Hi Ladies. I thought I'd try starting a thread dedicated to sharing experiences and advice about hiring and having nannies/aupairs for our children. I don't know how many of you have one, but it seems like the questions pop up pretty regularly.

We are applying to host an Au Pair for the next year, starting in August. For those who aren't familiar with the term, this is a young woman from overseas who becomes a live-in nanny and sort of cultural exchange student in your home for a year. You pay a small weekly stipend and provide room and board. She takes care of the kids and their needs (food, laundry) for up to 45 hrs/week. The cost for a year is about $14,000 total. (that includes program fees, stipend and such) It's not cheap, but for someone like me with 3 kids, it's really a bargain, especially when you consider that most nannies these days charge over $12/hr!

I'd love for everyone to share their experiences, ask questions, and give advice. :scratchchin: Childcare is a major issue for us MomMDs!

Are Au Pairs in the states really allowed to work 45 hours per week? I live in Switzerland and au pairs here are only allowed to work a maximum of 30 hours per week plus you have to pay for their language classes (this is the student part of their exchange). We haven't gotten an au pair because we are English speaking at home and we can only get an au pair permit if we are german speaking at home (so that they can learn the language from us). But I have lots of friends with au pairs, mostly from Central/Eastern Europe and most of their experiences have been good. One bad thing can be is they change every year and you and your kids have to get used to a new person. And sometimes it is like having another child (a teenager) in the house, which can almost make more work for you. I don't know how much au pair experiences in Europe compare to the states though. Good luck in your search.

Thanks.

I think the role of au pair is a bit different here in the US. They can work up to 45 hrs/week. We do pay up to $500 tuition for classes because they have to take 6 credit hours during the year that they are here. It's more of a nanny who gets to live in another country and take a couple of classes than the way it sounds like it's set up where you are.

There's a program called Educare here that is new. It's a 30hr/week working and 12 hrs of credits program. More education, less nanny.

Hi Texas Rose!

We just have one child -- 2yo daughter -- and for the most part we've gone through craigslist to find childcare. The first year was marked by a live-in part-time nanny who was a bit of a disaster (great for our daughter, lousy for us, made us feel like strangers in our own home!)...

The past year we've been sharing a nanny full time with another family, so that the two kids are together with a great nanny 50 hrs/wk. We're trying to find another family in our area to continue this arrangement through next year, and it's nerve-wracking that we haven't found anyone yet, as our current arrangement ends July 6... When I go into 3rd year, our daughter will be 3+, so it will be a good time to start something school-like and to get an au pair...

We also rent a room to a wonderful woman with reduced rent in exchange for ~5 hr/wk childcare to cover those weird hours that come up w/ med school and a husband who travles. She's a medical translator who is also on a med school trajectory.

So, there are many ways to do this...to find loving, energetic childcare...

Jen, sorry I didn't see your post sooner! I like the creative problem solving you've done with your childcare. Flexibility is such a great trait in parenthood.

Well, it's official. We've matched with an Au Pair who is coming to our home on Saturday! She's already in the country and had to find a new host family because of a problem with her previous host situation. (not her fault. They couldn't pay her. )

I'm excited that she's coming, and she sounds great, but at the same time I cannot believe that we just invited a complete stranger to come live with us! :scratchchin: She's 24 and from France. She has good childcare experience and references, so from here we just have to trust that this will work out. Once again, I think flexibility is key.

The great news about this, though, is that I no longer have to fret about who is going to pick my daughter up after her drama club meeting at school. I don't have to worry about getting the kids dinner on a late study night when my husband is out of town. And, I don't have to flip out if one of his trips falls over a call night for me when I start rotations in 6 months. What a weight off my mind!

Anyone who wants to know how it's going can check in with my weblog or PM me, btw.

Hey! We have hired a family member to live with us to work as a nanny. Our daughter will be in Kindergarten and the nanny will also be taking college classes.

Does anyone have any suggestions about software programs for doing payroll for the 'nanny tax' for her?

Thanks! Kim

just wondering-do you pay ur nanny for a holiday (like the 4th of july) when she does not come to work? what is the norm?
good luck with the au pair TexasRose

Our au pair arrived this afternoon. So far so good! She must be so overwhelmed at this point. The kids were a little intimidated by her accent and her height at first. (she's like 5'11. I'm only 5'2!) But everyone seems to be settling down. She's very down to earth and because she's 24, very mature. I think this is going to work well.

Kim,

You probably don't need a software program tohelp you do your nanny taxes. It seems complicated but, it really is quite simple. I didn't know anything either about how to do taxes properly but I learned. It probably took me 1-2 hours to figure it out. I live in California and went online for our state's Employee Development Department (EDD). They have all the info there. I spoke to a live person at the end to confirm I got it right. You can do the same in your state.

Basically, I had to download a form to get assigned an EIN (employer identification number). I also needed my nanny's full name, address and social security number. That's it!
On each weekly paycheck, I withheld 7.5% of her salary (social security) and 0.7% (I'd have to confirm this number) for her contribution to SDI (state disability insurance). Because she earned less than 20,000 annually, I was not required to withhold or submit any additional taxes, nor did I have to send payment monthly. I was able to do it on my regular tax form due April 15th. My nanny elected to do her taxes on her own.

In terms of 'forms' I did not use anything official. Just a plain piece of paper with my family's last name as a header. I did the same for her "W-2" form given at the end of the year. It worked fine for us.

Hope you find this useful.

TexasRose, any news? We don't have kids yet, but when we do we will most likely have an au pair. I'd love to hear about your experience. Interestingly enough... my husband and I were both au pairs - He was in France for two years (he's English) as an au pair. I was just an au pair for a summer job in France. I'll have to ask him about how much he worked... I was pretty much 24/7, but my job was short term. good luck - hope everything is going well

Things are going pretty well. It's been a whirlwind adjustment for the au pair because we took her with us on our family trip to CO the week after she started. (by car!)

It's amazing how much easier it is to run errands and get things done now that she's here. Last week I spent 4-5 hours with each of my kids individually, doing something they wanted to do. (unfortunately that meant seeing Shark Boy twice!) They were all glad to have some "mommy & me" time.

The au pair situation takes some getting used to because it does mean that there is now another person in our household that we need to consider when making plans, or just making dinner. I think that will get easier with time.

