63% of families are uncomfortable sending their children back to day care—here's how experts say you can prepare

Nearly two-thirds of parents who use child care say they're not comfortable sending their children back to day cares, preschools and child-care facilities as states reopen. In fact, only about 7% of parents feel it's safe to return to their normal, pre-pandemic routines.

That's according to a recent survey fielded by Care.com in May of over 2,000 U.S. parents with children under the age of 16 who pay for child care. Yet the survey found that just over half of parents don't believe that normalcy will be established until at least next year or until a vaccine is released. 

It's a concern that Bay Area-based parent Robin Nelson, 40, knows all too well. A professor of anthropology, Nelson has been juggling teaching, researching and homeschooling her two children for nearly four months. And while her son's summer camp and her daughter's preschool, which are both housed in the same facility, have reopened, Nelson and her husband are waiting to send them back. 

"We are seriously concerned about sending them, even though I trust the school to do everything they can do," Nelson says, adding that the facility has restricted class sizes to 10 people and is requiring masks for the older kids, 

"My son's going to have to wear masks all day," Nelson says of the new rules for her 8-year-old, adding that her almost 3-year-old daughter will be spared for now. Teachers are also required to wear masks at all times. 

Robin Nelson with her son and daughter. 

"I know that they're doing everything they can do, but we wanted to wait a few weeks to let them get the kinks out of their system as they get started," Nelson says. Where they live also plays into Nelson's concerns. "We're in the Bay Area — this has been kind of a mini epicenter of the crisis, so we had real reservations about sending our son and our daughter back." 

But Nelson is also worried about continuing to have her kids at home. "I am getting more concerned about our children's mental health," Nelson says, adding that the pandemic has been an "incredibly isolating" time for her children without the normal social interactions with their friends. "They kind of have each other," she says, but adds that there's a five year age gap, so it's not the same as interacting with their friends and other kids their own ages.

For now, Nelson's plan is to send the children to school and camp starting in July, barring a major surge in Covid-19 cases in their region of California. "We're monitoring outbreaks in the area," Nelson says. "I think we have to pay really close attention. And if it gets bad, we're going to have to go back on the plan to send them."

Many families rely on child care in order to be able to go to work, but like Nelson, it can be a tough call to determine how risky it is to send children to school and day care. If you live in a community with a low rate of coronavirus cases, then you're "probably much safer" to return to a more normal child-care routine than if you're in a community where there's a high rate of coronavirus spread, says Sally Goza, a Georgia-based pediatrician and current president of the American Academy of Pediatrics. 

But for most families, it's a sliding scale of risk. "Families are trying to figure out how to keep their bubble as small as possible and try to minimize their exposure as much as possible in order to protect their child," says Nathaniel Beers, president and CEO of the Washington D.C.-based HSC Health Care System.

It's important to consider your actual risk of getting sick, says Beers, who also volunteers as a pediatrician at Children's National Hospital. Thankfully, there is more and more evidence that suggests that children are "less susceptible to catching Covid-19 as well as having complications," he says. But families, care providers and regulators still need to be vigilant and take steps to minimize the opportunity to contract the virus as much as possible. 

In fact, the Centers for Disease Control and Prevention has issued a number of recommendations for day cares, preschools and child-care facilities to ensure the safety of children, families, teachers and employees as programs start to reopen. 

Among the major recommendations are:

• Promote healthy hygiene practices, including regular handwashing for children and staff
• Step up cleaning and disinfecting procedures, particularly of frequently-touched surfaces
• Implement social distancing strategies such as spacing out seating and nap areas
• Restrict classroom sizes and limit the mixing and interaction of children 
• Conducting routine health screenings, including checking temperatures of children upon arrival  
• Limit as much as possible the use of shared toys, supplies and learning aids
• Create plans and procedures for if a child or teacher becomes sick
• Implement flexible sick leave for staff and train additional employees if feasible

While extensive, the CDC guidelines are simply that: guidelines. State regulators are providing far more robust rules for child-care providers, but as a result what parents can expect will vary. 

In Massachusetts, for example, the Department of Early Education and Care has issued a 32-page guidance that, among other protocols, limits class sizes to a maximum of 10 children and sets up specific teacher-to-child ratios based on the age of the kids. Additionally, the state regulator is mandating that whenever physical distancing of six feet is not possible, masks must be worn for anyone over 2. But other states are not requiring masks and the guidance around the optimal class size and provider-to-child ratios varies. 

