Child Care - Can a Surrogate Go Too Far?

DESPITE a whimsical Halloween mobile suspended above the information desk and cheerful posters of giraffes, zebras, and lions decorating the corridors, the pediatric ward of Swedish-American Hospital in Rockford, Ill., bears no resemblance to a child-care center. Yet a program here called Cuddle Care offers a special service for working parents: day care for mildly ill children. For $3 an hour, the hospital will care for children who do not feel well enough to attend school or regular day care. About 20 children a month use the service, says to Lucy Westbrook, a pediatric nurse manager who founded Cuddle Care three years ago.

Twelve miles away at Highland Hospital in Belvidere, Ill., a similar program, the Rainbow Room, advertises: ``Loving care for the child too ill to go to school.''

As the number of working parents grows, so do the ranks of families facing a dilemma: What to do when a child can't go to school and a parent can't jeopardize a job or a paycheck by staying home? In response to what Mrs. Westbrook calls ``a desperate need,'' pediatric units across the country are branching into sick child care with cleverly named programs such as Get Well Care and Under the Weather. A small number of day-care centers also accept sick children, and private agencies in certain communities offer in-home care.

Yet however creative the names, however loving the care, these hospital-based or center-based arrangements for mildly ill children strike some parents as an imperfect answer - one more patch in our helter-skelter system of child care. Even Westbrook, while justifiably proud of her program, says, ``I raised five children, and I was at home with them. I don't think this is the best solution.''

Although she observes that hospital-based care poses few problems for school-age children (``they can push the nurse call button and somebody is going to cater to them with chocolate milk or Popsicles''), she notes that away-from-home care can be ``very difficult'' for under-the-weather toddlers.

It can also be difficult for parents, who find themselves up against corporate policies that fail to consider the unpredictable needs of families. As a consequence, mothers and fathers may face a difficult choice: either arrange for ailing children to be cared for by strangers, or call in sick so they can care for them at home.

Explaining the challenge, Ann Lewis, a political consultant, has noted, ``It is socially more acceptable in our society to say your car wouldn't start than to say you have a sick child.''

Although a few employers now pay part of the cost of sick child care, parents responding to a recent study by the National Council of Jewish Women rated ``paid sick days to care for a sick child'' as one of the most useful benefits an employer could offer.

In addition to hospitals, other enterprising care providers are tapping an expanding market for emergency and off-hours care, even on weekends and holidays. Varied services are springing up to help parents deal with odd schedules and full appointment calendars.

At the regional postal center in Syracuse, N.Y., for example, the Little Eagles Child Care Center is open 24 hours to meet the night-care needs of parents who work odd hours in police and fire departments, hospitals, factories, and the post office.

Capitol Evening Care in Washington, D.C., is open until 10 p.m., offering children dinner, help with homework, and a place to sleep. Another area agency, Night-Time Associates, provides in-home nighttime child care for families one Washington journalist characterizes as ``busy Capitol Hill professionals [who] often work past the dinner hour and well beyond 9 p.m.''

For parents with an occasional need for emergency care, these arrangements can serve a useful purpose by providing supervised care in a safe, loving environment. But already family experts, among them Jay Belsky, a child-care specialist and professor of human development at Pennsylvania State University, are expressing concern that the availability of longer child-care hours will encourage parents to spend less time raising children and more time pursuing careers and personal interests.

It would be an unintended irony if child care - the system that enables parents to be workers - became such an all-purpose convenience, covering every contingency day and night, that it had the effect of keeping workers from being real parents.