Support for Fathers

Lately, I have been giving a lot of thought to the important influence fathers can have in a family.

At home, we have just celebrated Father’s Day, and I have been thankful for the great partnership my husband and I have as we juggle our crazy work schedules, school, summer camps, and soccer games. At work, I have been spending a lot of time supporting our program for teen and young adult fathers. These young men face so many challenges in their lives, and still are dedicated to "being there" for their children. No matter what kind of day I am having, when I walk through clinic and see a young father holding his child close, cooing softly to her, it always makes me smile. I suspect I am not alone in this, and yet our health care system is not always friendly to fathers (or "nontraditional" families for that matter) or encouraging of their involvement.

Importantly, every family is made up a little differently – and thus fathers may be involved in different ways. Even two families that look similar on the outside may have different schedules and family arrangements; no two families fit into the same little "box". Watching a movie about family diversity at my daughter’s school earlier this year – which talked about all different types of family structure – the father of one of her classmates turned to me at the end and said, "Well, I hope that wasn’t too confusing for my son, because our family fits into about five of those categories!"

In some families, for a variety of reasons, the father (or the mother) isn’t available to be involved. Respecting the fact that no two families are the same, and so "involvement" looks a little different in every family, it does seem clear that positive father involvement has beneficial effects for children (and also on their partners). The National Fatherhood Initiative is a great resource for information, both for providers and parents.

There is relatively little literature on the topic of involving fathers in their children’s health care, although most agree this is a worthy area of focus. The well-child visit seems an ideal place to encourage this involvement, as it is an opportunity to develop a long-term and trusting relationship with a family. Dr. Craig F. Garfield and his colleagues (Pediatrics 2006;117;e637-45) have a number of recommendations to encourage father involvement in well-child care:

• Provide the father with "relevant and helpful" (perhaps written) information about his child’s health and development.

• When both parents are present, include both in the conversation, and direct questions to both.

• Encourage all main caregivers to be present at well-child visits, in order to facilitate conversation between provider and parent, as well as between parents.

• In families where there is more than one caregiver, and only one is present at a visit, invite them to schedule the next visit at a time when everyone can attend.

• Discuss how parental responsibilities are (and should be!) shared.

• If fathers are unable to attend the visit, invite them to write their questions down and send them in.

• Consider using technology for information exchange and as an engagement tool.

I would also add that it is important to be sure all staff in your office are on the same page with this – fathers should feel as welcomed in the waiting area as they do in the exam room! In my experience, there is great variability among fathers – some are very involved and comfortable with their child’s health care, and others really hold back. Regardless, creating a warm and welcoming environment for fathers is an important first step, and something easily done.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington. She is a member of the Pediatric News editorial advisory board, a member of the American Academy of Pediatrics Committee on Residency Scholarships, and president-elect of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.

Lately, I have been giving a lot of thought to the important influence fathers can have in a family.

At home, we have just celebrated Father’s Day, and I have been thankful for the great partnership my husband and I have as we juggle our crazy work schedules, school, summer camps, and soccer games. At work, I have been spending a lot of time supporting our program for teen and young adult fathers. These young men face so many challenges in their lives, and still are dedicated to "being there" for their children. No matter what kind of day I am having, when I walk through clinic and see a young father holding his child close, cooing softly to her, it always makes me smile. I suspect I am not alone in this, and yet our health care system is not always friendly to fathers (or "nontraditional" families for that matter) or encouraging of their involvement.

Importantly, every family is made up a little differently – and thus fathers may be involved in different ways. Even two families that look similar on the outside may have different schedules and family arrangements; no two families fit into the same little "box". Watching a movie about family diversity at my daughter’s school earlier this year – which talked about all different types of family structure – the father of one of her classmates turned to me at the end and said, "Well, I hope that wasn’t too confusing for my son, because our family fits into about five of those categories!"

In some families, for a variety of reasons, the father (or the mother) isn’t available to be involved. Respecting the fact that no two families are the same, and so "involvement" looks a little different in every family, it does seem clear that positive father involvement has beneficial effects for children (and also on their partners). The National Fatherhood Initiative is a great resource for information, both for providers and parents.

