The vast majority of childcare is still performed by the parents, in-house nanny or through informal arrangements with relatives, neighbors or friends. For example, in Canada, among two parent families with at least one working parent, 62% of parents handle the childcare themselves, 32% have other in-home care (nannies, relatives, neighbours or friends) and only 6.5% use a formal day care center.
Unlicensed and unregistered child day care programs do not have any of the following requirements: background checks, training/orientation, or health and safety requirements; and only minimal Code of Virginia requirements. Unlicensed centers must meet an exemption in the Code of Virginia in § 63.2-1715. Unlicensed family day homes must follow requirements in §§ 63.2-1727 and 63.2-1704.1 of the Code. VDSS does not inspect these programs.
Childcare infection is the spread of infection during childcare, typically because of contact among children in daycare or school. This happens when groups of children meet in a childcare environment, and there is an individual with an infectious disease who may then spread it to the entire group. Commonly spread diseases include influenza-like illness and enteric illnesses, such as diarrhea among babies using diapers. Illnesses and diseases may also include ringworm, head lice, and hand, feet, mouth disease. It is uncertain how these diseases spread, but hand washing reduces some risk of transmission and increasing hygiene in other ways also reduces risk of infection.
More contemporary proposals for government advancement of day care in the United States have experienced a checkered path, for example, in 1971, the Comprehensive Child Development Act was passed by Congress, but was vetoed by Richard Nixon. It "would have created nationally funded child care centers providing early childhood services and after-school care, as well as nutrition, counseling, and even medical and dental care. The centers would charge parents on a sliding scale." Various proposals have been considered, but to date, none leading to legislation that would establish a national policy supporting day care in the United States.