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This article aims to explore how child care is organized in families, documenting how mothers produce their individual child care solution, or “patchwork”, within the context of Canada’s underfunded and fragmented child care system. In a sample of 109 mothers from Alberta, Canada, where child care is conceptualized as primarily a private family responsibility, we use an ecocultural theoretical framework and a gender lens to 1) identify the constraints that influenced what kinds of child care mothers used, 2) explore the organization of day-to-day child care arrangements, and 3) explicate the accommodations and flexibility required to sustain the family routine. We show that in addition to previously recognized categories of child care—formal, informal, and mixed—families also used multiple informal and parent-plus (i.e., parental plus non-parental) child care. The procurement and management of child care—particularly when multiple care providers were involved—was gendered, often invisible, and required substantial accommodations and flexibility by mothers. We propose a day-care plus policy model of child care, where formal arrangements are supplemented as required. This policy model could help families avoid the complex scenarios we conceptualize as chaotic flexibility and assist families in achieving sustainable flexibility in the organization of care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)