Birth of a Father: Fathering in the First 1,000 Days

Partner and professional support are associated with father-infant bonding: A cross-sectional analysis of mothers, midwives, and child health nurses' influence on primiparous and multiparous fathers of infants in Sweden

OBJECTIVE

To assess if received professional and social support are associated with father-infant bonding among primiparous (first-time) and multiparous (multi-time) fathers.

BACKGROUND

Early father-infant bonding predicts several positive child outcomes. However, while received professional and social support positively impacts fathers' transition into parenthood, little research has tested if these factors are associated with a stronger father-infant bond.

METHODS

In total, 499 fathers (296 primiparous and 203 multiparous) of infants (aged 0-12 months) completed a cross-sectional online survey between November 2018 and March 2020. The survey included items related to socio-demographics, having a planned pregnancy, postnatal midwifery support, child health nurse support, child health center attendance, and social support. The parent-infant bonding questionnaire (PBQ) was used to assess the father-infant bond. Multiple linear regression models were estimated for the total sample and based on paternal parity. Missing data were managed through multiple imputation procedures.

FINDINGS

Fathers reported fewer bonding disturbances if they received support from their partners, postnatal midwives, child health nurses, and attended more child health visits. Primiparous fathers reported fewer bonding disturbances when receiving support from their partners, postnatal midwives, and the child health nurse. However, multiparous fathers had more bonding disturbances than primiparous fathers and received less professional and partner support.

CONCLUSIONS

Receiving more partner and professional support is associated with less father-infant bonding disturbances. To encourage a better father-infant bond, clinicians should invite and support all fathers, regardless of parity, as they transition to parenthood.

Exploring the role of OXTR gene methylation in attachment development: A longitudinal study

The current study explored longitudinally whether oxytocin receptor gene methylation (OXTRm) changes moderated the association between parental sensitivity changes and children's attachment changes over three waves. Six hundred six Flemish children (10-12 years, 42.8%-44.8% boys) completed attachment measures and provided salivary OXTRm data on seven CpG sites. Their parents reported their sensitive parenting. Results suggest that OXTRm changes hardly link to attachment (in)security changes after the age of 10. Some support was found for interaction effects between parental sensitivity changes and OXTRm changes on attachment changes over time. Effects suggest that for children with increased OXTRm in the promotor region and decreased methylation in the inhibitor region over time, increased parental sensitivity was associated with increased secure attachment and decreased insecure attachment over time.

Effects of a Baby Carrier Intervention on Fathers' Sensitivity, Involvement, and Hormonal Levels: Follow-Up of a Randomized Controlled Study

Objective. Fathers are of great importance for healthy child development. This randomized controlled study investigated the longer-term effects of an intervention using a soft baby carrier on fathers' observed sensitive caregiving, involvement, and oxytocin and cortisol levels. Design. First-time fathers were randomly assigned to use a baby carrier (n = 41) or baby seat (n = 39) and were asked to use the carrier or seat for at least 6 h per week for 3 weeks. Pretest (M child age  = 2.67 months), posttest (M child age  = 3.99 months), and follow-up (M child age  = 8.25 months) father data were collected. Results. No intervention effects of baby carrier use on fathers' sensitivity, involvement, and oxytocin or cortisol levels at follow-up emerged. Unexpectedly, fathers in the baby seat condition reported an increase in the amount of time spent with the infant. Fathers' sensitivity and oxytocin levels decreased over time, while cortisol levels increased over time, irrespective of condition. Conclusions. This study showed less optimal hormonal levels in fathers over time, suggesting that support during the first months of fatherhood is needed. Furthermore, use of a baby seat may have contributed to fathers enjoying their time with their infant and consequently their involvement in child caregiving.

