Michael W. Yogman, MD, FAAP
June 13, 2016
I checked my 2-year-old patient's height and weight, plotting it on the growth chart for her parents. I made sure her vaccinations were on track for this well-child visit and asked about her diet, sleep habits, behavioral milestones and other marks of healthy development. As I prepared the vaccines, she began to cry. Then, I pulled out a bubble wand.
As I demonstrated blowing bubbles to the anxious toddler, she stopped crying and grinned with delight. Moreover, her father's eyes widened like grapefruits and he asked for the wand. Turns out, he never really felt he had permission to play as a child, and this parenting intervention was as important for him as it was for his toddler.
I take every opportunity to encourage fathers to play with their children, and well-child visits are a perfect time to do this. I even write prescriptions for daily playtime with dad. As I've seen in my practice, and as research confirms, affectionate and involved dads can help boost a child's cognitive, language and social development, school success, self-esteem and overall wellbeing.
Dads from a wide variety of backgrounds are more involved than ever in raising their children. The 2008 recession, which left many men unemployed, combined with the continued advancements in women's careers, have opened a space for many fathers to take on new roles in their families. But regardless of family structure or income level, we have seen men from every sphere of life increase their engagement with their children. This includes gay fathers, single fathers, military deployed fathers, formerly incarcerated fathers, non-residential fathers and fathers of children with special needs.
"As I've seen in my practice, and as research confirms, affectionate and involved dads can help boost a child's cognitive, language and social development, school success, self-esteem and overall wellbeing."
Policy makers have finally moved beyond negative attitudes toward non-residential fathers. In the past, government programs for children rarely reached out to non-residential fathers – often labeled "deadbeat dads" -- other than to seek financial support. Today, we don't use that label. We now have programs such as Fathers Uplift, which brings formerly incarcerated fathers to the Boston Childrens Museum on Saturday mornings to re-engage and play with their children supervised by life coaches.
The medical community also has begun to look at the influence of men's wellbeing on their ability to father. Just as mothers do, fathers experience post-partum depression at a rate of 5 to 20 percent in the first year after birth. Early screening and treatment benefits both the father, the children and the partners. And when a mother suffers from post-partum depression, the father's support is shown to be a critical factor in her recovery and a protective factor for the baby.
Pediatricians can encourage both parents to be highly engaged. At the hospital, the medical team can target dads for bathing and diaper-changing demonstrations. On the post-partum floor after delivery, I never get tired of demonstrating to a brand new dad the amazing ability of his newborn to turn her face toward him when she hears his voice. And on several occasions, I've seen fathers of children with cerebral palsy or extreme prematurity become the most ardent, vocal advocates for special education programs in their children's school after being encouraged to participate.
"Pediatricians can encourage both parents to be highly engaged."
We also should advocate for better parental leave policies for both parents, which have been demonstrated in most other industrialized countries to promote fathers' involvement. The United States lags far behind other countries in supporting both mothers and fathers during the early months. Research shows that two parents often support a child's development in complementary ways. One parent typically emphasizes security and protecting the child from danger, while the other more often promotes independence, encouraging the child to explore, take safe risks and try problem-solving on their own. Studies have shown mothers generally concentrate on more quiet games, singing, and soothing activities, while fathers more readily engage the child's in active play, especially more rough-and-tumble "horsing around." Both styles provide unique mental and physical benefits and complement each other well.
Although these roles can vary within individual families, we can often see this dynamic in play. On a local playground I passed recently, I watched a father encourage his child to go to the top of the three-story climbing structure, while the child's mother bit her fingernails until she saw a broad grin of joy on her child's face when he reached the top. When adolescents are dropped off at college for the first time, I have seen dads encouraging their wives to get back in the car and leave so that their young adults can go off to orientation with classmates.
At times, overcoming the challenges to protecting children's health and wellbeing seem ever more complex -- whether that's removing lead from an entire community's water supply, or preventing the spread of emerging viral threats like Zika.
But other times, it is as simple as blowing bubbles.
Michael W. Yogman serves as Chair of the American Academy of Pediatrics (AAP) Committee on Psychosocial Aspects of Child and Family Health and AAP’s Massachusetts Chapter Child Mental Health Task Force. He is an assistant professor of pediatrics at Harvard Medical School and has practiced pediatrics in Cambridge, Massachusetts, for two decades after several years working full-time at Boston Childrens Hospital with developmental behavioral pediatrics pioneer T. Berry Brazelton, MD. Dr. Yogman also serves as chair of the Boston Children’s Museum board of trustees.