Now, new research finds that fathers can also experience depression after their babies are born, and that doubles their children’s chances of having three or more adverse childhood experiences before age 5.
“There are several things that motivated our study. The first was that paternal depression in the first year of life has already been shown to have other kinds of adverse effects on children, such as parenting difficulties or difficulties in child behavior later in life,” said the study’s author. Dr. Kristine Schmitz. She is an assistant professor of population health, quality improvement, and applied science at Rutgers Robert Wood Johnson Medical School in New Jersey.
“We also know at the outset that depression in fathers is often unrecognized and yet can be quite prevalent, so it’s an important issue to be aware of,” Schmitz added.
For this study, Schmitz wanted to explore what the relationship might be between a father’s depression early in a child’s life and adverse childhood experiences later in life.
These experiences may include domestic dysfunction and child abuse. They can lead to future health and mental health problems, even in adulthood. This can include poorer mental health, lower school performance, obesity, asthma and high blood pressure.
Schmitz analyzed data on more than 1,900 father/child pairs from the Future of Families and Child Wellbeing Study. About 75% of the parents in the study were single.
It investigated associations between depression in fathers in the first year of their child’s life and adverse childhood experiences when they entered kindergarten.
The risks of adverse events in the child, the study showed, went beyond sociodemographic factors and the mother’s postpartum depression, Schmitz said.
“It is possible that when fathers are depressed, they find it more difficult to engage meaningfully with their children, despite their desire to do so in many cases. And that can lead either to physical absence, like what we found, or even more to emotional absence,” Schmitz said.
Schmitz suggested that fathers should be screened for depression and offered treatment to reduce the risk of difficulties their children suffer.
Pediatricians already assess the mother for depression, she noted. They also often see fathers at baby appointments during the first year and have a unique relationship with families for this reason.
“Just by being with them often, you have the opportunity to gain trust and rapport and ask about those more nuanced questions,” Schmitz said. “But fathers and pediatricians and mothers, of course, all align together around the goal of protecting and nurturing and enabling their child to reach their full potential.”
That could give pediatricians a better rapport with parents when they broach this sensitive topic, he suggested.
Depending on where someone lives, there may be powerful treatment options that focus on dad, Schmitz said.
“We have a really strong maternal and child health policy in the United States, and I hope that it will begin to expand to explicitly include fathers,” he added.
Schmitz is scheduled to present the findings Sunday at the annual meeting of the American Academy of Pediatrics in Washington, D.C. Findings presented at medical meetings are considered preliminary until they are published in a peer-reviewed journal.
Most postpartum depression in fathers occurs a little later than in mothers, it is noted Dr. Michael Yougmana pediatrician at the Cambridge Health Alliance in Cambridge, Massachusetts, and past chair of the American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health.
For men, it starts when their babies are about 4 months old. Risk factors can include poverty, unemployment and relationship stress, Yogman said.
Symptoms may be different and not as easily captured by traditional measures, he noted. These include irritability, aggression and undermining of breastfeeding.
“When fathers are depressed, and particularly when both parents are depressed, the impact on children is really, really significant,” Yogman said.
It’s important to realize that this is a really critical time to encourage positive interactions between parents and children, she explained. However, even existing screening for maternal postpartum depression does not work for everyone. Screening rates are about 50%, he said.
Therapists are also unfamiliar with referring a father for postpartum depression, Yogman said.
“We need to develop a workforce that is receptive when fathers call. We had fathers tell us they would call, and the therapist was kind of dumbfounded that a father was asking for help,” Yogman said. “So that’s another piece of that dilemma that we have to solve before we can expect real acceptance in viewing.”
More information
The US Centers for Disease Control and Prevention has more adverse childhood experiences.
SOURCES: Kristine Schmitz, MD, assistant professor, population health, quality improvement and implementation science, Rutgers Robert Wood Johnson Medical School, New Jersey. Michael Yogman, MD, past chair, American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health, and pediatrician, Cambridge Health Alliance, Cambridge, Mass. presentation, American Academy of Pediatrics Annual Meeting, Washington, DC, October 22, 2023
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