Boston — It's been called the most inflammatory topic having to do with children today. The issue? Full-time substitute care for infants and toddlers. Although half of all children whose mothers work full time are cared for by a family member or relative, the shift away from in-home care has been dramatic. The number of children enrolled in day-care centers has more than quadrupled in the last 15 years. Centers now care for 15 percent of all children whose mothers work full time. That figure will likely increase as mothers and women of childbearing age continue to enter and reenter the work force.
But as more women head for the work place and the demand for day-care facilities grows, some professionals are beginning to ask fundamental questions: What are the effects of such care on young children who are separated from their parents for 40 or 50 hours each week? Do parents have all the facts they need to make a decision about whether to place an infant in full-time care?
''There has been a lot of misinformation about day care,'' says one former day-care provider. ''What we hope to be able to do is to alert parents to the fact that the debate is not over and done with by any means.''
In ''The Day Care Decision'' (New York: M. Evans and Co.), to be published in November, authors Bill and Wendy Dreskin argue that scientific investigations of the nature of bonding and of the emotional needs of children - investigations that have become the focus of the day-care debate - are at best limited.
''We still don't have as much hard data as we would like, and that's because it's very difficult to put things like love and affection and a feeling of security under a microscope,'' Bill Dreskin explained in a telephone interview. ''Clinical observations . . . don't lend themselves to a broad application - they don't answer the question about what is the minimum daily requirement of hugs and kisses that a child needs in order to thrive. Science just can't tell us those things.''
Until recently, the Dreskins had run a nonprofit preschool educational program for three- to five-year-olds in northern California. The first three years, they offered only morning programs. The following two years they expanded their programs to include full-time day care. That's when they began to notice changes in the children.
Three-year-olds who had been happy in a morning preschool program couldn't make the switch to spending a full day away from their parents. They began to cry for hours at a time, and either withdrew from their friends or turned into fighters. They refused to take their toys home at night (''What's the use? I'm here more than I'm home''). They dictated poignant pleas for the journals they kept for their parents (''I wish you didn't have to work, Mommy'').
The parents changed, too. They gradually stopped coming to parent meetings, and they no longer checked educational books out of the lending library. Instead of asking questions about what their children were learning, they only wanted to know what time they should drop their children off and pick them up.
As the Dreskins watched attitudes evolve - the change from parents caring about their children's educational development to parents wanting only a custodial arrangement - they realized their own goals weren't being met. Five years after they opened their preschool, they decided to close the doors.
''I'd always wanted to be involved in early childhood education, and the center had been my baby,'' Wendy Dreskin explains. ''But it had become very painful to watch what was happening to the children in our care.''
The Dreskins began to talk with other day-care professionals and to read all the studies they could find about full-time substitute care for young children. Their conclusion? Experts in the field are still deeply divided about the benefits and the potential harm to children of full-time day care.
Their response? Get that message to parents who need to hear it.
''Our feeling is that there's a growing awareness that the movement toward day-care centers and full-time care was a quick but shortsighted attempt to solve the problem (of how to care for children whose mothers work),'' Mr. Dreskin notes. ''It's been a solution which addresses the needs of parents, but not the needs of children.''
Most day-care advocates, of course, argue that what helps parents benefits the entire family.
''I'm not for day care blindly, but I do know that many parents, especially career-oriented women, feel strongly about being able to continue with their own lifestyles,'' says Alice Honig, a professor of child development at the University Syracuse and regarded as an expert in the field of infant day care. ''Given this reality, what we have been trying to do for the last 20 years is to train professional caregivers to be 'cooperators' rather than 'substitutes.' Working mothers need to know that the people taking care of their infants are familiar with current research and know what helps to make a secure attachment for children.''
In their book, the Dreskins point out that experts in the field of child development universally agree that a child's first three years are very special, ''a critical, formative period that is unlike anything else that happens.'' Where there is not agreement is about how the child's needs should best be met during those years - by parents or by substitute care-givers.
The Dreskins say one reason for writing their book was to provide support to mothers and fathers who want to be at home with their children during their early years. In questioning the ''experiment that is day care,'' they discuss a number of studies that have shown that children enrolled in day-care centers tend to be more physically and verbally aggressive, less cooperative, and less tolerant of frustration. They point out that the Soviet Union and several Eastern-bloc countries have backed away from providing full-time day care because of damaging effects on children, and they describe research on Israeli kibbutzim that show negative effects of full-time day care on creative thinking.
The authors also refute a number of ''myths'' that they say have been promoted by day-care providers (day care promotes independence; parents aren't the best teachers; peer contact is important for young children; it's quality time that counts), and they show how single parents and married couples have found ways to avoid full-time substitute care for young children by changing jobs or working flexible schedules.
For parents who can't make alternative arrangements, the Dreskins recommend in-home care as the first option for infants and toddlers, followed by a day-care home (the smaller the size of the group, the better), and finally a day-care center (preferably non-profit). To help parents decide how much separation a child can comfortably handle, they recommend a maximum of one hour a day for each year of age up to age five. ''Ideally,'' they write, ''a baby should be home with a parent until age three and then start a morning preschool for three hours a day.''
Are the Dreskins the only dissenting voices being heard today? Not exactly. But they are among the few professionals who have gone on record as being opposed to full-time substitute care for young children.
''The Dreskins are not the only ones who have encountered damaging kinds of behavior in children in day care, but they're the only ones who have written it up, to our knowledge,'' says Michael Meyerhoff, administrative director of the Center for Parent Education in Newton, Mass.
''People in day care realize it was not created because people felt it was a better way to raise kids, but because of real or perceived needs of parents,'' he continues. ''I would say over 90 percent of professionals we deal with would agree with our basic position - that full-time substitute care for children under age 3 is not ordinarily in the best interests of the child. But many of these professionals are involved in situations where it's economically or politically unrealistic to maintain that position. Because of the strong attacks they'd be likely to get, many people are not saying anything.''
One of the few voices that has been heard consistently for the past 25 years is that of Mr. Meyerhoff's boss, Burton L. White. Former director of the Harvard Preschool Project and author of ''The First Three Years of Life'' and ''A Parent's Guide to the First Three Years,'' Dr. White is director of the Center for Parent Education, a nonprofit public agency that provides assistance to professionals who work with infants and toddlers.
''I'm in the fortunate position of not being vulnerable,'' Dr. White explains. ''So I go ahead and concentrate on my one theme - that the best thing to do when it comes to substitute care is to provide little or none of it in the first six months, and that between six months and three years either the parents or grandparents should be with the child for the majority of his waking hours.
''Interestingly enough,'' he adds, ''more and more professionals are slowly and cautiously coming out of the closet now and saying we're not crazy.''