With permission of Bob Moran. Enjoy this video.
Most fathers who have experienced the NICU would probably say they are familiar with occupational therapy. The distinction on what exactly an OT does may be blurred with all the specialists that walked in to visit your infant in the NICU. When people hear the word occupation the first thought is a career. Don’t worry your infant is not expected to have a job already, although I’m sure it would be nice if they could start contributing to that college fund! The word "occupation" should be expanded to things that occupy our time; things that we do every day to occupy our time (Meaningful and not meaningful). For example playing with your child is a meaningful occupation vs. brushing your teeth may not be so much. In the case of infants their only job is to be, well, a baby. What do babies do? Eat, sleep, play, poop, etc. As a new dad your new occupations may be revolved around helping your child meet their milestones to be a successful toddler, child, teen and finally an adult in their own eyes. It is important to point out that OT’s partner with people throughout their entire lifespan. Transitioning to being a father is a major life change.
I am an Occupational Therapy student who dedicated my doctoral capstone project to exploring the needs of NICU fathers and their experiences after discharge. When looking closely at the research it was evident that there was not enough of a focus on fathers and wanted to bring your voices to light.
What we found?
Theme 1:
Dads and Healthcare Providers
Interacting with healthcare providers while your child is in the NICU and beyond can be intimidating.
- Ask for specific tasks to work on with your child during daily routines "specific dad tasks"
- Practice advocating for your role as a father- an important member of the team
- Don't be afraid to ask for information in writing, video, telelphone etc.
Here are some suggestions to healthcare providers based off of what the participants in this study said:
- Really ask, how they are doing? Because we know the instinct is to hear good and move on.
- Make dads feel like they are part of the team. We all have the same goals to help their child.
- Really understand the family dynamic. Who to call and when to call. There are more stay at home dads now and mom should not always be the default.
- Dads may not be present for all the therapies if they are working, but feel acknowledged when they are given activities to work on with their child.
- Approach families with empathy and an open mind. What they are going through is hard for both parents.
Theme 2: Adjusting Expectations
56.3% of fathers reported they wanted more support during the transition home
For some fathers, the transition is difficult especially when adding other factors such as caring for a medically complex child or transitioning to fatherhood during a pandemic. The challenge of bringing your precious little one home may not look how you pictured and it is common to have fears revolving around your child.
You’re used to having all these bells and whistles and you don’t have any machine when you come home and it’s like okay is he breathing? Every hour on the hour you would take shifts where you would sleep for a couple hours and then okay it’s your turn to go to sleep now I’ll stay up and make sure he’s breathing (Father B).
Theme 3: Changes in Priorities
OT’s specialize in looking at routines and how people spend their day. When interviewing fathers many dads talked about splitting duties with mom and expressed empathy for their baby's mother.
The NICU dad routine was generally:
- Wake up
- Work
- Relieve Mom
- Downtime with Mom
- Sleep
- REPEAT
Leaving little time for other occupations.
62.5% of fathers reported a change in engaging in hobbies, sports and recreation since bringing their child home.
62.5% of fathers reported rarely or never engaging in social activities
“I don't have a lot of engagements outside of work and being a dad. I don't really know that I'd have time for them if I did. It's pretty... it just sorta consumes all of my time between those two, between working and being a dad that's pretty much all I have” (Father D).
Theme 4:
The Unexpected Toll of the NICU: Mental Health & Emotions
Moms are not the only ones who experience the emotional toll of the NICU. It is not uncommon for fathers to have a delayed onset of PTSD symptoms 4 months following a NICU experience (Shaw, 2009). Based on this study, it is not uncommon to feel as if no one truly understands what you're going through and not wanting to burden others with your emotions.
I feel like you almost have to be machine like in those situations and just take one day at a time…You don't think about yourself you know what I mean you can't think about yourself in that situation. So you don’t think, Oh do I need help? Am I going to be okay? Just 100% not about me. (Father E)
Theme 4:
The Unexpected Toll of the NICU: Strong Dads and Validation
Half of the survey participants encouraged fathers to take care of themselves. Many dads expressed changes in activities that they did before the birth of their child, however they didn't mind that their time has become more family focused.
Some participants were encouraged to continue meaningful activities (occupations) by their spouse and healthcare professionals.
Some of the participants in the interviews expressed feelings of guilt when engaging in activities such as exercising etc.
Feeling like I'm never supposed to leave when that’s not really… like right now my wife’s here and the nurse is here like I could go anytime I wanted to, but it’s hard to feel like it’s okay to get out of the house and go somewhere else and not be right there. (Father J)
If no one else has said it here is your message to do anything that is meaningful to you.
Suggestions from the dads in the study:
- Go on a 15 minute family walk outside
- Pull out those golf clubs
- Practice contra dancing
- Go on a hike
- Play video games
- Go on a run
- Read a book
- Shave
- Blog
- Go to the mall
- Journal
- Podcast
- Wash your car
- Start a new show
- Give back to the NICU
- Call a friend
- 15-30 minutes of time for yourself
"Sometimes you you get so busy trying to be everyone else's anchor that you don't even realize you're actually drowning " -Author Unknown
A meaningful activity for yourself can positively impact how you engage in other activities throughout your day.
Theme 5:
Coping and Healing: Outlets for Emotions
The act of writing and journaling became a common outlet for dads. Journaling became therapeutic and cathartic for dads.
The following is a quote from a dad describing the process of writing his Facebook page; meant for keeping others updated about his child:
The conversations I was having were tough that I didn’t want my wife to hear, so I was surprised at how therapeutic writing that was and again I'm not a reader I'm not a writer, but as I was sharing that stuff they kept it from being locked up inside of my head and lock up inside of myself. (Father F)
Theme 5
Coping and Healing: Social Media
There was the act of writing itself and then there was the community that writing experiences gave. Fathers who used social media as their medium for expressing their emotions found a community that helped them cope and feel supported; whether that be peers in a dad support group or people following their story through their blog.
Now we have some Facebook groups and stuff like that and I'm coming across other groups that other dads are starting and seeing the numbers and how fast these things are growing you know… I mean and there's something going on right now where dads or NICU dads are really wanting to share their experiences and I don't think anybody realizes how big the void really is. Father I
References
Shaw, R. J., Bernard, R. S., DeBlois, T., Ikuta, L. M., Ginzburg, K., & Koopman, C. (2009). The relationship between acute stress disorder and posttraumatic stress disorder in the neonatal intensive care unit. Psychosomatics, 50(2), 131–137. https://doi.org/10.1176/appi.psy.50.2.131
For questions or further information please contact Bryana Salazar at b.salazar@usa.edu
Credits:
Created with images by AndisBilderwerkstatt - "baby feet father" • AndisBilderwerkstatt - "father son love" • Pexels - "books library shelves" • skalekar1992 - "people man adult" • valelopardo - "doctor tomograph i am a student" • trestletech - "baby parenthood hand" • PublicDomainPictures - "father baby portrait" • Pexels - "close-up macro teddy bear" • 4311868 - "beach pacific coastline ocean" • ThoughtCatalog - "wood desktop paper" • 6689062 - "black coffee coffee cup" • GingerQuip - "thank you thanks card"