I'm glad she came while I'm on vacation so that we have time to iron out all the wrinkles. (like what sort of discipline we use, what to feed the kids, etc.) I will say that my daughter, also the oldest, is having the hardest time adjusting. She wants the au pair to do everything exactly the way I do it and that's just not feasible. Everyone is different. By the end of the week, though, she was settling down as well.

I hope things work as smoothly once my classes start up again on Aug 1. I'm looking forward to being able to concentrate more on school this semester and spending less time worrying about the crazy daycare and all the little household things. (our au pair straightens up the kitchen and makes snacks & meals for the kids!)

Oh, and au pairs work about 45 hrs/week.

So I'll share with y'all some things I've learned about nannies/APs.

For those who don't know, we let our au pair go at the end of July. What seemed like small personality issues that I kept glossing over became major issues the last week of July. In retrospect, what I excused as natural homesickness and unhappiness with all the changes in her life turned out to be an AP who wasn't happy with anything (including the food I made!), didn't sleep at night, and made the rest of the family miserable. My kids were not sorry to see her go!

So, like I've been told many times by other moms, sometimes you have to try out several people before you find the right one! the AP has since found another family to work for and we have found another AP. She won't be here until mid-September, but we have the daycare as backup until then.

What I learned:
-Interview lots of people, even if you think the first or second one is wonderful!
-Trust your gut instinct about people.
-Let your kids be a barometer. If they aren't adjusting to her, maybe it's her and not your kids that are the problem.
-Set your expectations clearly at the beginning and try not to make exceptions too early in the relationship. Otherwise, asking for exceptions becomes the norm. This happened to us!

I still feel strongly that having someone in our home will be much better for the kids, so I'm willing to give it another try. This will be our 3rd babysitter in the last year, but I hear that's pretty normal in the beginning. Fortunately the kids are older and not upset about it. We're learning as we go!

The new AP is from Brazil and I love her enthusiasm and her appreciation of the importance of our kids to us. I'm keeping my fingers crossed!

Hey
I use to be a au pair/nanny and my only advice is to make sure the nanny is fun and open. You don't want a dull nanny around you and your children. So go outside of your "ideal" nanny and get a person with spunk.
As you see I was a spunk filled nanny :laughing:

All I have to say on this subject, with years of child care issues all behind me now, is if you are having an in-home caregiver with small children, GET A NANNY-CAM. I really really REALLY wish I had had access to that technology when my kids were little. I still feel guilty about some of the stuff that went on, that I didn't find out about til later, and I feel lucky that nothing worse happened, knowing now what could have. When my children start having kids, I will provide the nanny-cam myself if they can't afford one.

Our new AP arrived this evening. I've been trading emails with her on a daily basis since we selected each other last month. The kids have responded really well to her already. She even brought gifts for everyone that were specific for their hobbies or personalities. So sweet!

With any luck, this is finally the solution to the childcare drama in our lives. :crossfingers:

We are in the process of transitioning au pairs right now. We have had a wonderful, loving, fun, energetic Mexican au pair with us for the last year. She and my son LOVE one another and I have no worries when I am at work, or if my husbands travel happens to fall on a call night. I would offer the following advice, that I have learned over the last year:
Don't become TOO personally involved. As tough as that sounds secondary to the fact that they are caring for your child. We went way above and beyond for our AP, paying her more money, bending our curfew rules, taking her to the Caribbean...all because we really liked her and wanted her to do an extension year. WHich she initally agreed to then backed out of. Try to maintain some professionalism and a business sense about it.
We have a new Mexican AP coming next month, and I'm just hoping she'll be as good, and that I can follow my own advice.

Thx, ams, for sharing your advice. I'm glad you had such a positive experience. Our aupair is settling in pretty well so far. I'm also doing my best to maintain a more professional relationship. It's a tough balance because I want her to feel happy and welcome, but at the same time I need her to respect me as an employer. Tricky stuff.

Happily, she is so much better than the first gal we had. My plan is to stick hard and fast to the rules and schedules we planned so that the right expectations are set. I believe part of my mistake with the first gal was that we immediately took her with us on a vacation and tried to accomodate every single thing she asked for. (even when it wasn't best for us)

Good luck with your new AP and please share any other gems of wisdom!

ps- our AP can cook and likes to!

Just wanted to update.

Our AP is a gift from heaven! She's much more laid back and quiet than our family tends to be, so she really provides a nice balance to all the energy and intensity we have going on around here. She cooks for the kids, makes healthy snacks everyday, helps them with their homework and just generally provides a wonderful positive energy to our home. I really couldn't be any more pleased. :goodvibes:

I have a question for all of you have have used or currently use a nanny. To give you some information about my situation, I am 22 years old with a college degree, and 3 years previous nannying experience. I am married and am currently a live out nanny for two children, ages 6 and 8. I work between 40 and 55 hours a week. Aside from the usual nanny responsibilities I also am responsible for homeschooling both children. I do all lesson planning and educating of both children. My question is about my salary. I make $380/week and I feel this is unfair. In my previous jobs, I was paid hourly, and never made less than $10/hr, yet I never had the responsibilities I have in this job.
Do you think it is unreasonable for me to ask for a raise and what would you say is a fair salary? Thank you for taking the time to read this!

I have a question for those with Nannies/APs. How do you handle it when your Nanny tells you she's having a problem with the kids and brings up the fact that she can leave your family if it doesn't work out?

The problem is, she's very very quiet and my kids have been very very loud lately. They're not listening well to her and my daughter has been yelling at her brothers an awful lot lately. I understand the APs concerns and wish to have a more peaceful interaction with the kids, but I also feel a little threatened by the reminder that she can just up and leave me stranded.

I've had several conversations with my kids (school age) and I think we can work this out pretty easily. It helps that my husband's recent travel is now finished and my last final exam is in a week. It's just that this conversation makes me feel uncomfortable and vulnerable when it comes to our childcare. I've had such a tough time finding good childcare and this young woman is wonderful. I don't want to lose her, and I don't want to feel threatened abou it either!

In her defense, she put it in a very positive way "I love your family and you all are so good to me, I just can't imagine staying here another 9 months with this situation with the kids." She did NOT say "change things or I'll leave."

Any thoughts?

Get the noise level down. Lots of one-on-one with Mom and dad now that travel/finals are over, and use the 1-2-3 Magic method of discipline. The noise level in our house decreased TREMENDOUSLY when we started using it. Until your kids are old enough to fend for themselves, you're at the mercy of the nanny, so whatever Nanny wants (within reason) Nanny gets.

