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?