The infant mother dyad is an ever present part of the NICU dialogue, and with good reason as mothers play a crucial role in the health and healing of our fragile patients.  But what about fathers? 

In this Literature Spotlight, we highlight the work of Gesine Hearn, PhD, RN; Gina Clarkson, PhD, APRN, NNP-BC; and Matthew Day, BSN, RN, in their February 2020 article, The Role of the NICU in Father Involvement, Beliefs, and Confidence: A Follow-up Qualitative Study, published in Advances in Neonatal Care. 

Research has shown that fathers absolutely play a crucial role in the NICU and that infants of involved fathers show improved short and long term outcomes including improved weight gain, sleep, psychosocial behaviors and decreased length of stay. This study’s aim was to explore the factors impacting NICU father involvement from a longitudinal perspective through interviews conducted with fathers 4 to 5 years following their baby’s NICU stay.

When researchers reviewed the responses from fathers they began to identify some common themes. Here are just a few that the study identified. 

It Was Scary  Having a baby in the NICU is scary.  Fathers are not as likely to show these emotions outwardly but they are also experiencing fear, uncertainty, nervousness, and anxiety.

Just Be There Having a baby in the NICU often leaves parents feeling helpless, especially fathers. Father’s need to know that simply being present, being at the bedside with mom, with their baby is important. 

It Was Rough NICU parenting is not for the faint of heart.  This will undoubtedly be one of the hardest if not the hardest time a parent will endure.  Fathers are often called to continue normal working schedules to support their family while still spending time at the hospital. This translates into grueling schedules of commuting from home to work to hospital to home.

How can we help as bedside nurses? Researchers found that nurses play a key role in making a positive impact through supporting fathers in the NICU.  Two simple yet impactful ways the bedside nurse can help build stronger father infant bonds is through encouraging fathers to be present at the bedside regularly, and to ensure they are participating in infant care. 

What are some ways you support fathers in your NICU?

Supporting Fathers During COVID-19

As I read this article, I couldn’t help but wonder what the fathers who are enduring their baby’s hospitalization during this global pandemic would have to say?  Fathers are finding themselves in unprecedented positions in the wake of COVID-19.  

Caregiver Restrictions

In some cases, they are unable to be at their baby’s bedside at all. Many units have instituted policies that mandate families to identify a single caregiver for the hospitalization. Meaning that only dad OR mom may be at the bedside.  Whichever parent is identified, they are the sole caregiver allowed on hospital premises until the baby is discharged.  More often than not this will be mom leaving fathers out of the equation.  My heart aches when I’m in a patient room and mom is on Facetime talking to a father who has never met his baby. With no end in sight to visitor restrictions or to his baby’s hospitalization, this electronic relationship is all he will have for some time.

Fathers as Sole Caregivers

I have also experienced the opposite situation.  There are cases where mom is unable to be the sole caregiver. Imagine that you are a mother who has recently delivered a sick or premature baby and that your baby needed to be transferred to another hospital.  Even moms that are discharged early may not be able to drive themselves to their baby’s hospital or endure what is almost surely a long walk from the parking lot to their baby’s bedside.  Fathers are stepping in to the role as the sole caregiver allowed at their baby’s bedside. Where they may have imagined themselves in a supporting role, they now find themselves at center stage without the support of their partner.

Do you have a special program for fathers in your NICU? Have you seen the role of the father change during COVID-19? We’d love to hear from you!

Hearn, G., Clarkson, G., & Day, M. (2020). The Role of the NICU in Father Involvement, Beliefs, and Confidence. Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses., 20(1), 80–89.