Beyond the diapers and sleepless nights, perhaps the biggest worry for parents with young kids is that almost no state in America provides affordable child care for those under 5.

That's a conclusion reached in a new report Wednesday from the Institute for Women’s Policy Research. Annual payments in several states are higher than college tuition rates, eating up to a third of a working mother's income.

The average annual cost of full-time daycare for a baby in New York is now about $14,500. Parents can expect to pay roughly $16,500 in Massachusetts, $11,628 in California and $12,500 in Illinois.

In metropolitan regions, including some of the most competitive work centers in the country, the price soars even higher. Yearly costs in nation's capital are on average at about $22,000.

“No state," the IWPR researchers wrote wrote, "provides adequate child-care supports to a majority of children under five." The West appears to dominate the bottom third of the rankings.

A handful of statistics illustrate a growing national burden for families with kids: Over the last three decades, weekly out-of-pocket spending on child-care for families with an employed mother has almost doubled, according to the Census Bureau. The average annual cost of daycare is now higher than the price of in-state college tuition in 31 states -- and exceeds 40 percent of the average annual income of single mothers in 22 states.

Expensive, unreliable child-care is often why many new mothers have trouble getting ahead in the workplace, said economist Ariane Hegewisch, who focuses on work and family policy at the IWPR.

Some can't afford it and quit, only to return years later to a steeper uphill climb toward equal pay. Others settle for jobs below their skill sets or part-time work in return for more schedule flexibility.

“When we discuss the gender pay gap, people will quickly say: But don’t women make choices?" Hegewisch said. "Don’t they choose to take time out? Our report is about how our choices are structured -- and structured into a vicious cycle.”

Researchers graded states on two key access measures: How costly are full-time daycare options for infants? And how many four-year-olds are enrolled in publicly funded Pre-K or equivalent programs?

Daycare costs the most for working moms in D.C. It’s cheapest in Alabama.

There are some places where child care remains less burdensome -- the average annual cost of daycare for an infant in Alabama is $5,547. That's about one-sixth of the average working woman's income, making it, by this measure, the least expensive option in the country. In contrast, working mothers devote a third of the average annual income in Massachusetts, Minnesota and New York.

The majority of American parents, however, rely on care by relatives, including older siblings and grandparents, the study notes. One in four working mothers report depending on a patchwork of arrangements.

One reason...

Most kids eligible for federal child-care subsidies don't receive them.

For families that qualify for government help, actually getting that help can be difficult. Only 17 percent of children eligible for child-care subsidies under the federal parameters in 2011 received the assistance, the IWPR found. Long lines (and parents losing jobs to wait in them) hinder enrollment in some areas, the Post previously reported.

Use varies across age groups:

So, with limited resources, many U.S. mothers make sacrifices at work to shoulder more duties at home.

Women are nine times more likely than men to work part-time to care for their families.

Most female workers who chose part-time jobs cite "child-care problems" as the impetus for their decision, according to the IWPR.

And part-time workers are much less likely than their full-time counterparts to have access to any kind of paid leave, which, Hegewisch said, can make it harder to both support and care for kids.

An estimated 43 million workers can’t take a sick day --  for their own recovery or to tend to an ailing relative -- without shrinking their paycheck, according to the National Partnership for Women and Families. They’re often forced to choose between a chunk of wages or, say, taking their child to the doctor.

Beyond painful dilemmas, swapping full-time work for more time at home drastically diminishes lifetime earnings. Women older than 50 who leave the workforce due to care-taking responsibilities lose $324,044 in income and benefits over their lifetime, the IWPR estimates.

Every four-year-old in D.C. can enroll in public preschool. Most four-year-olds don't have that option in New Hampshire. 

Ah, public preschool. Call it free daycare with, at its best, developmental perks. Quality measures and funding vary considerably by state.

But across the country, more kids are joining the programs. Forty percent of four-year-olds nationwide were enrolled in publicly funded Pre-K or equivalent programs in 2013. That's up from 31.2 percent in 2002.

As far as access goes, the District of Columbia offers the most reachable options -- by far. There's room for every four-year-old in the capital's public preschools, the IWPR reports. Florida comes in second place with access for 89 percent. Oklahoma follows with 87 percent.

Only 12 percent of four-year-olds have access to public preschool in New Hampshire, the study found. Hawaii, Idaho and Utah are slightly better off at 13 percent each: