Take off.
I did it a bunch when my daughter was little and I was working.
Depending on the boss I had; what was going on at work; how sick my daughter was; and how much sleep I was getting, I would do some work from home.
The kids come first! I even had to leave a meeting my boss and I were hosting for a bunch of Sr. Execs. in our organization, because my daughter at 18 months old had a severe asthma attack while at day care. That's life. But that is also why I am not working now, my son has some series medical issues, and trying to juggle them, his doctor's appointments, regular illness, and his school issues, I just cannot work right now.
I hope the helps. I know many people who use a nanny, or neighbor/friend for this reason. Also my husband would take time off too. He and I traded depending on what was going on in our offices.