Webb said that although she has been a home-care provider for many years, only last week -- after Butcher's arrest -- did her husband ask her to stop give up such work. He feared that, were an infant to die while in her care, they could lose everything.
"They're threatening his livelihood," she said. "They're threatening what he has worked through the years for."
She said her insurance agent told her their home policy would not begin to cover their legal fees if a child died in her care.
Erlene Wilson, communications director for the state Department of Human Resources, said five providers quit after the Queen Anne's deaths. Between May 1998, when the deaths occurred, and September 1999, Caroline, Dorcester, Kent, Talbot and Queen Anne's counties together lost 27 family care providers, she said.
Strict limits in Maryland
Although there is a shortage of infant care nationwide, Moore said the problem is worse in Maryland because strict child-care laws limit the number of infants a person can care for. In a child-care center, the limit is three infants per staff member; in a family care center, the limit is two infants per household -- including the caregiver's.
Sandra J. Skolnik, executive director of the Maryland Committee for Children, said the nation's thriving economy exacerbates the shortage of infant care.
"It's an industry that's tremendously dependent on the economy," she said. "As the economy booms, the demand for child care booms."
At the same time, she said, salaries for child-care providers are low, and caregivers may be tempted to find more lucrative jobs.
In Maryland, the average annual salary for a home-care provider is $16,095. In child-care centers, a director earns on average $23,987, senior staff members earn on average $15,627, and aides earn $11,411.
The shortage of infant care probably drives up the cost. Weekly averages in Maryland range from $63 in Somerset County to $145 in Howard County for home care and even more for center-based care.
Long waiting lists
Commercial centers also are short on openings for infants. The Children's Discovery Center in Columbia has a waiting list for more than 300 infants, said director Lisa Lockwood.
She said some mothers put themselves on the waiting list before they are pregnant.
"She showed us the waiting list and I literally started to cry," said Aileen Blass, a Columbia mother whose 15-month-old daughter has since been accepted at that center.
"If we have a second child, I will sign up as soon as I'm pregnant, definitely," she said. "To get into a good center, that's what you have to do."
Moore said the shortage of infant care is also a problem for employers, who suffer when their employees are distracted or have to take days off.
And if parents can't find good day care in the crucial first years of a baby's life, she said, then society will have to pay more to support special education and juvenile justice programs.
Up to parents
It's up to parents to seek quality care, she said, even in the face of the shortage.
"It's really important for parents to understand how important these first years of life are in a child's development," Moore said. "They should not be choosing because of cost alone, or location alone. They need to look for quality, and if they don't know the components of quality, they need to research it.
"Most parents do an awful lot more research when they buy a car."