Just the thought of her children getting sick stresses out Ivy Sheehan.

If her boys, ages 11 and 4, are too sick for school and daycare, then Sheehan must make other arrangements.

Her employer requires 48 hours advance notice for time off, so staying home from work isn't a good option. Neither is relying on relatives; the single mother has no family within a 90-minute drive. Her friends have other responsibilities, and besides, nobody wants to baby-sit a sick kid.

"This has been on my mind big time," Sheehan says. "As long as your kids are in daycare, I think you have to face it."

Now that cough, cold and flu season is here, the question of what to do with sick children will be on the minds of many working parents. Daycare providers and schools see the problem play out daily.

"When you have to be at work, it's really hard," says Lori Pharris, director of a childcare center in Cincinnati. Recently, one of her own staffers missed work to care for her sick child.

Sometimes, parents take a chance and drop off sick children at day care.

"The kids tell us, 'Mommy gave me medicine.' But by 10 or 11 o'clock, their fever's spiked back up again," Pharris says.

Depending on local or state regulations, some daycare centers are required to isolate sick children and immediately notify parents to pick them up.

"If they're really sick, you can tell," says Susan Stai-Zureick, executive director of child development services for a YMCA.

Aside from parents missing work or relying on family, friends or neighbors, there are few options for sick-child care, and those that exist are too expensive for many parents.

"There isn't a perfect solution, unfortunately," says Sandy Haas, director of development for 4C, an agency that works to make childcare affordable and available in the Cincinnati area. It operates a childcare resource and referral service.

Family childcare — run by people who care for children in their homes — sometimes offers more flexibility in terms of accepting mildly ill children, she says.

But Stai-Zureick, a working mother, speaks for many parents when she says, "When your kid's sick, you don't want a choice. You want to take care of (your child)."

In an ideal world, she says, employers would recognize that workers sometimes need unscheduled time off.

"We've had parents who've told us if they miss one more day (of work) they're going to lose their job," Stai-Zureick says.

That's why it behooves parents to bank some of their vacation time in the event they need it to care for sick children, she adds.

Some progressive companies have stepped forward and have contracted to provide a "sick childcare" benefit for employees, who pay only a fraction of the regular hourly fee for a caregiver to come to their home and supervise a mildly sick child.

Planning ahead for childcare emergencies is key, Haas says.

There will always be breakdowns in childcare, whether your child is sick, the provider is sick or the childcare center closes because of a water main leak, she said.