Unfortunately, I think that's it. We are at the mercy of the au pair, essentially, because we don't want to put ourselves and our children through another change without any guarantee the next one will work. I am having a situation with my mexican au pair who keeps asking me to pay her more money. For example, yesterday her hours were 7-6. Tonight I'm on call and my husband has a work xmas party, so he'll be late. I am aware she is working outside of the 10 hour a day rule, but overall for the week she is still working less than 45 hours! My son goes to school two AMs a week and still naps 2 hours a day...But she thinks I should pay her more. This battle has been going on since day #2 with her. The problem is that the next door neighbors have a live out, older woman with her own car, expenses etc. and she gets paid $600/week. Any suggestions on how to come to a resolution? I don't want her to leave (she hasn't said she wants to), but then again I can't be counting minutes and stressing about this every day!

I'm sorry to hear that you've been having money problems with your au pair. Having the live out nanny next door is definitely making it harder. I don't know how exactly you can say this to her without upsetting her, but you all signed a contract for the pay that she gets. It might help to point out that she eats and lives for free, thanks to you. The nanny next door pays her own rent and buys her own groceries.

Fortunately our kids are settling back down and our AP seems very happy again. She never said another word about leaving, thank goodness.

Did you hear about the AP in Colorado who was killed by her ex-boyfriend (another AP)? Our AP just told us about this tonight. Terrible.

Just wanted to bring this topic back up again since I've seen people mentioning au pairs on other threads.

We've been so pleased with our au pair this year that we have just matched with another one who will start the week before our current AP finished at the end of August. We hope the overlap will help the new AP adjust and get familiar with everything. I will be in the middle of my Internal Med rotation when the next AP arrives, so I won't be as available to help out.

I even made a sort of unusual decision (along with my hubby) and chose a guy for our next AP. My reasons being that my kids are older and more in need of a "camp counselor" type and someone who is comfortable being an authority figure with older kids. The kids want to run around and play soccer and computer games, etc. So many of the young women we interview are more interested in young kids and doing things like reading stories and doing craft projects. So, we'll see how it works! The nice thing about our agency, aupair care, is that if it doesn't work out we can find a different au pair.

re: au pairs and live-in nannies

Hi all! Just want your input. I am going to be a 1st time mom in October. Is it required that au pairs and live-in nannies have their own rooms? I am in fellowship right now, and we live in a 2 BR condo. I'm expecting twins in October.

I have started looking into live-out nannies, and they are asking about $1000 a week to care for twin infants 55 hours/wk. (This is more than my fellow's salary) Going rate for nannies in my area is $15/hr for 1 child, so because I will have twin infants, its more work and they want to be paid more. In any case, I need to finish my training. my mother and my MIL (both who don't live nearby) feel that since I will be going back to fellowship soon after the babies are born, I will probably need help at night too. A live-in would be ideal, but we don't have an extra bedroom, and we can't really afford to buy another home right now, especially since my OB put me on bedrest at 21 wks and I have to be on UNPAID leave until I deliver.

I suppose an au pair would not work for me because we need more than 45 hours a week. I can't really say, "OK, I can't admit this patient right now. gotta go relieve my au pair" especially when I am in charge of the inpatient service.

My husband has made it clear that since he works full-time during the day, he needs his rest at night so that he can function at work, so he will not be helping. Can I take care of 2 newborns through the night and then work my normal 12 hr days and take call every 4th night? I cannot ask to cut down on my schedule because everyone takes turns covering the same service and they are already doing a favor by arranging my schedule so that I can take the time off for bedrest and maternity leave.

When do babies start sleeping through the night?

For those of you who had kids during your medical training, how did you finance childcare for your children when the nanny gets paid a significant amount more than your resident/fellow's salary? I suppose having 1 would have been easier because then, I could have just sent the 1 kid to daycare and hire a part-time nanny to pick up and watch kid until I get home. I only have another year to go once I get back to the training program from bed rest and maternity leave.

I suppose I can moonlight, but then I would never see my babies. I never thought 12 years ago that my decision to go to med school would make life so complicated. Even 7 years after graduating from medical school, I'm still in training earning peanuts to work long hours, and I can't find anyone to look after my children for more than 40 hr/wk without paying them more than I actually make.

How do people do it? I know as housestaff, we don't get paid much, but there are plenty of people in this country who earn less. How do they go to work and still have childcare? I suppose most people also don't have medical school loans that are as much as their mortgage.

Most people also do not work the insane hours that physicians do, nor do they have q4d call.

On sleeping through the night...

My 7 month old has been sleeping through the night from day one. I have a busy schedule and the additional child really has not added much more chaos to my life. I'm away 6am - 6pm most days, longer some days for the summer (which is usually 6am - 10pm during the year) and I'm managing well.

However my 2 1/2 year old has just recently developed a rountine of sleeping through the night. Her first year I literary thought I would die of sleep depervation. :banghead: The first 2 months of her life she NEVER sleep more than 2 hours at a time, and neither did I.

If you are lucky enough that BOTH twins sleep through the night from the start, and neither have any health problems (horrible reflux, resp. problems, etc.) 12 hours day shifts may not be too hard. But the chances of that? I would plan for all the help you can get. Parenthood is a HUGE adjustment. Plus, post-partum depression alone could wear you down. You can always plan for lots of help, and then adjust the hours later. You will also want time with them. If you CAN afford it, there will probably be days that you will feel that your entire salary is worth 6 hours of sleep.

Congrats and good luck!

Hello????!!! How is it any different for you? Why would YOU have to take care of them at night by yourself and then go to work? If you weren't going back to work, that would be a little different (maybe), but if you're working as well, he needs to participate in the nighttime duty equally. You are not going to be able to care for TWO newborns by yourself at night while working 12 hours in the day.

Rare are the babies who sleep through the night from day one. Very rare. You REALLY shouldn't count on it. If you get both babies to sleep through within 2-3 months, you should consider yourself very lucky. My son woke up every 2 hours for the first 2 months of his life, and then he would nurse for 40-45 minutes. So I only slept for 1h15mn at a time. I was exhausted, and that was with only one baby and I wasn't working.

I think you need to have a serious conversation with your husband... I don't think he realizes the amount of work caring for newborns will be. Can you have family come to help you for the first few months?