The Co-Parenting Across Family Structures Scale: Replication for Mandarin parents

Co-parenting, the undertaking of parents working together to raise their children, is well documented as an important consideration of children's adjustment in Western countries, but we know less about the role of co-parenting in other cultures. In China, for example, co-parenting has only recently emerged in the social science literature. This study aimed to examine the cultural sensitivity of the CoPAFS instrument among Chinese Mandarin-speaking parents. CoPAFS is a 27-item survey designed to assess co-parenting across married and unmarried family structures originally developed in English. Data were collected from 729 Chinese-speaking and 348 English-speaking respondents. Factor analyses and confirmatory factor analyses indicated that the overall model fit for the translated co-parenting measure was acceptable in Mandarin. However, the five CoPAFS subscales (trust, respect, communication, acrimony, and value) differed across comparison groups, with communication notable for its lack of endorsement among Chinese couples. Implications of measuring co-parenting within Chinese families are offered.

White matter microstructure organization across the transition to fatherhood

The transition to parenthood remains an understudied window of potential neuroplasticity in the adult brain. White matter microstructural (WMM) organization, which reflects structural connectivity in the brain, has shown plasticity across the lifespan. No studies have examined how WMM organization changes from the prenatal to postpartum period in men becoming fathers. This study investigates WMM organization in men transitioning to first-time fatherhood. We performed diffusion-weighted imaging to identify differences in WMM organization, as indexed by fractional anisotropy (FA). We also investigated whether FA changes were associated with fathers' postpartum mental health. Associations between mental health and WMM organization have not been rarely examined in parents, who may be vulnerable to mental health problems. Fathers exhibited reduced FA at the whole-brain level, especially in the cingulum, a tract associated with emotional regulation. Fathers also displayed reduced FA in the corpus callosum, especially in the forceps minor, which is implicated in cognitive functioning. Postpartum depressive symptoms were linked with increases and decreases in FA, but FA was not correlated with perceived or parenting stress. Findings provide novel insight into fathers' WMM organization during the transition to parenthood and suggest postpartum depression may be linked with fathers' neuroplasticity during the transition to parenthood.

Translation and Testing the Reliability and Validity of a Japanese Version of the Paternal Antenatal Attachment Scale (PAAS-J)

Background and Purpose: This study aimed to translate and validate a Japanese version of the Paternal Antenatal Attachment Scale (PAAS-J). Methods: The PAAS-J was translated through a pilot study and a survey of fathers with pregnant partners. Results: The survey involved 189 fathers. A confirmatory factor analysis was performed, but the model fit was poor. Therefore, an exploratory factor analysis (EFA) was performed. Based on the results of the EFA, three items with low interitem correlations and factor loadings were deleted, and a 13-item scale consisting of 2 domains was created. Coefficient alpha was .80. The intraclass correlation coefficient of the retest method was .80, confirming its reliability. Conclusions: The PAAS-J was found to be reliable and valid.

Concordance in dietary intake among caregivers and infants during the period of complementary feeding: A scoping review

Dietary intake during infancy shapes later food preferences and is important for short- and long-term health and wellbeing. Although caregivers are thought to influence the developing food preferences of infants, children less than two years have been notably absent in existing meta-analyses on the topic. This scoping review seeks to fill this gap by using a systematic process to identify and summarize the published literature on the resemblance of caregiver and infant diet during the period of complementary feeding (6-23 months). Articles were included if they assessed intake of foods or beverages other than human milk or commercial milk formula and reported a test of association between the intake of caregivers and infants. Four electronic databases (PubMed, EMBASE, Scopus, and Global Health) were systematically searched for articles published since 2000. Thirty-three articles, representing 32 studies, were identified. The majority of studies examined infant intake of food groups/items (n = 20), seven studies examined infant dietary patterns, and six studies examined dietary diversity. Studies predominantly reported associations between diets of mothers and infants (n = 31); three studies reported associations for fathers. Most studies assessed infant diet at one timepoint (n = 26), with 12 studies combining the intakes of younger (0-11 months) and older infants (12-23 months). Food groups examined, in order of frequency, included 'non-core' foods and beverages (n = 14), vegetables (n = 13), fruits (n = 12), protein foods (n = 6), grains (n = 5), and dairy foods (n = 4). Definitions of variables for food groups and dietary patterns were highly heterogeneous, but consistent for dietary diversity. Nearly all studies (n = 31) reported significant associations between dietary intakes of caregivers and infants. Findings suggest caregiver diet may be a promising focus for interventions aiming to shape the food preferences and dietary intakes of infants.

