The Effect of Paternal Kangaroo Care on Paternal Role Adaptation in Preterm Infants Hospitalized in Neonatal Intensive Care Units: A Randomized Controlled Trial
This 2025 randomized controlled trial conducted in Iran demonstrates that paternal kangaroo care significantly improves and sustains role adaptation among fathers of preterm infants hospitalized in neonatal intensive care units, supporting its integration as a practical strategy for family-centered care.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
When a baby is born too early, the world they enter is often a place of beeping machines and sterile glass, a stark contrast to the warmth and closeness they would have known in the womb. For parents, especially fathers, this separation can feel like a barrier, making it difficult to step into the role of a caregiver when their child is surrounded by medical equipment rather than held in their arms. The concept of "paternal role adaptation" describes the journey a father takes to understand, accept, and feel confident in his new responsibilities. It is the process of moving from feeling like an outsider looking in to becoming an active, capable participant in his child's life. While hospitals have long recognized the value of keeping mothers close to their premature infants, the specific impact of encouraging fathers to take part in this intimate care has been less explored. This question matters because the early weeks after birth are a critical time for a father to build a bond with his child and to find his footing as a parent, a process that can be complicated by the stress and isolation of a neonatal intensive care unit.
In a study conducted in 2025 at hospitals in Shiraz, Iran, researchers set out to see if a specific, hands-on approach could help fathers navigate this difficult transition. They focused on a practice known as kangaroo care, which involves holding a baby skin-to-skin against the parent's chest. This method is already well-known for its benefits to the infant, such as regulating body temperature and heart rate, but the researchers wanted to know if it also helped the father. They recruited forty couples who had a baby born between 32 and 36 weeks of gestation. The fathers in these families were between 18 and 45 years old, and their infants were stable enough to be cared for in an incubator or a cot without needing a ventilator. The researchers divided these families into two groups. One group received the standard care, where the mother held the baby for an hour each afternoon. The other group, the intervention group, had a different routine: for seven consecutive days, the baby spent thirty minutes with the mother and then thirty minutes with the father, both times in the same skin-to-skin position.
To measure the results, the researchers asked the fathers to fill out a detailed questionnaire before the week of care began, immediately after it ended, and again four weeks later. This questionnaire asked about how well the fathers felt they were performing their duties, how much they understood their child's development, and how secure they felt in their new position as a parent. The results showed a clear difference between the two groups. Before the study started, both groups of fathers felt similarly about their ability to adapt to their new roles. However, after the week of shared care, the fathers who had spent time holding their babies skin-to-skin reported a significant increase in their sense of role adaptation. This improvement was not just a fleeting feeling; it remained strong even four weeks after the intervention ended. The fathers in the intervention group felt more capable of handling their responsibilities and better understood their child's needs compared to those in the control group.
The study found that this boost in confidence and adaptation was particularly strong in the practical areas of parenting. The fathers who participated in kangaroo care felt more competent in performing daily tasks and more established in their position as the father of a premature infant. They also reported a deeper understanding of how their child was developing. Interestingly, while the intervention helped with these functional aspects of fatherhood, it did not significantly change how much the fathers worried about their child's health or the challenges of the situation. This suggests that while holding the baby helps a father feel more capable and connected, it does not automatically erase the deep-seated fears that come with having a premature child. Those worries often require additional support, such as counseling or clear communication with medical staff, to be fully addressed.
The researchers concluded that inviting fathers to participate in skin-to-skin care is a simple, accessible, and low-cost way to help them adjust to fatherhood in a high-stress hospital environment. The findings suggest that when fathers are given the opportunity to hold and care for their premature infants directly, they are more likely to feel like genuine, essential members of the care team. This effect lasted for at least a month after the care period ended, indicating that the experience leaves a lasting mark on how a father sees his role. The study highlights that family-centered care in neonatal units should not just focus on the mother and baby, but actively include fathers as key partners in the healing and bonding process. By doing so, hospitals can help fathers build the confidence and connection they need to support their children during the most vulnerable days of their lives.
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