Wow, you've really got a problem there. Some random thoughts:

When do babies sleep through the night? About half of them by 6 weeks of age, and most by 4 months. I was lucky (or maybe it's genetic--mom said we all slept through by 6 weeks). Mine all slept through by 6 weeks, but since twins are often born early, all bets are off. If at all possible, make sure you take at least 6 weeks of maternity leave postpartum. It's quite likely the babies will be born by c-section, and either way you will NOT feel ready to work long hours any earlier than that. See if you can get a relative (mother, MIL, or ANYONE) to come and stay after the birth for at least awhile.

Bedroom space: To begin with, babies do not need their own room. My parents raised 7 of us in a 3-bedroom house. The most recent baby slept in a corner of the hallway, behind a tri-fold screen. If your room is big enough, you could put them in a corner of your room. (My parents' room was barely big enough for a dresser and a bed.) That would free up a room for a live-in. Can you find a student who wants free room and board in exchange for being home on the nights you are on call? That's what we did when my husband took a job out of town that was supposed to last 6 weeks and lasted 18 months instead.

Husbands: I don't know your husband and I don't mean to be critical, but I think he's being unreasonable to say that he needs his sleep at night because he has to work the next day. When you go back to your fellowship, you will be working during the day AND night. What does your husband think about your need for sleep then? Twins require a LOT of time from BOTH parents.

Good luck to you. I know it all seems impossible from where you are right now (bored and bedrested with nothing to do with your time except worry), but it WILL work out somehow.

I could not agree more with the previous poster about the bedrooms. Both of my kids are still in our bedroom, and our bed to be exact. We put the crib in our room, b/c even if my 7 month old did sleep in the crib instead of our bed I would still want him in the room with us. Otherwise I would be getting out of bed every hour to check on him. I can't speak for twins, but it was so nice to be able to have my infants in the bed with me, and to nurse and fall right back to sleep. There rooms are nothing more than decoration. In retro I would much rather have 4 people in my room and have help then to have a cute nursery.

you guys are talking alot about APs and I like the price more than US nannies but i would like to hear about live out nannies also. i don't think that we want anyone livinig with us. If you've had a live out nanny did you use a nanny service? What have your experiences been with live out nannies?

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.

My two cents:

It is worth whatever money you have to borrow for peace of mind that your children are safe and happy while you are at work.

The place we had our daughter at this year was...ok. Not great and we had all kinds of little fights with them. It was draining and frustrating (and we found a new spot for next year).

Also, if your husband can't/won't help at night - then, I think you better prepare to hire someone to live with you, or a night nurse or something. people mean very different things when they say "sleeping through the night". Is that 6 hours? 8 hours? and usually whenever the baby(ies) get sick, are teething, etc...not usually sleeping the night those nights. And Murphy's law says, it will never be the same nights as each other.

if you had someone who could live-in (like a student, the room and board idea from before) and help out at night - perhaps they could drop/pickup at daycare for a little extra money, or you could hire another student part-time to at least pick up - there are lots of options.

however, in terms of peace of mind and stability, (especially with limited family support) you might need to pay for some more expensive option.

off the top of my head example: if you had an au pair who could pick up the kids from daycare, make dinner and help out overnight, get the kids to daycare and then have days free, that would be under the 45hr rule. but, you would need daycare for the daytime hours.

I was just thinking about that. Daycare + babysitter/nanny/au-pair for the evenings. I don't know if it would be cheaper for you, and it may be more complicated logistically

But 50 hours a week with twin infants makes for long long days, no matter how much you pay the nanny. Some evenings, I'm watching the clock to see how much longer before my DH is home to relieve me. That's with only one child, who's MINE! You may get better care for your children if you split the task... maybe? :twocents:

Good luck to you. You'll get through it, no matter what!

Baby nurses: Did anyone use a baby nurse after you had your babies? Was it helpful? My friend suggested it to me because I'm having twins, and will be recovering from 4 months of bedrest and c-section after we bring the babies home. We don't have family near-by, and my DH managed to go on so many vacations by himself this year that he has saved only 1 wk of vacation for after the boys are born, so I'll be home alone with the babies right from the start. How long does it take to recover from a c-section? Will being on bedrest for over 4 months really make me that deconditioned? Calling around, the going rate is $2000/week for a baby nurse. Is it worth it?

Back to your question about combining daycare and nanny at night: Actually sending the twins to daycare during the day and then hiring someone for the night would end up being way more expensive, since daycare will cost almost the same as having a nanny for the day, and then we would still have to pay the night person. Also, the risk with daycare is that if either baby gets sick, I have no backup daycare. I also can't take any more time off work because I'm using up all my leave for the pregancy and the bedrest for the remainder of my fellowship.

tsunami- some programs allow you to take off time and then add it to the end of the fellowship thus extending the fellowship by that amount. would that be an option here?

I guess I didn't figure it would be cheaper to get more help - just that you might actually need more help.

Remember a C-section is surgery. You will need recovery time.

Thinking happy thoughts in your direction!

tsunami, I was pretty deconditioned after 4.5 months of bedrest. My legs got really skinny and I got short of breath and tired after climbing one flight of stairs. It is hard to know how much of the SOB and fatigue was due to the term pregnancy, though. After I went off bedrest at 37 weeks, I made an effort to get out and about every day, and my symptoms did seem to lessen during the two weeks prior to delivery.

My husband took 1 day off from work after the baby was born, BTW.

Thanks for everyone's replies. I guess I don't really know how much help I am going to need. Being a parent for the first time and having twins is really scaring me. I don't know the first thing about babies. Even during peds rotation in med school, they wouldn't really let any of the med students examine or get near the infants.

I would like more help, but in reality, we can't afford it. The 2nd mortgage we are taking would cover the salary for one daytime nanny since I am unpaid these 6 months I am out. As for a baby nurse, that sounds really nice, but DH and I talked about it, and unless we can pay the baby nurse with credit card, we can't do it. We're just trying to cut everything down to the necessities...

I'm not complaining that DH only has 1 wk off for the delivery and after the babies are born. I'm kind of ticked off that he gets 4 wks of vacation and he's used it all up. Even after we found out we were having twins, he has gone on surfing vacations for 1 wk at a time, alone or with one other surf buddy. In fact, he's gone surfing this week while I'm at home on bedrest.

BERKLEYITE - I am already taking off extra time from fellowship that I need to make up at the end. My original finish date was June 2007, but I'm going to have to make up 6 months at the end of fellowship due to all the time on bedrest and 8 wks off after the babies are born. It doesn't seem like enough time. It's not a problem with the fellowship program as long as I am back for my inpatient service Mar, Apr, May, & Jun, but because I have to make up 6 months through Dec 2007, I will miss the deadline for both my subspecialty boards.