Maternal and paternal insightfulness and reaction to the diagnosis in families of preschoolers with Autism spectrum disorder: associations with observed parental sensitivity and inter-parent interaction

Sensitivity among parents of children with Autism Spectrum Disorder (ASD) is based on parental insightfulness and on resolution regarding the child's diagnosis. This has been supported in studies of mothers, and we examined whether the same is true regarding fathers. Also, we asked whether parents' Insightfulness and Resolution tap general mentalization and therefore also be expressed in parent-parent interactions. Eighty preschooler boys with ASD and both of their parents participated. As expected, fathers who were more insightful and mothers who were more resolved were more sensitive. Contrary to expectations, no associations were found between fathers' resolution and mothers' insightfulness and their sensitivity. Associations were found between parental insightfulness and resolution and positive parent-parent interaction. The findings are the first to demonstrate the insightfulness-sensitivity link among fathers of children with ASD. Also, they suggest that both insightfulness and resolution involve general mentalization that is evident both in parent-child and parent-parent interactions.

The validity and reliability study of the first-time fathers questionnaire in Turkish

The father's participation in the birth contributes significantly to the mother's birth experiences as well as to the fatherhood process. Since fathers have traditionally not been allowed to attend childbirth in Turkish public hospitals, which now is changing, there is a lack of research in this area. To remedy this shortcoming, a questionnaire that explores the Turkish fathers' experiences of childbirth is needed. The study aims to translate, validate, and adapt the pre-existing First-Time Fathers' Questionnaire to the Turkish language and culture. In the first stage of the study, the questionnaire was translated to Turkish. Expert opinions of the First Time Father Questionnaire were taken, and the content validity was checked. The revised questionnaire was then completed by 110 fathers. The average age of the fathers participating in the study was 32.12 ± 6.8 and 80 % of them were found to be middle class. The construct validity of the questionnaire was tested with explanatory factor analysis and confirmatory factor analysis, finally a test-retest was performed. The Cronbach's alpha coefficient for each dimension of the 20-items questionnaire was as follows: knowledge = 0.90, acceptance = 0.90, anxiety = 0.88, and emotional support = 0.66. All sub-dimensions correspond to 68.5 % of the total variance. The confirmatory factor analysis model showed consistency for the data (X2/DF = 1.078; RMSA = 0.027; CFI = 0.992; GFI = 0.900; AGFI.0.829). Therefore, the adaptation of the First Time Fathers Questionnaire is a valid and reliable instrument in evaluating the childbirth experiences of first-time fathers in Turkish culture.

Configurations of mother-child and father-child attachment relationships as predictors of child language competence: An individual participant data meta-analysis

An individual participant data meta-analysis was conducted to test pre-registered hypotheses about how the configuration of attachment relationships to mothers and fathers predicts children's language competence. Data from seven studies (published between 1985 and 2014) including 719 children (Mage : 19.84 months; 51% female; 87% White) were included in the linear mixed effects analyses. Mean language competence scores exceeded the population average across children with different attachment configurations. Children with two secure attachment relationships had higher language competence scores compared to those with one or no secure attachment relationships (d = .26). Children with two organized attachment relationships had higher language competence scores compared to those with one organized attachment relationship (d = .23), and this difference was observed in older versus younger children in exploratory analyses. Mother-child and father-child attachment quality did not differentially predict language competence, supporting the comparable importance of attachment to both parents in predicting developmental outcomes.

