Many working families in Tennessee do not have access to the child care they need when their children are very young. Each year the parents of nearly 200,000 Tennessee children under age 5 struggle to find suitable child care to support their employment and career advancement. Inadequate child care acts as a barrier to worker productivity and to economic growth. Using new statewide survey data and economic analysis, we calculate substantial economic losses when families of children under age 5 do not have adequate child care. These families report reduced time at work, less productive work, and diminished career prospects. Almost every family with young children is affected. (author abstract)