New dad’s experiences with child health nurses

Child and Family Health nurses play a key role in the assessment of infants and young children between the ages of 0-5 years old. These nurses are often a valued resource for parents regarding sleep strategies, immunisations, feeding issues and milestones development.

A cross-sectional survey of 612 fathers of infants (aged 0-24 months), reported that fathers’ attendance during child health visits and reception of support from midwives and child health nurses, were associated with ‘more positive coparenting’ for fathers.

However, for many fathers, interactions with child health nurses are often nil, or very brief only. Whilst there are known structural barriers for the low engagement (for example; fathers may be in employed work when the child health nurse visits typically within business hours), it would seem apparent that the engagement of both parents (if available), would help to support and strengthen the new parent journey, particularly for first-time parents.

Researchers from Sweden have published a study examining new fathers’ experiences of individual conversations with child health nurses.

The study was noteworthy in that the individual conversations dads had with the child nurse, were often the first (and only) talks these men had had with a health professional following the birth of their child.

Study design

Parents were invited to visit a Swedish Child Health Centre with their 3-month-old child for a routine check-up and vaccinations as part of the regular Child Health Service programme.

Whilst at these 3-month appointments, time for an individual conversation with the non-birthing parent (father) was added to the clinic visit, with the aim of promoting parental health and nursing support.

Study participants

  • 16 fathers were included in this study.
  • All fathers lived with the child’s mother.
  • Median age of fathers (32 years of age).
  • 15 were employed.
  • 9 of the 16 dads were first time fathers.
  • Most had completed high-school, four fathers had a tertiary degree.

Study results

Following interviews with the 16  fathers, three key themes emerged which are discussed below (all quotes have been taken verbatim from the original research manuscript).

Theme 1: Being invited into a supportive context

Most fathers reported feeling welcomed when invited to participate in conversations with child health nurses. This was perceived by dads as being acknowledged (as a caregiver) in their child’s development separate to the mother. As one father reflected,

“Felt exciting somehow, having my own conversation, kind of, well a little special, that it matters that you are a dad too”

Some fathers reported that having one-on-one conversations with the child health nurse afforded an opportunity to speak freely,

“I felt a certain degree of relief. Everything that’s said comes from me”

The purposeful use of open-ended questions by the child health nurse were considered as helpful when speaking with the dads in this study,

“When you sit there and are asked questions, then you come to think of things, they pop into your head”

Theme 2: Talking about what was important

Many fathers observed that this was the first time they had been asked direct questions by a health professional following the birth of their child, and this opportunity to speak; elicited poignant memories for some fathers,

“Good that we could touch on my background, that I lost my father a long time ago, that it felt surreal calling myself a dad”

A few dads noted that conversations led by the child health nurse regarding relationship strain and balancing requirements between home-work-life were important to hear,

“It [the conversation] came to revolve, not so much on being a father, rather on being in a relationship, with a child, you could say. What are the challenges, new challenges in this?”.

The fathers viewed the child health nurses as an essential resource. The ability (and opportunity) to ask any question of the nurse (in the absence of the child’s mother) was seen as invaluable,

“You receive information about … what to do and not to do and such, if you smoke you are not supposed to be close to … in close contact with the child. There were some things I had no idea about”.

Theme 3: Taking it home

Fathers reported feeling ‘validated and relieved’ following their conversations with the child health nurse. Conversations often produced periods of reflection and introspection for the dads regarding their role in the home,

“I used to carry him in the baby carrier in the evenings, until he fell asleep, and when we talked about it, that was when I realized, that yes, this is something that just he and I have. It felt special, in a way”.

This nurse-led process provided one father with the confidence to initiate conversations with his partner,

“This was really the first time I talked to someone about the birth – and it led me to go home and talk with my partner”.

It also provided opportunities to reflect on parental activities and responsibilities,

… [the CHS nurse] pushes buttons, giving the father food for thought. She asked about the amount of time I spend with my child, and it made me think, I don’t know if it was an eye-opener. Then lately, after the conversation, I have spent more and more time with my child when I get home from work, and have kind of made it a routine, and I really appreciate that”.

Study conclusion

The Swedish researchers concluded their study of new fathers’ experiences with child health nurses by noting that; ‘this study showed how an individual conversation with a child health nurse for the non-birthing parent, in this study all fathers, can contribute to parental support on more equal terms’.

Expert Opinion: Dr Louise Wightman, Clinical Nurse Specialist Child and Family Health  

The role of the child and family health nurses is to support the whole family including supporting fathers to build their relationships with their children. Often fathers are present in the early days of their children’s lives and participate in the first home visits offered by child and family health nurses but have less contact at subsequent child health checks. Having a specific time set aside for a conversation with fathers would provide an opportunity to explore how fathers cope with parenting and recognise the crucial role fathers play in their children’s growth and development.

Fathers need to be asked about their perspective on their child’s development and be encouraged to ask further questions to increase their understanding of their child’s growth and development milestones. This conversation supports their validation as a caregiver, as well as a support person to their partner’s caregiving. Fathers may see breastfeeding for example, as a barrier to their involvement in the care of their child. Exploring the topics of feeding, sleeping and playing with fathers is an opportunity for child and family health nurses to discuss the many activities related to a child’s social and emotional development that can build the relationship between fathers and children.

It is important for fathers to have the opportunity to explore their parenting experience in a safe and nonjudgemental environment as this may be the time that they question how they were parented and what that means to them as fathers. If fathers can discuss their concerns about balancing being a father, partner and working, they are better able to articulate their needs for support around their wellbeing and the wellbeing of their families.

Fathers can experience postnatal depression and this impacts on their ability to connect with their children and partners. The child and family health nurse may be the first person who has asked them about how they are feeling and acknowledged the challenges that they may be facing in their home and work lives. Connecting with a child and family health nurse provides fathers with possible referrals to other important support services to manage their health and wellbeing.

Fathers should be encouraged to be present at their child’s health checks and see this as a significant opportunity to contribute their knowledge about their child’s growth and development. Health services need to consider how they provide flexible health services to meet the needs of fathers in caring for their children.

Article written and reviewed by...

  • Michael Whitehead is a Registered Nurse with over 25-years’ experience working in men’s health, emergency nursing and remote Indigenous health. Michael holds a Bachelor of Nursing degree, a Master’s Degree of Clinical Nursing, Graduate Certificate in Clinical Redesign and a Certificate in Sexual and Reproductive Health. Michael is a published author and researcher and is the current National Chair for Nursing and Allied Health with Healthy Male Australia.

    Registered Nurse
  • Louise Wightman is a Registered Nurse, Registered Midwife and Child and Family Health Nurse with over 35 years of experience in providing care to children and families. Louise has worked in a range of regional, rural and remote nursing and community services in three Australian states as well as Canada and the UK. Louise currently works as a Clinical Nurse Specialist in Child and Family Health in a regional health service in New South Wales, Australia. Louise has a keen interest in research related to parenting, the health and well-being of families, and advocating for child and family health nursing practice through education and leadership. She was awarded a Doctor of Philosophy focused on quality and competence in the specialist practice of child and family health nursing. Louise has been the Chair of the Maternal Child and Family Health Nurses Australia (MCaFHNA) for the past six years and has represented MCaFHNA at national forums and strategic working groups.

    Clinical Nurse Specialist Child and Family Health