Triadic family interactions at 2 years: The role of prenatal marital quality and infants' attachment configuration with mother and father

This longitudinal study uncovered prenatal marital antecedents of infants' attachment configurations with both mother and father at 12-15 months (n = 125). We also examined the contribution of both marital quality and infants' attachment configurations (secure with both parents, insecure with both parents, secure with mother-insecure with father, and insecure with mother-secure with father) to the quality of triadic (mother-father-toddler) interactions observed two years post-birth. Couples who displayed less negative affectivity and were more emotionally attuned were more likely to have infants securely attached with father and insecurely attached with mother (vs. insecure with both parents) and they engaged in more adaptive family interactions at two years. Also, a secure infant-father attachment relationship forecast more balanced triadic family interactions, regardless of whether the infant-mother attachment was secure or insecure. In contrast, a secure infant-mother attachment relationship was related to less controlling behavior during triadic interactions, regardless of infant-father attachment security.

Mentalizing in first-time fathers: reflective functioning as a mediator between attachment representation and sensitivity

Sensitivity in parent-child interaction is essential for child development. Since fathers are increasingly involved in childrearing, identifying factors leading to paternal sensitivity is crucial. We examined the relation between attachment representation and reflective functioning (RF) as factors influencing paternal sensitivity in a longitudinal study including N = 40 first-time fathers (Mage = 33) and their 6-month-old children. We used the Adult Attachment Interview during pregnancy to assess paternal attachment representation and general RF, the Parental Development Interview to assess fathers' parental RF, and the Emotional Availability Scale to measure sensitivity at child's age of 6 month. Data show that secure paternal attachment representation, high general and parental RF are associated with higher levels of paternal sensitivity. Further, parental RF mediates the association between attachment representation and paternal sensitivity. These findings contribute to the identification of a causal interplay in that they suggest an explanatory effect of RF on the association between fathers' attachment representation, and sensitivity.

Postpartum Paternal Depression: Its Impact on Family and Child Development

The postpartum period is when parents undergo great changes and gain new responsibilities. Factors such as the changes that come with having a baby, not meeting the expectations about parenthood, having a child with a difficult temperament or health problems, or relational problems can be quite challenging in this period. These problems can deeply affect the psychological well-being of the parents. Although studies on depressive symptoms of mothers during pregnancy and postpartum are at an important level, studies aiming to examine the psychological state of fathers for the same period are still limited. However, perceptions that postpartum depression develops due to hormonal changes during pregnancy have been reshaped by the findings that this situation may also develop due to psychosocial factors. Relatedly, the number of studies on postpartum depression experienced by fathers has increased over time. Results of those studies show that fathers' psychological state also influences their parenting and the development of children. Fathers may experience paternal depression due to a lack of social support, economic conditions, relationship dynamics, and changing living conditions in the postpartum period. This situation may cause fathers to avoid parenting duties, spend less time with their children, be unable to cooperate with the mother, and have anger problems or deterioration in the relationship with the mother. The effects of depression on individuals' parenting styles negatively affect child-parent attachment and may cause children to develop emotional and behavioral problems. Therefore, it is very important to examine fathers' psychological state for children's development and the healthy progress of family dynamics. This review aims to address the effect of paternal depression on parenting and child development.

'Everything that's said comes from me': New fathers' experiences of individual conversations with the child health nurse

AIM

Swedish Child Health Services provide regular health surveillance of children 0-5 years and support to parents, with the aim to contribute to equitable child healthcare and to promote physical, emotional, and social health for children. Individual conversations with the child health nurse, including screening for postnatal depression, have been recommended and well implemented for mothers, whereas routines for a visit specifically for the nonbirthing parent vary and are not well studied. The aim of this study was therefore to explore how nonbirthing parents experienced individual conversations with their child health nurse, held 3 months after the birth of their child.

DESIGN

Qualitative interview study.

METHODS

Semistructured interviews were conducted with 16 fathers who had participated in individual conversations with a nurse at their child health centre, 3 months post-partum. Data were analysed with qualitative content analysis. The study adhered to the COREQ checklist for qualitative studies.

RESULTS

The findings are presented in three categories: 'Being invited into a supportive context', 'Talking about what was important' and 'Taking it home', each of them including three subcategories. The individual conversations, without the mother present, made the fathers feel important and allowed for a different type of content, tailored to their own needs. The conversations were validating and led to changes in daily routines with their child for some fathers.