Ok - I don't even know what to say about your husband taking surfing vacations while you're pregnant... I nearly screamed at the computer.

tsunami, what is your subspecialty? I don't think it would be a problem to get hired somewhere as a "board-eligible" doc when you finish your fellowship, until your next boards date comes up.
I'm mad at your hubby for going surfing and leaving you alone on bedrest, esp. if money is tight.
And what kind of med school teaches peds without letting students examine the kids? That's just nuts. I'll have to remember to tell my students how lucky they are the next time I teach newborn exams.

My husband went on a skiing vacation when I was 36 weeks pregnant and on bedrest. I think they know that after delivery, it will be a long time before they have that kind of freedom again. :rolleyes: But it's no fun to be alone and on bedrest...and in your case, the finances make it that much worse. I hope he realizes that since he is essentially vetoing the baby nurse, he will have to be up some nights helping with the babies.

I think all MomMDs are FURIOUS at your husband right now. I can't believe it. I don't mean to be critical (well, maybe I do), but does he realize how much work two newborns will be?

I already would be mad because he refuses to get up at night to help you, but this is just too much. I'm all about letting go of small things, but this would cause a HUGE fight in my house.

Good luck to you, sweetie. We all know you'll make it. It'll be hard, but you'll get through it. Soon, you'll be thinking the exhaustion, worries, financial troubles, etc. are a small price to pay for your two little wonders.

:grouphug:

Tsunami- just wondering but is your husband from a culture or even family that sees women as subordinate? what gives?

No, I don't think its his culture. He's American, going back 15 generations. He comes from a physician family, so I thought he would understand.

DH is the son of a orthopedic surgeon. When he was growing up, his father worked mostly as a trauma surgeon, so he hardly got to spend time with his father. His mom was a grade-school teacher before becoming a SAHM and always was there when he was growing up. Maybe DH's attitude is just playing up on those gender roles. Lately, his parents have been more supportive of the situation than he has been.

it may be more that his mom was a sahm and that's all he knows. but he knew that you were a dr before you married him, rgiht? have you tried talking to him about it? I hope that things work out.
how is the bedrest going? I am so tired that i almsot wish that i was on bedrest. however i can imagine that it would get boring after awhile. still it;s better for th ebabies. when are you due?

I've just discovered this old thread, started by TexasRose quite a while back, with lots of info for momMDs on hiring childcare providers. I wish I'd found it 9 months ago, when I was desperately searching for the first time! Anyway, thought I'd bump it up in case it may help someone else.

But even more interesting to me is Tsunami's plight BEFORE she had her twins... It's a gripping story! Tsunami -- I'm wondering how your story continued. Did your hubby step up after the darlings were born? How did you end up handling the childcare dilemmas?

Hi all, its Tsunami here,

I forgot about this thread. I have had a few phases of childcare arrangements since I last posted...

Well, to give y'all an update, I had my twins at 36 weeks, and they stayed about 1 month in NICU. After the babies were born, my mom quit her job and came to stay us. We paid her a "salary" each month and paid her taxes and social security. My mom's previous job was paid minimum wage, so she didn't mind leaving that job to be with her grandbabies. There would have been no way for me to complete my fellowship if my mom were not there, as DH was not very hands-on. I can probably count on my fingers the number of times he has changed a diaper. Because they were so small, he told me he was afraid he would break them. They are both healthy and turned 2 a couple of months ago.

After I finished my training, I got a my first job about 40 minutes drive from where my mom and sisters live. So we moved, and my mom went back home to take care of my sister's daughter, now 6 months old. Since I started working, I found a nice home daycare in our new neighborhood for the twins who are now 2, and hired a lady, somewhat of an "evening nanny" to stay at the house and clean, cook dinner, and take care of the kids after they get home in the evening until I get home from work around 7 or 8 o'clock. I drop the kids off in the morning and my husband picks them up. The twins are still waking up several times during the night for bottles of milk, either because they are thirsty or hungry. I take care of them during the night after I get home. So when DH is home alone with the kids, he does so with the assistance of a nanny. He is more involved now and helps them with dinner, the bath, getting changed into pajamas and does the bedtime story.

DH likes the new area but was disapointed to have left his job and friends. The move was hard on him, but we are adjusting. My job is busy and I have been dealing with my own time management issues at work, mainly staying too late doing charting and phoning patients about their results.

Do any of you feel like your brain hasn't been the same since having children? Is it permanent? or is it just sleep deprivation?

Thanks for the update, tsunami! I'm glad that you did figure out a way to make things work for your family. Congratulations on having 2 active and healthy toddlers! I'm sure they bring you immense joy. Hopefully your husband will step up to the plate more and more as the twins grow older; I've seen several "manly" men have difficulty with babies but become fabulous, very involved, dads to their boys later on. Well, mine has been sluggish since I first got pregnant 3-1/2 years ago! I feel like my head is 85-years-old; I forget things all the time. :banghead: And on those rare occasions when we do go out for dinner, I have the most trouble calculating the tip, even if it's just doubling the tax! (Previously, mental calculations came easily, unless of course I had enjoyed some wine or cocktails! But of course that doesn't happen anymore either, as I've been either pregnant or breastfeeding since 2005.) Hopefully this old brain will improve someday, but I've no idea, since, with a 5 month old and an almost-3 year old, I've been in a constant state of sleep-deprivation for the past 3-1/2 years as well. Good luck to your brain!

Hi tsunami! wow... I must have been pretty mad... I put a lot of mad faces! Sorry - I really don't hate your husband

Congrats on the kiddos and thanks for the update.

I have a 5 mos old... brain still recovering... hope it gets better!

OK - now I have my own nanny/au pair question...

Anyone dealing with crazy schedules for both you and your husband?

I'll be going back to 3rd year starting the end of June. Hubby has erratic schedule... sometimes out of town 4 days, sometime up to 10 days at a time. In between he can be home anywhere from 4-10 dd at a time.

My question is -- how do I cover long days and nights with an au pair?

