In some areas it is not just family members who help.
My sister had a home child care “business” that was “unofficial” and took care of the kids of friends when she had young kids of her own.
Money may have changed hands—but nobody talked about it and nobody asked.
I have a friend who lives near Goose Creek, SC (close to Charleston) and she is expecting their first child. The cheapest daycare around her is $1200 a week - and it has a waiting list. She and her husband both work and have recently purchased a small house (2 bedroom) and with their financial commitments they cannot afford to loose an income. The cost of child care is outrageous.