Maternal recognition of positive emotion predicts sensitive parenting in infancy

Research on parent-child relationships demonstrates the importance of maternal sensitivity for the development of children's emotion regulation, social competence, and health; thus, it is important to understand the emotional-cognitive capacities underlying maternal sensitivity. We followed 120 mothers and their full-term infants from the newborn period to 5 months postpartum. Mothers' emotion recognition during the newborn period was measured using a validated facial emotion recognition task assessing discrimination (d') of six facial expressions of emotion: happiness, fear, anger, sadness, disgust, and neutrality. Maternal behavior at 5 months postpartum was coded from a mother-infant free-play session using Ainsworth's Sensitivity Scales. Preregistered analyses revealed that mothers' ability to detect happiness specifically (but not other emotions such as fear or sadness) in the neonatal period predicted greater observed sensitivity 4 months later, β = .30, p = .002, ΔR² = .08. Results suggest that maternal recognition of positive emotion may be uniquely predictive of sensitive behavior in low-stress parent-infant interaction contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sensitive responsiveness in expectant and new fathers

Fathers have an increasingly important role in the family and contribute through their sensitive responsiveness to positive child development. Research on parenting more often included fathers as caregivers in the past two decades. We present a neurobiological model of sensitive responsive parenting with a role for fathers' hormonal levels and neural connectivity and processing of infant signals. We tested this model in a research program ("Father Trials") with correlational and randomized experimental studies, and we review the results of these studies. So far, interaction-focused behavioral interventions seem most promising in supporting fathers' sensitive responsiveness, even though the mechanisms are still uncharted.

Intrusive parenting in early childhood: A review and meta-analysis

This systematic review and meta-analysis examines similarities and differences in intrusive parenting between mothers and fathers and relations between intrusive parenting and early childhood development. The authors integrated 55 studies and differentiated cognitive skills and socio-emotional problems as developmental outcomes. The present study employs three-level meta-analyses to reliably estimate effect sizes and examine a range of moderators. It finds a moderate effect size of similarities in intrusive parenting within a family (r = 0.256, confidence interval [CI] = [0.180, 0.329]). No significant differences were observed in intrusiveness level between mothers and fathers (g = 0.035, CI = [-0.034, 0.103]). Intrusive parenting had a significant positive association with children's socio-emotional problems (r_mother  = 0.098, CI_mother  = [0.051, 0.145]; r_father  = 0.094, CI _father  = [0.032, 0.154]) but was not related to cognitive skills. Moderator analyses suggest that East Asian mothers exhibit higher intrusiveness levels than fathers, whereas Western parents display no significant differences. Overall, these results reveal more similarities than differences in intrusive parenting and that culture likely plays a role in shaping gender-specific parenting behaviors.

Fathers' sensitive parenting enhanced by prenatal video-feedback: a randomized controlled trial using ultrasound imaging

BACKGROUND

The aim of this study was to evaluate an interaction-based prenatal parenting intervention program aimed at promoting parental sensitivity and involvement in expectant fathers using ultrasound images: Prenatal Video-Feedback Intervention to Promote Positive Parenting (VIPP-PRE).

METHODS

In this randomized controlled trial, 73 first-time, healthy expectant fathers were enrolled. Participants were randomly assigned to the VIPP-PRE intervention (n = 39) or a dummy intervention (n = 34). Parental sensitivity was coded from video-recorded 10-min interactions with an infant simulator at a prenatal pretest and with fathers' own infant at a postnatal posttest. Prenatal and postnatal involvement was assessed via an application on participants' smartphones.

RESULTS

Fathers receiving VIPP-PRE demonstrated increased sensitivity across the perinatal period, relative to fathers receiving a dummy intervention. Fathers' involvement with the infant increased significantly from the prenatal to postnatal period, regardless of the intervention.

CONCLUSIONS

Prenatal video-feedback using ultrasound imaging of the unborn child has the potential to promote the quality of parenting in an important, but understudied, population and period: men in the transition to fatherhood. Future research should examine the long-term effectiveness of VIPP-PRE and its effectiveness in increasing parenting quality in at-risk families.

