Dad on Duty: Prepared, Present and Part of the Triad

Becoming a father for the first time has you looking at your baby in awe and, in the next moment, wondering what you signed up for. Believe me, this is normal. I so enjoyed the movie “The Ugly Truth”. For those of you not familiar with it, the story revolves around a radio show host, Mike, who is extremely cynical about relationships and a woman who believes in true love and finding the “perfect man”. Somewhere in between, they both find out that in all relationships there is joy and difficulty. I like to liken this to the parent journey. On the one hand, your baby is more than you could ever have imagined, and on the other side is the ugly truth. Sleepless nights, the sense of responsibility and the worry can be overwhelming.

Fathers often experience a sense of being on the outer edge of the circle with all that goes on during the birth and in the days that follow. Back home, fathers often express feelings of uselessness, not being equipped with the tools required and can also feel displaced from their partner’s life.

It is tough, but there are so many things that fathers can do to ensure that they are a crucial part of this new triad. It begins with being prepared for the arrival of your baby and knowing what to expect:

1. Before the birth 

I would strongly recommend joining antenatal classes. Not only will you meet other couples, but you will be provided with information on which to base many important decisions. One of these decisions will be your birth plan. Are you going to try the natural route, or is a caesarean indicated? What is your partner’s expectation of you during the birth? 

2. During and shortly after the birth

A normal delivery takes time, especially if it is a first pregnancy. Be prepared to stay with your partner. In case of a caesarean, go into the theatre. Fathers often get given the honour of cutting the cord. You will be able to go into the nursery for baby’s first bath. Mom may still be receiving medical attention during this time, so you play an important role. 

3. What to expect while in hospital with regards to baby:

• Meconium – The first stool, which is dark and sticky.
• TSH test – This is a thyroid function test. The thyroid is a critical hormone required for normal growth.
• Blood group – Your baby’s blood group is usually tested from the cord blood.
• SBR test/ Jaundice – It is crucial that your baby’s jaundice levels are monitored. High jaundice levels are usually treated with lights.
• Metabolic screen – This is an additional test which may be offered to you. It screens for certain treatable, inherited conditions which your baby may have. Conditions such as cystic fibrosis can be detected immediately to lower the risk of severe illness.

4. What to expect while in hospital with regards to Mom:

• Colostrum – A highly concentrated, nutrient-dense, yellowish fluid, which is produced before the breastmilk arrives. It is often called liquid gold because it plays such a vital role in immunity, gut health and growth.
• Breastfeeding is not always easy. Your job will be to keep breastfeeding sceptics away and to keep in mind that the most successful breast feeders are women who have an involved partner. Breastfeeding takes 40 hours a week. Sounds like a full-time job to me. She will need your help and encouragement.
• Engorgement – When the breastmilk comes in, Mom’s breasts may get swollen and sore. As Mom’s body adapts to the amount of milk she needs to produce, this will settle.
• Three-day blues – About 80% of new mothers experience this phenomenon because of rapid hormonal shifts and fatigue. You can support her by caring for the baby between feeds and ensuring that the anxiety and tearfulness don’t extend beyond two weeks.
• Pain at birth site – Whether it was a normal delivery or caesarean, Mom may experience pain. Watch for fever or increasing pain.

5. Once home

Donald Winnicott coined the term “Primary Maternal Preoccupation”. It explains the shift in a mother’s focus where she prioritises her baby and becomes intensely attuned to the baby’s needs to the exclusion of everything else. Fathers must make the relationship a triad. Get involved. This is crucial for the welfare of the baby and family unit. Here are some tips on how to do this:

• Hold your baby naked against your chest – it’s great for gut integrity. Baby will respond to your heartbeat, smell and body temperature.
• Baby wearing – Carried babies cry 43% less, fall asleep quicker and sleep for longer. Your heartbeat makes them feel secure and calm.
• Bonding with baby reduces chances of depression in fathers.
• Make your own rituals – bath time, nappy changes, winding.

There isn’t a right way… your way is good too.

6. When should you be concerned about baby?

Fathers play an important role in assessing a situation. Should you be concerned, keep these points in mind: 

• Fever – normal is between 36.5⁰C and 37.5⁰C. Anything above this should be investigated, especially in the first 3 months.
• Jaundice – looks yellow, is excessively sleepy, poor feeding.
• Excessive crying.
• Vomiting – possetting is normal. This is a little bit of spit up after feeds. Vomiting may indicate a more serious problem.
• Diarrhoea – A sudden change in frequency should be closely monitored to ensure baby doesn’t become dehydrated.
• Constipation – A breastfed baby doesn’t usually struggle with constipation. In the case of formula-fed babies, it is important to ensure the bottle is being mixed correctly. There are also formulas designed to assist with constipation.

7. Post-natal depression

Fathers play a very big role in recognising the symptoms. Depression may occur in any mother but is exacerbated by:

• Stress during the pregnancy and delivery or complications during birth.
• A previous history of depression and anxiety.
• The signs – sadness, crying, irritability, anxiety, insomnia, exhaustion, feelings of not coping or struggling to bond. If the symptoms last for more than two weeks, but especially after six weeks following the birth, please seek medical help.
• Stay involved. Your presence in your baby’s world is especially important at this time.

8. What about us?

The loss of intimacy with a partner can be very difficult for a father. There is light at the end of the tunnel, but it may take time. Remember this: 

• Intercourse is only recommended after Mom’s six-week check-up.
• A high percentage of women experience low libido and sexual dysfunction from between a few weeks up to one year after the delivery.
• Breastfeeding can lead to vaginal dryness, which makes intercourse uncomfortable.
• Postpartum blues and tiredness play a big role in the loss of libido.
• Talk to one another and take time out.
• If the problem persists, speak to your partner’s gynaecologist.

 Conclusion 

Remember that you are a father now. There are plenty of studies which will support the fact that your involvement is vital to the social, psychological and physical wellbeing of your baby. You have a role to play in every step of this journey. So, when you are pacing the passage at 02:00, with a baby that is struggling to sleep and an exhausted mother in the next room, remember the “beautiful truth”- there will be bad days, but these will be outweighed by the good ones, as long as you are there for the ride.

 References 

• https://my.clevelandclinic.org/health/body/22434-colostrum
• https://kidshealth.org/en/parents/newborn-screening-tests.html
• https://psycnet.apa.org/record/2012-08721-001