As increasing numbers of women have entered the labor force, increasing numbers of children, particularly infants and toddlers, have become active participants in child care. Research and opinion regarding the effect of child care on infant emotional and social development is conflicting. Most infants in child care are securely attached to their parents; however, there is an increased risk of insecure attachment in infants in child care when compared to infants in home care. Participation in child care has been associated with both positive and negative outcomes in relation to social development. High-quality child care is associated with improved child outcome. The quality of child care can be assessed by characteristics such as low child-to-staff ratio, small group size, and training of child care providers. Families are in need of a greater variety of options to meet goals of economic stability and child rearing. It is the role of the pediatrician to monitor child well-being, to objectively advise parents as consumers of child care, and to encourage the availability of high-quality care to all children.