IMPACT

This study identifies a brief and focused prenatal intervention using assisted interactions between the father and his baby by means of ultrasound imaging as a promising strategy to improve sensitive fathering in the early postnatal phase. Our study shows that pregnancy provides a window of opportunity for promoting prenatal involvement and bonding in expectant fathers, with potential long-term benefits for the future father-child relationship. Ultrasound measures are currently used to monitor fetal growth and development, but our results suggest that they may also create an opportunity for stimulating father-infant interaction to promote postnatal caregiving quality.

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline

Improving parenting, child attachment, and externalizing behaviors: Meta-analysis of the first 25 randomized controlled trials on the effects of Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). VIPP-SD combines support of parental sensitive responsiveness with coaching parents in sensitive limit setting. Here, we present meta-analyses of 25 RCTs conducted with more than 2,000 parents and caregivers. Parents or children had various risks. We examined its effectiveness in promoting parental cognitions and behavior regarding sensitive parenting and limit setting, in promoting secure child-parent attachment, and reducing externalizing child behavior. Web of Science, MEDLINE, PubMed, and recent reviews were searched for relevant trials (until May 10, 2021). Multilevel meta-analysis with META, METAFOR, and DMETAR in R took account of the 3-level structure of the datasets (studies, participants, measures). The meta-analyses showed substantial combined effect sizes for parenting behavior (r = .18) and attitudes (r = .16), and for child attachment security (r = .23), but not for child externalizing behavior (r = .07). In the subset of studies examining effects on both parenting and attachment, the association between effect sizes for parenting and for attachment amounted to r = .48. We consider the way in which VIPP-SD uses video-feedback an active intervention component. Whether VIPP-SD indeed stimulates secure attachment through enhanced positive parenting remains an outstanding question for further experimental study and individual participant data meta-analysis.

The social predictors of paternal antenatal mental health and their associations with maternal mental health in the Queensland Family Cohort prospective study

Antenatal depression (AND) affects 1 in 10 fathers, potentially negatively impacting maternal mental health and well-being during and after the transition to parenthood. However, few studies have assessed the social predictors of paternal AND or their possible associations with maternal mental health. We analysed data from 180 couples participating in the Queensland Family Cohort longitudinal study. Both parents completed surveys measuring mental health, relationship quality, social support, and sleep quality at 24 weeks of pregnancy. Mothers also completed the same surveys 6 weeks' postpartum. Antenatal depression, stress, and anxiety were highest among fathers reporting lower social support and higher sleep impairment. Maternal AND, stress, and anxiety were higher among mothers reporting higher physical pain and poor sleep quality. Postnatally, mothers reporting lower social support also reported higher depression, anxiety, stress, and psycho-social well-being. While there were no significant associations between AND among fathers and maternal antenatal or postnatal depression, an exploratory analysis revealed that mothers whose partners reported lower antenatal social support also reported lower postnatal social support and higher postnatal depression. Our findings highlight the importance of including data among fathers to achieve a whole family approach to well-being during the transition to parenthood.

Parental protection in fathers with negative caregiving experiences: Heightened amygdala reactivity to infant threatening situations

Parental protection is an important, yet understudied, aspect of parenting behavior. Predictors of the quality of protection and potential underlying neural mechanisms are still unknown. In this study, we examined whether negative caregiving experiences in fathers' own childhood are related to protective behavior and neural reactivity to infant threatening situations. Paternal protective behavior was measured with self- and partner-reported protective behavior and behavioral observations in an experimental set-up (auditory startling task) in 121 first-time fathers (mean age child = 19.35 weeks, SD = 11.27). Neural activation during exposure to videos of infant-threatening (vs. neutral) situations was measured with functional magnetic resonance imaging (fMRI). We found a significant and positive association between negative caregiving experiences and amygdala reactivity to infant-threatening situations. A history of negative caregiving experiences was not significantly related to reported or observed paternal protective behavior. Our findings suggest that fathers with negative caregiving experiences show emotional hyperreactivity to cues of infant threat.

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