Dads Matter Too: Making Room for Fathers at Well-Child Visits

Fathers want to be involved in their infant’s care, as asserted in the seminal work of Garfield and Isacco (2006). Moreover, fathers have unique concerns and questions that should be addressed at well-child visits. Pediatricians and other healthcare providers play a vital role in supporting fathers during well-child visits (Garfield & Isacco, 2006; Yogman & Craig, 2016). Further, research has shown that involving fathers in well-child visits greatly improves their child’s health, including their child’s development, social and emotional outcomes (Gears & Mendoza, 2024). Therefore, it is essential to create father-friendly, pediatric practice environments in which fathers feel comfortable bringing their child to a well-child visit and asking questions regarding their child’s care.

Pediatric settings should deliver father-friendly care that focuses on 1) challenging  assumptions held by pediatric care teams, 2) educating staff on their perceptions of the father’s role, and 3) creating a welcoming environment for fathers (Gears & Mendoza, 2024; Yogman & Garfield, 2016). Please note that the Yogman and Garfield (2016) article was reaffirmed by the American Academy of Pediatrics (AAP) in 2022 and remains relevant to current pediatric practices.

Challenging Personal Assumptions of Pediatric Care Teams

It important that pediatric care team members confront their own biases regarding the role of the father at office visits. All team members should support fathers of all races, ethnicities, sexual orientations, and socioeconomic backgrounds. Key considerations include the following:

·       Assume the child’s father is as involved and informed as the mother. Pediatric team members may not be aware of the extent of the father’s involvement with the care of his child, particularly since children are often seen multiple times throughout the year.

·       Presume engagement. Don’t assume that your job is to help the father engage with his child. If he is at the appointment, he is already invested in his child.

·       Ask fathers what they want to know. Don’t assume you know the questions that a father may ask or their priorities regarding their child. Fathers who attend well-child visits are invested in their child’s care and deserve the opportunity to voice their concerns (Gears & Mendoza, 2024).

Educate Staff

Members of the Pediatric Care Team may hold different perceptions about the father’s role, which can differ across families and cultures. Research consistently demonstrates that the father-child relationship is critical to the child’s well-being. Therefore, all pediatric staff, including front-desk personnel, should be informed of key research findings related to the importance of father involvement with their children. Key strategies include:

·       Become familiar with father-friendly program principles. Search for father-friendly programs that may help strengthen pediatric practice environments. For example, the National Fatherhood Initiative provides training and support to community organizations and businesses that want to learn how to make their environment more father-friendly (fatherhood.org).

·       Highlight the important influence of fathers on child development. Share evidence-based information with fathers or mother/father dyads about the positive impacts of the father on the child’s health and development.

·       Discuss cultural differences in raising children and the role of the father. Encourage pediatric care team members to engage with other parents from different cultures to better understand varying expectations and the roles of fathers (Gears & Mendoza, 2024).

Create a Welcoming Environment for Fathers

Pediatricians and other HCPs can expect to see increasing numbers of fathers at well-child visits. It is essential that fathers feel “welcomed” and “respected” at pediatric offices. Here are some strategies for creating a father friendly environment for fathers:

·       Speak to the father directly. Introduce yourself, make eye contact, and address the father directly, whether he is alone or with the child’s other parent. Ask for the father’s name and encourage him to ask questions in the visit (Gears & Mendoza, 2024; Yogman & Garfield, 2016).

·       Explore the father’s marital relationship. During the initial visit, politely inquire about the father’s relationship to the other parent (ex., married, living together, separated) and assess cultural beliefs related to child rearing (Yogman & Garfield, 2016).

·       Focus on strengths. Invite fathers to share something they enjoy about their child. This approach fosters comfort, encourages engagement, and strengthens the father–child relationship. (Gears & Mendoza, 2024; Yogman & Garfield, 2016).

·       Fathers’ role in play. Stress the importance of fathers engaging in age-appropriate play with their children (Yogman & Garfield, 2016).

·       Encourage the father to assume some roles early in the care of the child. Support fathers in assuming caregiving roles early in infancy. Alone time with the child helps the father develop confidence which will benefit the father’s style of interaction with his child (Yogman & Garfield, 2016).

·       Ask fathers about the infant/child caretaking skills. Ask fathers about caregiving skills they wish to improve and provide referrals to community resources that support skill-building and confidence (Yogman & Garfield, 2016).

·       Provide anticipatory guidance at each pediatric visit. Based on the child’s age, provide growth and development information at each pediatric visit, and answer any questions from the father and/or mother (Krantz, Gievers, & Khaki, 2020).    

·       Include images of fathers. Display images of fathers and children in waiting areas and practice materials. Consider putting father-directed magazines in the waiting area (Gears & Mendoza, 2024)

·       Put changing tables in all bathrooms. By installing this equipment, fathers can seamlessly and independently take care of their children (Gears & Mendoza, 2024

·       Create a father-friendly survey. Encourage fathers to complete the surveys so the pediatric office can evaluate and improve father-friendly practices (Gears & Mendoza, 2024; Yogman & Garfield, 2016).

Conclusion

Fathers want to be involved with their child’s medical care at well-child visits. Pediatricians and other HCPs must foster father-friendly environments where fathers feel welcomed, valued, and supported. As Garfield and Isacco (2006) emphasized in their seminal work,  “Pediatricians play a vital role in supporting fathers and families as they engage the health care system, all working together to seek the most positive health outcomes for the child” (pp. e643-644).

References

Garfield, C. F., & Isacco, A. (2006). Fathers and the well-child visit. Pediatrics,117, 637-645.  https://pubmed.ncbi.nlm.nih.gov/16585280/

Gears, H., & Mendoza, L. (2024). Partnering with dads to enhance pediatric care. Center for Health Care Strategies, pp. 1-4. https://www.chcs.org/search/?fwp_main_search=partnering+with+dads+to+enhance+pediatric+care

Krantz, J., Gievers, L., & Khaki, S. (2020). Investigating parental concerns at the first well-child visit. Clinical Pediatrics, 59(1), 83-86. https://journals.sagepub.com/doi/10.1177/0009922819884571

Yogman, M., & Garfield, C. F. (2016). Father’s roles in the care and development of their children: The role of pediatricians. Pediatrics, 138(1), e2016128. http://publications.aap.org/pediatrics/article-pdf/138/1/e20161128/1702988/peds_20161128.pdf

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