This paper presents an overview of early child care for children under five years of age in the United States that is meant to draw attention to the problems posed by the inaccessible nature of early child care, which many parents need in order to work. Furthermore, this paper attempts both to explain why the problems with early child care have persisted in the United States and to justify fixing them. With a commitment to improving economic conditions for low- and moderate-income residents of New England, the Boston Fed's approach to this work places these working parents at the center. This means the report examines child care based on its impact on working parents and assesses solutions according to how they affect working parents. (author abstract)