Yet early childhood education in the United States receives the least public investment of any schooling, leaving parents to bear much of the financial burden.

The average cost of full-time infant care at a Baltimore center, as opposed to a home-based site, is about $11,560, according to data from the Maryland Family Network, a private nonprofit that advocates for children and families.

That figure, which factors in the highest- and lowest-quality care options, is 40 percent higher than the average cost of tuition and fees at a state university — $8,220 in 2012. And it's roughly 30 percent of the median household income in the city before taxes.

"It's a real struggle for most parents," said Steve Rohde, the network's deputy director of child care resource and referral services.

The state's poorest families receive some help through care vouchers, but not enough, Rohde said.

Maryland's Child Care Subsidy Program has recently been released from a freeze that saw the number of children served drop through attrition to 16,500 in January from 26,000 in early 2011.

Funding problems have meant that many people who should be eligible for the program aren't, and those who are eligible are relegated "to the cheapest and, in many cases, the lowest quality care in their communities," according to Maryland Family Network testimony submitted last month to the state legislature's Joint Committee on Children, Youth and Families.

And the subsidized families are still paying an average of nearly 15 percent of their already stretched household incomes in co-pays, according to the Maryland Family Network.

Middle-class dilemma

It's not just the poorest families who are hit hard by the price tag of child care, however. Middle-class parents, especially those aware of the studies discussing the importance of quality care, face a dilemma. They can't comfortably afford the priciest care, but they're afraid to accept anything less.

"We've put off having a second child" until the first reaches school-age, said Sticklin, whose 4-year-old son attends Downtown Baltimore Child Care Inc. "It would be too expensive to have two children there at the same time. It would be like another mortgage payment for us."

The nonprofit center, located on the campus of the University of Maryland, Baltimore, charges more than some other city options, but says it also offers better-than-required staffing ratios and a research-based education program. Full-time tuition for preschoolers ages 3 and up runs about $13,500 per year; the infant program costs $20,400.

Sticklin started looking for care when she was about four months pregnant, knowing that she wanted to return to work when her son was 12 to 16 weeks old. She interviewed nannies, looked at every available city center and checked out home-based, family facilities, ultimately deciding that bigger was better for her.

"I was much less comfortable with the overall safety aspects of [home-based care]," said Sticklin, who works in human resources. "I went to a few of them in rowhouses, and it just seemed very cramped, just cribs lined up in a room, and it just didn't give me a good feeling."

While many families are happy with small, home-based operations — which are often the most affordable — they can be harder for parents to evaluate, said Andrews, the Hopkins dean, because they're less public than center-based care.

Data from the Maryland State Department of Education also show that kids who are cared for in centers are better prepared for kindergarten than those in family facilities — 87 percent compared with 77 percent statewide. (Children who stay home or with a relative are the least prepared statewide, at 71 percent.)

In Baltimore, 77 percent of children who attend centers were ready for school last year, compared with 61 percent in family facilities.

That often makes center care the most in demand, though the quality varies widely from place to place.

The department of education is responsible for regulating, licensing and inspecting all child care centers and family facilities in the state.

Parents can look up inspection results online at http://www.checkccmd.org to see if centers are up to date in their staff training, providing safe spaces and putting the proper development plans in place for each child.