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.