Involving fathers and father figures in their child’s health care can significantly improve the health and well-being of a child. Children with involved dads are more likely to experience positive child health, developmental, social, and emotional outcomes, including improved mental health and performance in school.  Health care settings, however, are often mother- and child-focused, particularly during pregnancy and in the toddler years. Yet without a father’s perspective, providers can miss out on critical details that paint a full picture of a child’s and their family’s health. As the child grows and develops, fathers and father figures have a unique perspective to share, whether a father lives in the home with the child or not.

Pediatric care teams can improve their quality of care by challenging personal assumptions around fathers’ roles, educating staff on the benefits of involving dads, and creating a more welcoming practice environment for all caregivers. As a result, practices can help better support their patients’ health and well-being. These shifts also reinforce — for fathers and other caregivers — fathers’ roles as significant contributors to their child’s health.

This tool offers practical tips for pediatric providers to make the practice environment more father friendly. It is a product of Accelerating Child Health Transformation (ACHT), a national initiative led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation that aims to improve children’s health care through anti-racist practices and family-driven approaches.

A Note From Co-Author Louis Mendoza

I’ve dedicated years to help men have their voices heard and provide connections for support through the Washington State Fathers Network. It’s so important to make a special effort to support men because — at the risk of making generalizations — society and some of its institutions, like medicine and education, can be so mom- and child-focused that they lose out on the important perspective that men have on the health and well-being of their family. And, if there is a health issue in the family, men are less likely to have a network to tap into for support and also less likely to ask for emotional or logistical support.

Action Steps for Creating a Dad-Friendly Pediatric Setting

Below are several practical considerations for pediatric care teams seeking to create a more dad-friendly practice environment.

1. Challenge your assumptions.

Many factors, including personal biases and how we were raised, impact how we understand the role of a father. It is important that staff at all levels confront their beliefs about fathers to actively support inclusion of fathers of all races, ethnicities, sexual orientations, and socioeconomic backgrounds in the pediatric setting.

[Fathers] just want to be included — included in a respectful manner where they’re recognized as relevant parents and not have their position slighted or undercut in any way. At times it’s offensive when you’re treated as someone who needs to be engaged or motivated to parent.

Kevin Cox, stepfather and Program Manager for FELLAS Fatherhood Program, Partnership for Maternal and Child Health of Northern New Jersey
  • Assume that a child’s father is as involved and informed as their mother. Unless you know otherwise, assuming that a father is not as involved or informed as the other caregiver does a disservice to the family. Since pediatric medical teams typically only see children several times per year for short visits, it is likely that they are not aware of the many ways that the father is involved.
  • Recognize that the father may be the only parent attending the appointment. Providers may assume that if only the father is present at the appointment with the child, they are waiting for the mother to arrive. Though this might be the case, the father may be the primary parent taking the child to medical visits. Instruct the care team and other staff to ask the father if anyone will be joining him for the appointment.
  • Presume that the dad is already engaged instead of assuming that it is your job to help a father engage with his child. If he is at the appointment or calling you about his child’s care, this means that he is invested in his child’s well-being.
  • Ask fathers what they want to know. Instead of assuming what a father’s questions or priorities are, simply ask. A father may have questions in mind about his child that are the same or different as his co-parent. Further, do not assume that a patient’s father needs extra or remedial help to understand the information you are conveying.

2. Educate staff.

Understanding we all have different perceptions of the role of a father, it is important to share research with the care team, including front desk staff, that shows the long-lasting, positive impacts that a father-child relationship can have and how different these relationships can look from one family to another.

We want all family members to feel welcome … It starts with phone calls and walking through the door, how one is greeted, the eye contact we make with everyone, eliciting concerns of all parties. It doesn’t stop there. We want all parents and caregivers to know that they belong and that they matter.

Mary Ann Woodruff, MD, Pediatrician, Pediatrics Northwest
  • Become familiar with father-friendly principles. Father-friendly principles, including those shared by Washington Interagency Fatherhood Council and the Alameda County Fathers Corp in California, can help providers and systems strengthen their father-friendly services and systems. For example, the Alameda County Fathers Corp encourages programs that serve families to actively recruit men for positions that serve families and children or to create positions that specifically focus on working with fathers, if they do not already exist.
  • Highlight the important influence of fathers on child development. It can be helpful to share information with other caregivers on the positive effect that the presence of a father has so they have a better understanding of how his presence can impact the health outcomes of a child.
  • Discuss cultural differences in raising children and the role of fathers. Encourage staff to speak with parents and those in the community to understand any cultural differences in how parents approach raising a child and/or the role of the father. 

3. Create a welcoming environment for fathers.

Making changes to the clinical environment in practical ways, as outlined below, can support fathers and father figures to feel more welcome during child health visits.

After having five children, my youngest child’s pediatrician was the first person who ever remembered my name. I was so surprised. It made me feel more comfortable in that setting — like I mattered, that she cared. I’m trusting the doctors with the care of my children — shouldn’t they know my name, too?

Morris Carr, father and Family Advisor for ACHT, and Men’s Health Coordinator, Access Community Health Network
  • Speak to the father directly. Whether he is there alone or with mom, make eye contact with the father, make an effort to learn his name, and ask him questions and his opinion. 
  • Focus on strengths. Fathers, like all parents and caregivers, enjoy talking about their children. Consider asking the father what their favorite thing is about their child to help fathers become more comfortable sharing about their child and to better understand their unique relationship.
  • Create a father-friendly survey. Use a survey to better understand how to work with fathers and provide a sense of how father-friendly your practice is currently, for example the Father Friendly Check-Up from the National Fatherhood Initiative.
  • Include images of fathers. There are often many images of mothers and their children on the walls of pediatric practices or on practice flyers. One easy way to make fathers feel more included in their child’s care is by including fathers in those images. The Washington Father Council offers a fatherhood photo bank with many royalty-free images to use. Practices can also consider putting out father-directed magazines in the waiting room.
  • Put changing tables in all bathrooms. Doing so ensures that fathers can seamlessly take care of their children. It also shows all caregivers that you understand that changing a child is a task that can and should be done by both parents. 
  • Find ways to engage fathers in program and policy design. When gathering patient and family input, it is important to be intentional about reaching out to fathers and father figures who can share their unique perspectives and lived expertise.

More From Fathers About Experiences in Pediatric Care

Learn how pediatric practices are prioritizing fathers’ experiences in practice, watch the CHCS webinar The Critical Role of Dads: Exploring the Benefits of Father-Friendly Pediatric Care.

*Louis Mendoza is the retired director of the Washington State Fathers Network.

Posted: May 2024