We have absolutely NO FAMILY in the area

Any suggestions? Also - pls PM me any agencies that you ladies found helpful to find live in au pairs... (I don't think I can afford a nanny)

thx

On my last flight, I was seated near a woman who coordinates au pair placement for an agency near where I live. So she talked my ear off about au pairs for awhile and I have to admit, she was a powerful saleswoman ... it sounds great. We don't have an extra bedroom, so an au pair isn't an option for us, but wow, they're cheap! And flexible. The woman I met also said that in the case of some countries, it's possible to extend the au pair's stay by 6-9 months if the placement is working out especially well. If we ever manage to move to a bigger place, we'll consider getting an au pair.

But merri, I can't see how an au pair is going to possibly work out for you. They are contractually limited to a 45 hour work week. Unless you're planning to do a daycare/au pair combo? That might work. Maybe the au pair could work early in the morning, late in the afternoon/evening and at night when you're on call? But I would be surprised if daycare + au pair is much cheaper than a nanny. I don't know where you live, but here (HCOL area, to be sure), full time daycare for an infant runs nearly $2K/month and an au pair is something like $350/week. You could probably get a nanny for $3500/month.

It's a tough problem you have, and you have my sympathies ... I'm sure you'll find a good solution!

Me, too!!!!

There would be a dead husband buried under the house, and a fat life insurance policy helping to pay for childcare 'round these parts. Lol! Oh, wait. That was my inside voice.

I need to be spanked for not reading the entire thread before I posted, so I'm editing. The previous statement stands, however. I'm glad that you found a way to make it work, though!

I found that woman's business card ... she works with Cultural Care.I haven't actually used them, so I can't offer a definitive recommendation, but she seemed on-the-ball.

merri,

I am in my residency, and I am having the EXACT same issue as you.... how to cover early mornings, late evenings, and 1 full weekend a month of call. I have a great hands-on husband, but he is out of town sporadically for usually a week at a time. We dont have a plan on how to manage this yet!

I have been wracking my brain as to whether to do day care, and hire someone for pick up and to stay for an 2-3 hours in the evening. Another thought I have had is to have a live in nanny (in our TINY spare bedroom), and do a few days a week of day care if she can work longer hours on the other days. But that still doesnt cover me for call nights.
I feel pretty stuck... although female residents and physicians do this somehow...so I believe that there has to be a way! (other then a willing family member...which would be ideal)

if I figure out the magic combo, I will pass it on... in the mean time, would love to hear of creative ways that others manage childcare, with a slightly ABNORMAL schedule!

Thanks Emily -

oceanpearl - I'll let you know if I figure it out...

We don't even have a real room - the au pair would have to live in our downstairs den (which is very private, and essentially could be a bedroom).

Another bad part is that since both of our families live away - once we get an au pair... they will have no where to stay.

As far as the 45 hour work week... I was hoping that the au pair might be flexible... that is maybe one week work 20 hrs (when hubby home)... the next week 50-60 - (hubby not home)... I don't know. Some of my classmates have offered to babysit when they are in 4th year and I'm in 3rd - but of course I can't count on that.

It's depressing because this will be an ongoing issue and will get even worse during residency.

I spoke to a local agency - they said that their nannies ran $100 per day! I don't think we can afford that... I mean I still have 2 more years of 40K tuition to fork out...

This stinks!

I could absolutely be wrong here, but my sense (from my single conversation) is that work rules for au pairs come straight down from the State Department. In addition to the 45 hour weekly max, they can't work more than 10 hours/day and have to have at least 1.5 consecutive days off/week. It seems plausible that you could get someone who'd be happy to do 60 hours one week and 20 the next, but if it's *technically* against the rules (which, maybe it isn't; I could totally be wrong), it'd be tough to screen candidates for willingness to work that way, you know?

If you call an au pair agency and ask, would you mind sharing the answer? I'd be interested to know.

What about a college student (or preclinical med student) willing to sleep over on the nights you're on call and your husband is traveling?

Merri,
I hate to break this to you, but I actually don't think it's possible to have two parents with non-traditional work schedules and no family to help, unless you hire a full-time live-in nanny. And it can't be an au-pair from an agency, because they have too many rules on hours/day, etc. as mentioned above.

The problem is day care, most babysitters, or au-pairs won't be able to cover the early morning hours, late nights, overnights, weekends that you'll have to work in residency and in practice when you are on call. When I was first in practice, my husband had traditional hours and the first baby was no problem. If I needed to go in during the night, he was there. During the day, we used a variety of home daycare, babysitters, daycare center, etc. Occasionally I took her with me on rounds if I was stuck on a Saturday, but not too often, and it was distracting. Also not something you can do in med school or residency.

Two more children, a move, and a change in my husband's job later, and I had to make changes. His job now requires frequent travel like what you described. It's just not possible for me to have a regular practice with call. Occasionally I have had a neighbor high school student stay overnight, but that isn't something you can count on on a regular basis.

So for that and a variety of reasons, I changed jobs and now work in urgent care with regular hours that I can control based on his schedule.

My experience with lots of women physicians is that their husbands either stay home with the kids, work regular hours, or the physicians work part-time. I don't know anyone who has a full-time practice with call whose husband travels or works irregular hours.

Good luck to you, though. I hope something works out!

Agree with Lisa. I think I mentioned this in another post, or maybe somewhere in this thread. When my husband took ajob out of state that was supposed to last 6 weeks and ended up lasting 18 months, I kept my daytime in-home nanny and found a young woman to move in with us who had a regular day job and needed a place to stay for several months until her wedding. She lived and ate with us in exchange for coming straight home from work to relieve the daytime sitter and make dinner for the kids. Once I got home her time was her own, except she carried a pager if she went out (I did my own OB back then) and had to be immediately available if I was on call. If she had something important going on that couldn't be interrupted (Like tickets to a big concert or a family wedding) she told me in advance and I arranged other backup. We did that for over a year and it worked well. She got free room and board in exchange for about 10 hours of work a week.

Thanks for the ideas -

It's really worrying me. I'm supposed to go back to third year in July - and I'm just not sure how we are going to do it... plus this is going to be a continual issue through residency and once I start to practice. How can we afford this?! It makes me think that I can't afford to finish my training (but how can I afford not to - with the disgusting amount of debt we are in... hmmm wish I could get a bailout...)

Does anyone have experience with a full time nanny? If yes, how did you find her/him, what was the pay range? WHat about healthcare, does the family have to provide it?

I'll let you know if I make any progress...

I briefly considered a live-out nanny when I thought we weren't going to be able to find daycare. Here in my area (SF Bay Area), legal, experienced nannies run $18-20/hour plus taxes and benefits (definitely health insurance and paid vacation). The other day I met a nanny at the park who confided to me that she's "underpaid" at $18/hour, although she did have two kids to care for. Not sure about live-in, since we don't have space for that arrangement.

