We had a variety of arrangements as the kids grew up, some better, some not. When they were tiny we had a wonderful woman who came to the house. She took great care of the kids and also did all the laundry including cloth diapers (now I'm dating myself). Sadly, she did not come with us when we moved out of state (I tried). After that we had daycare, then daycare/at home combo where I hired their favorite daycare worker to bring them home early and start dinner (almost all of the workers were--just barely--part time so the centers wouldn't have to pay benefits). After they went to school we had after-school day care, and later after-school home care by a series of high school or college students. Said students also functioned as drivers for after school activities and worked for a longer day during the summers to drive to summer activities (I always had the summers pretty well planned by March). What I remember mostly, especially when they were young and got sick a lot, was that the whole thing was like a house of cards. If somebody woke up with a fever one of the cards came out and the whole thing fell apart. The chicken pox was a major disaster. Luckily I had a supportive husband and (in a pinch) a mother in law who was able to come help when things really got bad. It really was terribly hard a lot of the time and I doubt it's got any easier since. Like I told a younger colleague the other day, "eventually it does work out. They grow up and leave home."
-By a FP with grown children