Genmedmom here.
Childcare is such a huge issue for working parents. It can be so expensive, and it is so important. With me in outpatient primary care and my husband traveling for his work pretty frequently, we needed to figure it out.
Thankfully, we have my mom who lives close by and provides the bulk of childcare for our little ones. We have also used daycare, as well as nanny services, both to give her a break and to provide socialization for our kids.
Family help is the best, but it can't always work, for many reasons. Daycare has the advantage of providing key socialization, as well as building relationships with other working parents, a bonus that I didn't realize would be until it was. However, if we didn't have my mom to pick up our kids at the end of the day, we'd be pretty miserable. It probably wouldn't work at all.
I found nannies to be the most difficult. It was almost a part-time job to find a decent nanny, even with Care.com. And, they weren't always decent. Plus, that option can be very expensive, prohibitively so. Upwards of twenty dollars an hour in the Boston area, for a nanny with experience.
Other docs have written about au pairs, and that options sounds wonderful, but one has to have a place for the person to sleep, and we just never had that. It's a small house, barely enough room for us and the two kids. Au pair, sadly, was never a possibility for us.
What childcare options have worked best for others?