I've also been looking into the Boston nanny market. Looks like the going rate there is similar to here, $15-20/hour for a legal live-out nanny, with the expectation that you'll pay taxes and benefits. Live-in (again, legal) nannies appear to be more like $400-600/week. (Thus the appeal of the au pairs! Half the price!)

The nanny I met in the park said she found her current employers through Craig's List, although she's also worked with agencies in the past. I am astonished by how expensive the agencies are ... 1-3 months salary! Yikes. Also expensive in Boston; I found one agency that charges > $3K for placement of a full-time person.

Depending on how you feel about it, undocumented/under the table is cheaper, for sure. (Skip if you're ever planning to be Surgeon General!) I have friends who employ a fabulous woman to care for their son. She's not documented and they pay her under the table, obviously. I think she started at $12/hour, but she's so great that they now pay her more like $15 or $17. But they also save on the payroll taxes. I don't think they pay for her health insurance, but I'm not sure. I do know that their relationship with her is somewhat complicated and they compensate her additionally with needed favors (as in, extra cash) from time to time. But that may happen with any nanny, I don't really know.

I can only assume there's a broad range of prices across the country. Hopefully you live in a moderate COLA. I really feel for you. Any chance your husband can switch jobs or pull back from all the travel for awhile?

I may have found a live out nanny :crossfingers:
She's a lovely Polish retired woman - who is totally sweet, loving - with great references.
Have to finish discussing pay... she was asking for vacation and sick... not sure I can do that... but really want to keep a good person. :crossfingers:

Hi Emily -

I realized I never replied to your post! I wish my husband could change jobs... but he can't. He job is to travel (pilot) - so kind of out of the question . Trust me to marry someone with a worse schedule than a surgeon...

My husband and I are both physicians and had our first baby during residency. We had a FT live-out nanny who stay overnight occasionally if we were both working nights. She was older, retired but needed the supplemental income. It was perfect for our son the first two years. We went through an agency, which was expensive, but we felt we needed an agency since we weren't experienced in interviewing or hiring nannies. We gave her paid vacations but no health coverage.

For our most recent nannies, we have used nanny websites. My favorites are www.gonannies.com and www.enannysource.com You can browse for free to see if there are people in your area you'd be interested in. You pay to post a job listing and get full access to the nannies' profiles (ie, their contact information). You have to run your own background and reference checks, but it's a fraction of the price of a conventional agency. And I felt a little better using the nanny websites than Craig's list (although I did find my most recent after school baby sitter on Craig's list and she is awesome). Good luck! You'll figure it out. There are lots of moms in medicine who have found creative solutions to the issues.

Wow - lots of great posts here! I have been stressing out about finding childcare for our child (due Nov 13). I'm a private practice anesthesiologist and my DH is a engineering manager with office hours (thank god). I'm really fortunate in that my hours are quite flexible. However, as with anything in medicine, things always come up and I'm already stressed about how we will manage those times!

I worry a lot about the costs of childcare - nannies in our area want $15-20/hr. We don't have the space for a live in but we may have to become more open to that after we check out our monthly expenses! The whole process is so daunting and overwhelming. Additionally, we'll need to move to a bigger home so in the short term all our expenses are going to increase and my salary (until I head back to work) will tank.

I have faith everything will work out but like a lot of female physicians I want to be in complete control of this and it's just not going to work out that way .

Ok it was good to see this old post. i posted as Berkleyite last. I couldn't' remember my username and have a different email address now. I guess. Anyway we had a nanny for 6m at the start of my residency. It was harder than I had imagined. Although many of the good things that i wish for now were there such as, her getting the kids together in the mornings and being there if we are late getting home, etc, the things I didn't like were her not taking the initiative to plan activities for the baby, not doing the housework she was supposed to do and things like that. So we were thinking about putting the kids in a day care again. especially since my husband had very flexible hours at that time. Anyway one morning on the way to work she got in an accident. She hurt her leg and was out of commission for 6 weeks. Well that was the same time that we got off of the wait list at a nearby day care that we loved. so it all worked out. Now my husband's hours have changed and the kids at at the day care from 7:30 to past 6!!!! I really dont' like that. I wish that i could have a nanny again but we cant' afford it.

Hello. I am new to MomMD. Seems like a very valuable resource, so I'll give it a shot.
I am a 4th year medical student slated to start a Family Medicine residency in July. We recently had our first baby, a boy, who is now nearly 9 weeks old. In January I am returning for my last 5 rotations before graduation. My husband currently works out of town, and I will be with the baby alone most week nights. We have several options for daytime nannies, but the nights are what worry me as our son is not sleeping more than 4-5 hours yet, and I wonder if I need someone there with me at night in order to get enough rest myself. Even being off from rotations since his birth it's a challenge to get enough sleep. Will I be a brainless zombie back on rotations if I don't get someone to help with nights? All opinions appreciated.

I think I've posted this somewhere else in this thread, but I used to have a daytime nanny and a girl who lived here in exchange for room and board and being available at night if I had to go out.
You will probably be a zombie if you don't get some night time help, if not this spring, definitely after you start FP residency.

Look into maybe finding a college student who will help cover nights in exchange for room and board.

AnnaM,
I do remember seeing your post somewhere (this post is long!). My only concern is that we have a 2 bedroom house and the only room she could sleep in would be the baby's room. Is that too much to ask?

Just a thought here: babies don't actually need a whole room to themselves. When my Mom was having her 7 kids in a 2.5 bedroom house (the third bedroom was barely big enough for a twin bed and dresser), the newest one always slept in a crib in the hall, behind a folding screen. Or, of course, you could move the baby in with you. When we had our live-in it was because my husband took a job in Arizona that lasted 18 months. I moved my 2-year-old daughter in with me to free up a room for the live-in.

Ladies,

This is certainly a long and productive thread on the subject. Let me know if there is any information I can contribute regarding the au pair option. Several of the families I have worked with are dual-working physicians.
I was an au pair myself 10 years ago for 18-months-old triplets and a 5-year-old girl... very cost-effective option especially when you have several children under 6.

I too worked as an au pair abroad... as did my husband. We worked our butts off. Unfort the work rules here in the US are very strict - if I remember right only 45 hours max per week, no more than 10 hours a day. More like a student work study arrangement. Doesn't work out for my family. However, I do know a resident down the street from me who has an au pair (her husband has a reasonable schedule) - first two were ok, the current one is wonderful.