Of course, there are other additional steps child-care centers may be taking as well that are not mandated. Many of the providers CNBC Make It has spoken with in recent weeks are prioritizing having kids spend more time outside. The risk of infection is less when you're outdoors, Goza says. "It's easier to physically distance when you're outdoors than in a small room," she says, but adds that it needs to be weighed against the health of being outdoors. If it's extremely hot and muggy, or there's poor air quality, it can be detrimental for children to stay outside for long periods. 

Bottom line: Parents need to ask questions. What is the child-care provider doing to keep group sizes small? What social distancing measures are they implementing? What hygiene and hand-washing protocols will be in place? What is their masking policy? How are they training staff? 

"Those are all critical things to ask. I don't know that any of those things would be deal breakers though," Goza says. "If you're comfortable with the fact that the staff is very committed to doing everything they can to stop the spread of the virus, I think that's the key."

The only real situation that parents should consider a red flag is if there's a lack of communication and transparency, Beers says. "If you were going to be sending your child to a child-care center, you need to feel empowered to ask for information. If that child-care center is not sharing that information with you about how they are going to keep you and your child safe, that should be a red flag because that suggests maybe they haven't thought through all the issues that they need to raise."

Both parents and children are really struggling with all these changes required by the coronavirus pandemic, but both Beers and Goza say there are steps that families can take at home to make the transition back to day care or school easier and safer. 

Make sure immunizations are up-to-date

While there's no vaccine for Covid-19 available yet, Goza says it's important for children to be up-to-date on their other immunizations. Especially since many children may have skipped appointments and check-ups during state shutdowns. "We don't need them to go back to day care or into school and spread other vaccine-preventable diseases. It's really critical to do that," she says, adding that parents should call or make an appointment with their pediatrician before sending kids back. 

Additionally, Beers recommends that parents prioritize getting their children a flu shot this fall. "We want to make sure that kids have additional protection from a flu this year, as we do every year, but certainly this year is even more critical," he says.

Practice wearing masks 

Whether or not your child-care provider requires children to wear masks all day, Goza and Beers both say it's a good idea to practice keeping one on at home to get children comfortable with the idea and feel since there are likely times when they'll have to use one.

It's about making sure that kids know that wearing a mask is normal, and that it's a part of the return to normalcy, Beers says. 

"It's hard to keep a mask on a young child, but I have seen it. Children are actually getting very good at it," Goza says. 

Find a handwashing routine that works

Handwashing is incredibly important to stopping the spread of Covid-19, Beers says, so it's critical that children are comfortable with washing their hands thoroughly multiple times a day.

To help kids wash their hands for a full 20 seconds, Beers recommends letting your child pick out their favorite song or something that they seem to enjoy when you sing it for them. That way, they learn to wash their hands for that full 20 seconds. 

"It's hard, even for many of us as adults to step back and think about what is really 20 seconds," Beers says, adding that there are lots of different songs out there that people can sing that will get you to the 20 seconds. "Everyone has their favorite one, or the one that drives you the least crazy today," he says. So encouraging kids to practice with that can be key.

Get kids back into their routines 

For many families, the last few months have meant abandoning normal routines, but Beers says that as parents start to consider sending children back to day care and school, it can help to re-establish those habits ahead of time. 

As you think about reentry for kids, think about when they eat, sleep and socialize. It's about them getting up at the right time so that you're not trying to rip them out of bed because they are sleeping late," Beers says. Have them eat during the times that are going to be consistent with when they will eat at school or nap around the same time that they would nap at school. "All of those are components that are about building that routine and that expectation," he says, adding that families may want to drive or walk by their day care or school to reorient kids.

 Stay alert

"Parents need to be pretty vigilant if their child is in day care or school," Goza says. Keep a close eye on your child's health and watch for symptoms, although that's easier said than done Beers and Goza say. 

In fact, the average kid gets five to nine colds a year that last about two to three weeks. "So that means about three quarters a year, potentially, your child could have a cold," Beers says.

But parents don't need to go it alone, Beers says. "Parents shouldn't feel like the burden is upon them to figure it all out because it's often difficult to differentiate [what kind of illness is going on] in young children," he says. In other words, it's OK to have your pediatrician on speed-dial.

Keep in mind that pediatricians may not have all the answers either, Goza says. "We're learning as we go because this virus is new," she says. "So we're all learning how we're going to have to handle this."

Don't miss more in this series: 

• My preschool closed and now I'm looking at schools with tuition over four times what I was paying
• Affordable child care is increasingly difficult to find in the U.S.—coronavirus could make it harder
• 51.7 million parents have lost income during the coronavirus pandemic—and experts say it may be especially hard for them to head back to work
• Fewer than 1 in 5 employers offer child-care help, but experts say coronavirus may make it an imperative
• Day-care director: 'I'm struggling—and it's not because I'm not a good business person'