Father’s Day was created in 1910 through the hard work of Sonora Dodd. Sonora’s mother died in childbirth when she was 16, leaving her father William Jackson Smart to raise her and her five younger brothers. Impressed with the job he did, Sonora sought to celebrate fathers everywhere and mirror the growing support for Mother’s Day. Not until 1972 would Father’s Day become a permanent national holiday when President Nixon signed it into law.
Looking at publications in Pediatrics over the past 2 years reveals how our understanding of fathers and their roles today have advanced since 1910. A recent study (10.1542/peds.2016-3245) of the impact of father loss (through death, incarceration or separation/divorce) on offspring’s telomere length—a kind of cellular-aging clock effected by chronic stress and biologic aging—revealed among the almost 2,500 9-year-old children that those with a father loss had significantly shorter telomeres (14% reduction), with effects 40% greater for boys. Another study (10.1542/peds.2017-4314) looking at the effect of both maternal and paternal incarceration before the age of 18 on children’s health behaviors found that paternal incarceration was associated with a host of negative health behaviors, including forgoing healthcare and prescription drug abuse. Together, these findings show the diverse ways fathers contribute to child and family well being.
Yet there is still much to learn about fathers and their potential contributions. Less than a year ago, Lee et al published a systematic review (10.1542/peds.2018-0437) of father-inclusive perinatal parent education programs. Programs offered to fathers during this crucial transitional time period may be useful in supporting fathers in their new roles. Unfortunately, of the 1,353 articles initially included, only 21 met the minimum study criteria of some father outcomes within 1 year of the child’s birth. Likewise, Morgan et al recently published a systematic review (10.1542/peds.2016-2635) of fathers’ involvement in pediatric obesity treatment and prevention RCTs finding fathers grossly underrepresented. Of the 213 eligible RCTs, 80 were confined to one parent (where only 6% were fathers) and while 133 studies were open to both parents, 92% of these reported no objective data on father involvement and therefore had an impact on the outcomes.
How are we to uncover paternal contributions to child and family health if we neglect to include fathers—in all their varieties—in our conceptualization of family formations, functioning, and outcomes? Thankfully some of this work is being done; for example, exploratory research (10.1542/peds.2018-0683) among same-sex fathers—a growing population—reveals a number of barriers and stigma for these fathers in many social contexts, especially among religious institutions. In addition to expanding research, might there be policy changes needed to support fathers as they transition into parenting, balancing their work, and family responsibilities? Some argue that parenting and early childhood is a key area where implicit bias is squarely against fathers, increasing the risk that they may not recognize the important role they have to play with the child and family.
These are just a few of the myriad of ways fathers are involved with their children. One poignant example making its way around the internet is this very simple conversation between a father and his 19-month-old, a terrific developmental model of a “serve and return” interaction. While many things have changed since the first Father’s Day in 1910, Father’s Day serves as reminder of this important and unique relationship that is happening for many of our patients every single day.