Currently have a nanny... on #4 since May 09. (Ok, 1 only lasted a day... one was great but didn't work out do for legal reasons, #3 was the first really nanny for us - for almost 3 mos - but she wasn't as flexible as she thought... #4 - current is good. Has been with us for almost 6 months...)

Great thread...my husband and I are considering an au pair or nanny. We currently have a 16 mo-old and are considering soon enlarging our family. Daycare has been more cost-effective for us with one child, since my husband's work schedule is relatively flexible and we have family close by who are invaluable for call weekends/nights; however, if we double the number of kids, it seems like it would be cheaper to pay one person to watch both kids as opposed to doubling the amt for daycare. Further complicating matters is my husband's imminent deployment this winter...since he has been doing the lion's share of the child-care/housework during, this, my intern year...so "live in" may be required. I am a little nervous about an au pair, but I also think it could be a great learning experience for my child with exposure to another language/culture. It is very helpful to hear everyone's ideas and experiences; we need to keep this thread alive!

We have a nanny that we share with another family. We found her b/c the other family already had her with a third family, and that girl was going to school, so we slid into the spot. worked well b/c the other family had already had the nanny for 2 years, so really knew and trusted her. We love the nanny share concept b/c the kids play together, and aren't alone with an adult all day. We are now putting my daughter in school full time for the fall, and will be keeping the nanny for our new son, and getting a new family with an infant to share the nanny with. For us its about %200 more a month than the good full time daycares, with less illness, so worth it. We o pay her extra when we're both on call and need her to keep our daughter overnight, or be here at 530 AM and having the flexibility is so worth it!
We considered an au pair, but as others have said, having someone in your home can feel intrusive... And our nanny is a professional with 15+ years experience so we felt more comfortable going this way.

I have a nanny, and we have our accountant file the tax forms, unemployment insurance forms, etc. It costs us $100 per quarter -- not cheap but well worth it in my book. Also, he will prepare a paystub if needed, like when the nanny needed one as proof of employment to rent an apartment.

This post always has great info
So our last nanny was really great and was with us for 8 mos before getting cancer (and she is only in her 40s). My husband ended up taking nearly 2 mos off work as I was on my surgery rotation. Over the summer we had a college student babysit for us (when hubby returned to work) - and I just sold my soul to the other students in order to take call when hubby was home. Currently our toddler is in an in home daycare - which is ok... kid seems really happy, loves the other kids. Owner is ok, not very customer oriented. Only been with her for 3 months and she's already taken 4 personal days (for good reasons) - but always was the worst timing for me. Finally got kiddo into pre-preschool for 3 days a week starting in Jan after being on the waitlist for over 2 years! I'll be home with a soon to arrive #2, but have to take the spot. Hoping to get him into preschool fulltime next summer - so will cut down on some costs. Thinking about getting either 2 nannies (I know an attending couple that do this), or maybe if preschool works out I might be able to swing an au pair. We'll see. I guess the new resident work hours might help me with having less consecutive hours on duty? I guess taking 2 years off during med school might pay off after all?

Great thread. We are having a similar discussion in my family. I am taking a new job in a new state as an attending and my physician husband will not be able to join me for 4-5 months due to his current contract. We have a 2 yr old daughter and are trying to figure out what the best options are for her. Currently, I am a junior attending at a medical center and the med ctr has an incredible daycare. We have also been lucky in that we have worked out call schedules so my husband and I are NEVER on call the same night. I am not sure what my new job situation will be. So if anyone has any ideas on where to find a nanny/daycare in New Orleans let me know! Also, any suggestions on how to handle being a semi-single parent for 4 months. We don't have family in New Orleans, so this is really going to be an adventure.

Looks like this thread has been less than active for a while, but I need some advice, so here goes:

I am about to start a family med residency and my husband is in the army. He will be deploying this fall so it will be just me with my two girls--ages 2.5 years and 2 months. My nearest family will be four hours away, and while I'm sure I'll make new friends at church, I don't feel comfortable just asking anyone for help.

I've been researching live-in nannies, as I think that's the most practical option with nights, weekends, call, etc. But if I'm working up to 80 hours per week, wouldn't that mean that nanny would have to as well? How on earth am I going to afford the rent on a large enough home to house my family plus a nanny, pay her (at least) $1000 per month stipend, pay for pre-school for my toddler, and still make ends meet? Two salaries will help, but am I going to have to dedicate mine entirely to child care?

Suggestions?!?!?

Thanks!!!!

We don't have a nanny now but did look into it before we started residency, and I believe you can't have a nanny work 80 hrs/wk. We figured that we would have had to get 2 nannies or done daycare + nanny for before and after care. I'm sure others can chime in.

As for how to pay for all of this - you might have to dedicate yours entirely to child care... My day care here is ~1200/mo per child and you have 2 kids so that's 2400/mo. In the state I live in you can only have a child at daycare for 50 hrs/wk max so I'd also have to pay before and after care which would probably average an extra 10-15 hrs/wk at ~$10/hr (both kids combined). There's another 400-600/mo. You'll also have weekend call (not sure how often in fam med) and daycares aren't generally open then, so you'll have to pay the sitter or nanny for those days. You'll be capped at 16 hrs per shift now with the new rules, and maybe average 1-2 weekends per month (??). You could probably get away with paying ~100/day depending on location (I think I could find that where I am). So estimate another 200/mo.

OK, totals: 2400 + 600 + 200 = 3200/mo for childcare. Or, ~38k per year. Your pre-tax salary will likely be in the mid 40s (mine is 47k) but that depends on location.

Maybe others will also have input

Yup, that would be my entire salary

Yep. Your whole salary will go to childcare. Where I live it would be my whole salary and then some. (Next year I'll have a three year old and a newborn in daycare full time. I expect my monthly tab will be about $3200. A nanny would cost another $3-4K. I make $3600/m after taxes as an R2.) You will need daycare + nanny or two nannies. Actually I bet the cheapest thing would be two au pairs ... are you allowed to have two au pairs?

Has anyone thought about getting a foreign nanny? I was on greataupair.com and saw that there also nanny listings from all over the world like Italy, UK, Brazil who are speak English. I don't know the logistics but some have visas already. I'm sure there's some fee to the agency involved. If anyone has any experience with this, please share.