Childcare Options for the Working Mom (Part II)

Continuing my prior posts on childcare options available for the working parent, I will now discuss alternatives to in home day care.  Note this is meant to be a general guide, and from my experience only. Anyone referring to these posts should of course contact the particular provider to confirm whether these apply.
Traditional Day Care Center
Pros:
Licensed and regulated
Longer hours
Fewer care interruptions for weather, vacations or provider illness
Background checks for employees
More defined programs
Greater structure
Greater propensity for illnesses to spread may also build stronger immune systems long term

Cons:
Pick-up times and rules may be inflexible. Fees for late pick-up may be hefty
Higher child to provider ratio
Some decrease in level of personal interaction given to each child
Greater number of illnesses compared to in-home care
Strict rules on child illnesses (ie fever free for 24 hours before allowed back to the center)
Possible long wait lists
Greater liklihood that you will need to continue to pay for care (to keep your spot) on days when your child does not attend (ie for vacation or during maternity leave for a new sibling)

Au Pair
My husband and I have really enjoyed the au pairs that we have hosted in the past.  Programs vary but in general au pairs come to your home from another country and spend a year (or a summer depending on the type of au pair) in your home, living in your home with your family and providing up to 45 hours a week of childcare services.  Hours are flexible and generally set by you (with some restrictions such as one weekend a month off, and one whole day off per week etc.).  In addition, the au pair must take 6 credit hours of courses.  Our experience was very positive and incredibly valuable for our children. I now have 3 children who can speak Spanish with no discernable accent (for their age) and who are very open and accepting of cultural differences.  Our au pairs lived in our home and participated in many meals and we brought them on vacation but otherwise they spent a lot of their free time out with friends or in their rooms... since as anyone with young children knows, it's very hard to be in sight of them and still "off duty."  Thus there was some change in our family life, but we did not find it unpleasant or invasive.
Pros:
Individual attention for the child / children
Lower child to provider ratio
Extremely Flexible hours - the au pair could be on duty over night if needed, or in split shifts
No need to take your children out of the home
No need to worry about daytime meals or children's laundry
Your child may learn a new language
Your family may benefit from cultural diversity
For two or more children, generally a lower cost option overall
Regulated by the federal govenment
Au Pairs from a reputable program have background checks, must pass a basic English language evaluation and are given first aid and child care training before entering your home
Younger, often more fun childcare provider
Sick children can stay home with the au pair if needed
The au pair can drive the children to or from after school activities as required

Cons:
Upfront cost can be prohibitive since most programs require a hefty fee at placement
Some language challenges may occur
Some younger au pairs may have certain behavioral challenges (similar to having any young adult in your household)
Possible loss of privacy
Some additional effort on your part in terms of helping your au pair adjust to the U.S. and feel welcome
Some additional effort on your part in researching and interviewing candidates to find a good fit
45 hours a week may not be enough for some parents
Some inconveniences when the au pair takes his or her vacation or if they are very sick. (In my 3 years with au pairs, we have minor interruptions).
Some loss of social interaction if the au pair does not have playgroups

Traditional Nanny
Pros:
Individual attention for the child / children
Lower child to provider ratio
Possible Flexible hours depending on the provider
No need to take your children out of the home
No need to worry about daytime meals
Sick children can stay home with the nanny
Nanny may be able to drive children to and from after school activities

Cons:
Greater expense compared to some other options
Not officially regulated though providers may have first aid or child care education
Some interruption to service for provider's vacation, illness or weather
Would need to do some additional legwork to check references and do background check