Fathers are needed in the neonatal intensive care unit

Photo: Jim Lynch. Creative Commons.

It is important for fathers to have physical contact with their babies in a neonatal intensive care unit.

Six different research articles published in 2016 have looked at fathers in neonatal care units. The researches come to three main conclusions:

  • Babies need to have physical contact with their father.
  • Mothers need fathers to be present.
  • There are things that parents can do to make sure the intensive care unit helps fathers in the best way.

Babies need fathers to be present

It is important for fathers to have physical contact with their babies in a neonatal intensive care unit. It benefits the baby and it strengthens the father-baby bond.

Researchers at Hallym University Sacred Heart Hospital in South Korea ran an experiment to show the benefit of fathers giving “tactile stimulation” to their premature babies. They trained 20 fathers who then stroked their babies for 10 minutes a day over five days. They then compared these 20 fathers and babies with 20 other fathers and babies who had not been through this process. They found that babies who had received tactile care from fathers had higher oxygen saturation levels. Meanwhile, the fathers reported more paternal attachment.

The stroking sequence taught to the fathers was:

  • Make sure your hands are clean warm and you have taken off rings and watches. Do not use oils.
  • Place the baby in a restful position with his or her face turned to the right.
  • Smoothly stroke the baby’s body in the following four ways, for 2½ minutes each: (1) from the top of the head to the neck using the right palm; (2) from the neck across the shoulders and back to the neck using the right finger; (3) from the upper back to the buttocks and reversing to the upper back using the right palm; and (4) from the thigh to the foot on both legs simultaneously using the father’s right finger.

When fathers are close to their babies in this way, hormonal and neurobiological changes take place within him, increasing his attachment to the baby and triggering innate caring instincts. (For example, see Testosterone changes in caring men and Babies decrease fathers’ testosterone.)

Mothers need fathers to be present

Mothers experience more stress in a neonatal intensive care unit if the father is not present. “It was very important to be two”, said one mother in a Norwegian study of 8 mothers and 8 fathers who had had a baby in intensive care.

Things mothers and fathers can do

Neonatal intensive care units are not always very good at involving fathers properly. A big study of 9,000 parents in 11 neonatal intensive care units in Finland, Sweden, Norway, Estonia, Spain and Italy found that units performed weakest in fathers’ participation in infant care, particularly in the view of fathers.

The researchers top tips are:

1. Make sure the father is really OK!

This is not selfish. Mother and baby need the father to be OK.

Whilst both parents experience the situation in similar ways – stress, fear, alienation and a sense of chaos and unreality – mothers and fathers can respond in different ways. Fathers can try to fit into the role of the “strong” person. Sometimes they have to cry alone and unseen. If the mother is also unwell, the father is concerned for her care as well as the baby’s, while the mother can focus more of her concern on the baby.

2. Get father time alone with the baby

The research shows that fathers can be 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, so may let the mother take over. But mothers need a break and babies need their fathers.

3. Stroke and carry the baby as much as possible

Nurses should be ready to teach fathers the practice of stroking the baby and carrying them skin-to-skin (often called “kangaroo care”).

4. Don’t rely on second-hand information

Many fathers have to keep working and look after other family members too. There is a risk 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.

5. Get flexible access to the unit

Flexible access to the unit and longer visits are important for fathers. There is a risk of this not happening if the father is taking on the other family responsibilities.

6. Connect with other fathers in the internet

This is what some fathers said to other fathers on social media groups in a US research study.

“I think that one thing I could have used was communication with other dads who had been through the NICU experience. The moms were able to bond in the pumping room but I had no place to meet or talk with other dads that had gone through what I was expecting.”

“The whole preemie thing is terrifying. Everybody around the situation is focused on mom/baby. Dads are left to worry about everything and everyone. As a dad, you may feel lonely. Hopefully, you will get some support by talking to people in here.”

“Because of our choice to speak up, [infant’s name] is receiving the support he so desperately needs. Feeling empowered and speaking up to advocate for your child is such an important aspect of helping your child whether it’s in the NICU or after you come home.”

“I don’t want to be weak in front of my wife. I don’t think she knows how bad I am hurting right now.”

“We guys like to fix things and this is something that cannot be fixed and there’s got to be some frustration about that. I wouldn’t want my wife asking me how I feel.”