Sad dads: a challenge for pediatrics.

Astandout feature of the current generation of 67.8millionUS fathers1 is their involvement with their children. Time-diary studies have revealed that US fathers increased time spent on child care duties from 2.5 hours/ week in 1965 to 7 hours/week in 2000, an amount greater than fathers in Australia, Canada, France, Britain, andHolland.2 In 2006, 24%of 11.2million preschool-aged children whose mothers work are cared for by their fathers during their mother’s working hours.3 The notion of “family pediatrics,” aswell as the American Academy of Pediatrics report on fathers and pediatrics, encourages clinicians’ active support of fathers, especially in light of today’s changing families and the positive outcomes associated with father involvement.4,5 However, operationalizing provider support for fathers is not always straightforward. In this issue of Pediatrics, Davis et al6 draw attention to the way that paternal depression affects fathers’ parenting behaviors of their 1-year-old children. In their study, Davis et al focused on 4 behaviors typically discussed by pediatric providers during well-child visits: 3 positive behaviors (playing games, singing songs, and reading) and 1 negative behavior (spanking). The sample came from the Fragile Families and Child Wellbeing Study, a nationally representative, longitudinal birth cohort study of US children, born from 1998 to 2000, and their parents. Of the 1746 fathers in the sample, 7% reported a major depressive episode in the previous year. These depressed fathers were only half as likely to read to their children but 4 timesmore likely to spank their 1-year-old as nondepressed dads. For pediatricians committed to children’s well-being, this is strong evidence for supporting fathers by addressing their parenting behaviors and possible depression in clinical encounters. Confirming earlier research,7 82% of the fathers in the Davis et al study had attended a well-child visit in the previous year, which afforded an opportunity for engaging fathers in pediatrics.