There is relatively little literature on the topic of involving fathers in their children’s health care, although most agree this is a worthy area of focus. The well-child visit seems an ideal place to encourage this involvement, as it is an opportunity to develop a long-term and trusting relationship with a family. Dr. Craig F. Garfield and his colleagues (Pediatrics 2006;117;e637-45) have a number of recommendations to encourage father involvement in well-child care:

• Provide the father with "relevant and helpful" (perhaps written) information about his child’s health and development.

• When both parents are present, include both in the conversation, and direct questions to both.

• Encourage all main caregivers to be present at well-child visits, in order to facilitate conversation between provider and parent, as well as between parents.

• In families where there is more than one caregiver, and only one is present at a visit, invite them to schedule the next visit at a time when everyone can attend.

• Discuss how parental responsibilities are (and should be!) shared.

• If fathers are unable to attend the visit, invite them to write their questions down and send them in.

• Consider using technology for information exchange and as an engagement tool.

I would also add that it is important to be sure all staff in your office are on the same page with this – fathers should feel as welcomed in the waiting area as they do in the exam room! In my experience, there is great variability among fathers – some are very involved and comfortable with their child’s health care, and others really hold back. Regardless, creating a warm and welcoming environment for fathers is an important first step, and something easily done.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington. She is a member of the Pediatric News editorial advisory board, a member of the American Academy of Pediatrics Committee on Residency Scholarships, and president-elect of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.

Lately, I have been giving a lot of thought to the important influence fathers can have in a family.

At home, we have just celebrated Father’s Day, and I have been thankful for the great partnership my husband and I have as we juggle our crazy work schedules, school, summer camps, and soccer games. At work, I have been spending a lot of time supporting our program for teen and young adult fathers. These young men face so many challenges in their lives, and still are dedicated to "being there" for their children. No matter what kind of day I am having, when I walk through clinic and see a young father holding his child close, cooing softly to her, it always makes me smile. I suspect I am not alone in this, and yet our health care system is not always friendly to fathers (or "nontraditional" families for that matter) or encouraging of their involvement.

Importantly, every family is made up a little differently – and thus fathers may be involved in different ways. Even two families that look similar on the outside may have different schedules and family arrangements; no two families fit into the same little "box". Watching a movie about family diversity at my daughter’s school earlier this year – which talked about all different types of family structure – the father of one of her classmates turned to me at the end and said, "Well, I hope that wasn’t too confusing for my son, because our family fits into about five of those categories!"

In some families, for a variety of reasons, the father (or the mother) isn’t available to be involved. Respecting the fact that no two families are the same, and so "involvement" looks a little different in every family, it does seem clear that positive father involvement has beneficial effects for children (and also on their partners). The National Fatherhood Initiative is a great resource for information, both for providers and parents.

There is relatively little literature on the topic of involving fathers in their children’s health care, although most agree this is a worthy area of focus. The well-child visit seems an ideal place to encourage this involvement, as it is an opportunity to develop a long-term and trusting relationship with a family. Dr. Craig F. Garfield and his colleagues (Pediatrics 2006;117;e637-45) have a number of recommendations to encourage father involvement in well-child care:

• Provide the father with "relevant and helpful" (perhaps written) information about his child’s health and development.

• When both parents are present, include both in the conversation, and direct questions to both.

• Encourage all main caregivers to be present at well-child visits, in order to facilitate conversation between provider and parent, as well as between parents.

• In families where there is more than one caregiver, and only one is present at a visit, invite them to schedule the next visit at a time when everyone can attend.

• Discuss how parental responsibilities are (and should be!) shared.

• If fathers are unable to attend the visit, invite them to write their questions down and send them in.

• Consider using technology for information exchange and as an engagement tool.

I would also add that it is important to be sure all staff in your office are on the same page with this – fathers should feel as welcomed in the waiting area as they do in the exam room! In my experience, there is great variability among fathers – some are very involved and comfortable with their child’s health care, and others really hold back. Regardless, creating a warm and welcoming environment for fathers is an important first step, and something easily done.

Dr. Beers is assistant professor of pediatrics at Children’s National Medical Center in Washington. She is a member of the Pediatric News editorial advisory board, a member of the American Academy of Pediatrics Committee on Residency Scholarships, and president-elect of the District of Columbia chapter of the American Academy of Pediatrics. She said she had no relevant financial disclosures.