A review of 27 research papers on fathers in neonatal intensive care units, led by midwife Jill Ireland at St Mary’s Matarnity Hospital in Poole, UK, concludes with a set of recommendations for how fathers should be supported.

1. Help relieve parental stress, fathers included.

Some studies show fathers report less stress, but others find gender stereotypical behaviour – fathers’ not expressing their emotions and talking about “being strong” and “soldiering on”. (But only about 50% of fathers are found to be like this – others are open about their emotions.)

A New Zealand study found that fathers with pre-term babies are more likely to suffer from depression.

Relieving stress is ultimately important for the baby.

2. Let the father bond with the baby and have time alone with the baby.

Fathers can see themselves as secondary parents and staff can treat them that way. Some of the studies observe that fathers are less intimate with the baby when the mother is present – they defer to the mother. Fathers tend to express less determination to be in control of the care of their babies than mothers do.

Teaching the father care skills, such as stroking the baby and skin-to-skin contact is important.

A Scandinavian study found that fathers bond more strongly to their babies when they are pre-term than when they are born at full-term. The disruption of normality perhaps allows more space for the father to develop a caring role.

3. Ensure that fathers are well informed.

Fathers have the same information needs as mothers, but information provided in the wrong way can inspire fear rather than comfort. There is a risk with fathers that they receive too much second-hand information because they are not present during working hours.

Staff should be available in the evenings to communicate information directly to fathers.

4. Fathers need flexible access to the unit.

Again, according to gender norms, fathers are more likely to take on the other family responsibilities, such as caring for older children, managing family communications and earning money.

Allowing longer visits to fathers is important, so that they have more access to all the supports recommended above.

Ireland J, Khashu M, Cescutti-Butler L, van Teijlingen E & Hewitt-Taylor J (2016), Experiences of fathers with babies admitted to neonatal care units: A review of the literature, Journal of Neonatal Nursing 22

Photo: Teddy Kwok. Creative Commons.