For most parents, child care is the largest household expense by far, and the cost is continuing to rise, according to a new report from Child Care Aware of America.

The report found that the annual cost of infant care, which increased 2 percent last year, ranged from about $4,600 in Mississippi to $15,000 in Massachusetts.

The cost of caring for a 4 year old also rose last year by more than 4 percent and ranged from $3,900 a year in Mississippi to $11,700 in Massachusetts.

Editor's Note: The ‘Unthinkable’ Could Happen — Wall Street Journal. Prepare for Meltdown

In almost half of all states, the cost of center-based care for an infant exceeded annual median rent payments. And when two children were factored in, the costs exceeded rent payments in all 50 states.

To put that into perspective, the Star Tribune reported that in Minnesota, child care costs can consume half of the annual income of a single mother and costs more than a year of state college tuition.

With a weak economy, high unemployment and rising costs for other goods, such as food and gas, the high costs of child care are not negligible. On the contrary, they are increasingly becoming a strain on household budgets.

Many parents are having to rethink how they do things. Some are choosing alternatives such as unlicensed care providers. Others are questioning whether they can afford to expand their families.

“Some parents have to make some very difficult decisions: Do you pay your child care or do you pay your rent?” CNNMoney quotes Marsha Basloe, executive director of New York's Early Care and Learning Council, as saying.

Earlier this year, the U.S. Department of Agriculture released a report that found a middle-income family would spend $234,900 to raise a child born in 2011 to the age of 18, a 3.5 percent increase from the previous year, according to Bloomberg. Adjusted for anticipated inflation, this cost would rise to $295,560.

A typical two-parent, middle-income family spent $12,290 to $14,320 in 2011 on each child, Bloomberg reported.

Editor's Note: The ‘Unthinkable’ Could Happen — Wall Street Journal. Prepare for Meltdown