A review of literature has listed key support needs of fathers in neonatal care. In many respects the needs of fathers are similar to those of mothers, but fathers have been studied very much less.

Challenges faced by fathers include:

• Feeling out of control (as for mothers).
• Work constraints. Typically, work leave entitlements for fathers are inadequate – they are very short, with no flexibility for the considerably enhanced difficulties of having a sick baby.
• Being classified as a second-class parent or “novice” and not as a full carer.
• Other family responsibilities, such as earning money and caring for other children.

Research shows that for most fathers of a new baby, if they have information they use it well in the care of the baby and feel empowered. A problem in intensive care can be too much information and also the timing of information, which can easily be imparted to the mother while the father is not there.

The article refers to the growing number of examples of webcam projects, whereby parents can see their babies at all times by logging in online. These are regarded very positively by parents, according to recent research.

Since fathers’ time in NICUs is typically limited, the use of this time is important. Staff can, for example, plan care of the baby when the father is present, though there are many constraints around this, for example the inflexible times of consultant visits. A care plan that specifically includes the father is another possibility, so that all the neonatal medical team are aware of the role the family wants the father to play.

A key suggestion of the article is that fathers are formally assessed when their baby is admitted to the NICU, so that their needs are understood and planned for. The article recommends the “fathers support scale” published in 2015 by Paula Mahon et al. This scale has 33 questions for fathers to rate on a 1-4 scale.

Taking Care of Your Baby

As a father of a baby in the NICU, how important are the following things to you?

1. Getting regular information about your baby’s health
2. Getting information about your baby in plain, non-medical language
3. Being able to get the information you need about your baby from the NICU doctors
4. Being able to understand what you hear about your baby on rounds
5. Getting recommendations for your baby’s care from one doctor after medical meetings about your baby.
6. Getting the information you need about your baby from the NICU nurses
7. Knowing the roles of staff who care for your baby
8. Getting a general idea (rather than a detailed report) about your baby’s health daily
9. Feeling you are kept as well informed as the baby’s mother
10. Being able to get information about your baby by phone
11. Being able to talk with your partner often
12. Being able to talk with friends about your baby often
13. Being able to go to work
14. Being able to take time off work to be with your baby
15. Being able to take care of your finances
16. Being able to help with the care of your other children
17. Being able to talk with other NICU parents
18. Being able to talk with your extended family about your baby
19. Being able to get away to have some time on your own
20. Being able to exercise
21. Being able to pray or do other spiritual practices
22. Getting away to have somentime with your partner
23. Being able to talk to an expert about your emotions or feelings
24. Being able to touch and hold your baby
25. Being able to comfort your baby if he/she is in pain or looks upset
26. Being able to do routine care for your baby such as feeding and diaper changing
27. Being a part of important decisions about your baby’s care
28. Having different doctors’ opinions about the best way to treat your baby
29. Getting a medical opinion about your baby’s care from one doctor after a group discussion
30. Being able to talk to parents who had a baby in the NICU in the past
31. Understanding possible long-term problems your baby might have
32. Being able to stay and sleep overnight in the NICU when your baby is sick (even if you live close to the hospital)
33. Being able to have your baby take part in research studies

Walmsley R & Jones T (2016), Are fathers supported by neonatal teams?: an exploration of the literature, Journal of Neonatal Nursing 22

Mahon P, Albersheim S & Holsti L (2015), The Fathers’ Support Scale: Neonatal Intensive Care Unit (FSS:NICU): Development and initial content validation, Journal of Neonatal Nursing 21

Photo: Crawdrewford. Creative Commons.