaper as get older. They tell me that if I'm patient, I might be able to get at least one of the twins into their program in 3-4 years, even though I got on the wait list once my home pregnancy test was positive.

I started looking into daycare centers in our community (within 5 miles of our home). There are some that open by 7:30 am, which would make me cut it close getting to work, but all of them want you to pick up the kids by 6pm. The price of daycare is pretty close to hiring a nanny... The places I called charge $1550-1750/infant/ month (that's $3100-3500/month for twins). One of the daycares said they would give me a whopping 5% discount on the 2nd twin. I suppose daycare is still an option, but I'm worried we won't get there in time to pick them up. The $5/minute late fine would end up costing more than just hiring a nanny. I can't tell you how many times I've been paged to come back while walking to the car or pulling out of the parking garage at work.