Parents face a trade-off in the effect of child-care problems on employment. Whereas large settings may increase problems because of child illness, small group care may relate to provider unavailability. Analyzing the NICHD Study of Early Child Care, we find that child-care centers and large family day care lead to mothers' greater work absences because of a sick child, but not to maternal job exits. Greater work absences because of unavailability of small home-based providers are associated with mothers' job exits, especially when mothers have low earnings and use nonrelative caregivers. Our findings accentuate the need for improved hygiene practices in child care, expanded personal leave coverage for parents, and greater backup care for sick and well children.