NEWSLETTER
June 2017
Father's Day
Happy Father's Day!

This Sunday is Father's Day, and we'd like to acknowledge and celebrate all the dads in our community. Thank you for the the person that you are as well as all that you do for us--your partner and your children. 

This month we shine a special light on self-care for dads. Taking care of yourself is critical, especially if your partner or you are experiencing a perinatal mood or anxiety disorder. This can be a simple as keeping yourself healthy. It may also mean seeking help from a therapist to help you adjust to your changing role.

We are delighted to feature an interview with Nicholas Kasovac, of the DAD project as Swedish Hospital, which focuses specifically on the father-infant relationship. We share the latest research on depression in expectant fathers. And we highlight lots of resources for dads, both local and online.

Thank you, dads. You are integral to our families.
In This Issue
Parent Corner
Dads Need Support, Too!
 
You are a father now. Whoa. You and your partner have a little human to care for. Things are changing fast. We learn right away that when we become parents we're going to need to make some sacrifices: we are no longer the focus of our own lives; our children are. The enormous and quick jump from our old lives to the new is overwhelming for most of us. And maybe Mom is feeling depressed or anxious or likely both! This all seems impossible to handle and where do you even begin? Certainly not with taking care of yourself; isn't it selfish to think about taking care of yourself when the mother of your children is struggling? Nope, not selfish at all. NECESSARY.
 
Just like we tell moms--if you want to be able to care for others you have to take care of yourself. I'm not saying you should start booking weekends away with your buddies. But it is important for you to find some kind of release of anxiety and some nourishing activities for your soul to help you help your partner get through this time. Need some ideas? Some "easy" (things you can actually do when you have a baby at home) types of self-care include: eating healthy foods and cutting back on alcohol and sweets, seeing a movie, meditating in your car, game night with friends, yoga, going for a walk or run, lunch with a friend, a bike ride, keeping a journal. Think about what re-energizes you and do it! And try to get it in on a regular basis. And don't forget to give Mom some time for herself!
 
It's also important for us to talk about how it's not just moms who get depressed or anxious after having a baby. Postpartum dads struggle, too. If you're feeling more irritable and angry, isolated and lonely, using more alcohol or drugs to feel better, feeling run-down, or any other significant changes that are making it difficult to be a father and a partner--talk to someone. You might be experiencing more than the typical blues and nervousness associated with having a baby. About 1 in 10 dads will experience a mood disorder after the birth of a child. If this is you, don't hold it in; get help. Dads need support, too! You can start by calling PS-WA's Warm Line: 1-888-404-7763. You can even request to speak to a dad. Also check out Postpartum Men, an organization for men experiencing postpartum depression. And PS-WA has a great list of resources just for dads and a list of mental health providers on the website.
 
Now that you have some ideas about what to do, how exactly are you going to fit this in? How do you balance your needs with Mom's? Well, it's not easy, but it's doable.  Make home to work/work to home/running errands, etc., a time for you to do something for yourself. If you work outside of the home (even if you work at home), take a lunch break and do something good for yourself. Take a few minutes before walking in the door to do a meditation, read something or any other short, but pleasurable activity that will help you transition back home easier. It may not always work out and you won't be able to do everything you used to do with your partner, for yourself or even by yourself. BUT, you can hold on to a few key practices that make you feel better and develop new ones that fit in to this new role you have as Dad.
Interview
Nicholas Kasovac, MA, R-DMT, IMH-E(II)®, Infant Family Specialist and founder of the DAD Project

Can you tell us a bit about your program at Swedish?  

It's called The DAD Project, which stands for Dads And Development. It's a place for Dads and Infants to learn about each other and foster their relationship. I created it about 10 years ago when I was a home visitor for preemies once they left the hospital. There were families asking if there was anything for dads, and at the time, the only program offered was Boot Camp for New Dads. That was a class for three hours that taught dads the basics of infant care. The thought crossed my mind-- "well, then what do the dads do with this infant now that they know the basics?" The infants I visited were preemies and were at risk for developmental delays, so I realized if the dads knew some basic information about child development, they would have something to do with their infant AND learn about their infant's development. I also realized there were other reasons to offer this type of group for dads that would benefit them, their infants, and moms. In particular, it was an opportunity for mom to have some time to herself to focus on "self-care" while dad had the baby alone (but with other dads and me).

What is the mission?

The mission is to highlight and foster the relationship between Father and Infant in an experiential way. Research has repeatedly demonstrated that fathers contribute to their child's development in different yet significant ways. This venue helps to promote that knowledge as well.

What can dads who participate expect?  

Dads can expect a loosely structured group with other dads and infants. My hope is that the dads learn to apply their problem-solving and critical thinking skills to caring for their baby, rather than always having an answer that is black and white. (Every baby is different, just like every situation.) Also, I have a different outline for each session with both unusual and common topics, however, that is always deferred to whatever questions, topics, or challenges a dad brings in that day. My intention is to have all their questions answered to quell any anxiety or confusion. Rather than me telling them what they need, I get to address whatever "baggage" they may be carrying with them at that time. The unusual topics are varied, e.g., scientific theories, sports-related activities, mathematical principles, that are eventually applied to child development. Additionally, I show a couple videos that are useful and informative. The most common feedback I get from participants is how much they appreciated the open and flexible format.

How would a dad enroll if he was interested in joining?  

Dads (or moms for dad) can enroll by going to the Swedish website ( www.Swedish.org ), click on the "Classes & Resources" link, choose "Childbirth, Parenting, & Family" Classes, scroll down to the "Postpartum Support" section, and click on "DAD Project"  OR follow this link:   http://www.swedish.org/classes-and-resources/childbirth-parenting-classes - DAD . There three different locations usually offered at different times of the year. Some dads choose a group based on their calendar, and some dads choose based on location.

What are some of the common challenges you see new dads facing in your work?

I'd say the most common challenge for new dads is the amount of conflicting parenting and developmental information with which they are faced. This comes from the internet, books, sometimes mom, grandparents, other family and friends offering advice or "you shoulds...," cultural myths, and medical professionals. Some of this information, especially information from older generations, we now know from research is actually NOT good for the baby. This is why the information I present is based on research or repeated patterns from over 10 years of anecdotal experience, where I've seen the range of what can happen with infants. This is coupled with my emphasis in The DAD Project on dad's problem-solving and critical thinking skills to help them through a process whereby they (with mom) make an informed decision that is best for their child.

Other common issues include sleep (misinformation or lack of information), tummy time (for which I have an effective, innovative approach that works!), and developmental delays caused by "big plastic equipment" and out of sequence motor skills (e.g., standing too early). All of which are addressed in The DAD Project.

What tips do you have for the dads with whom you work?  

To me, the most important question the dads can learn and repeatedly ask themselves is this:  "Is it best for baby......or convenient for me?"  This rhetorical question invites them to take a moment, use their critical thinking and bring to their awareness how this specific decision will impact their child. In our discussions of this question, we also talk about those times when a parent needs to choose something that is convenient for them, but it will be done with consideration and thoughtfulness.

Another key point I nauseatingly emphasize is "The personal/social/emotional domain is the MOST important domain of child development. It underlies all the other domains and provides the foundation on which the others are built." If there's any question about that statement, I refer anyone to review and consider the experiments of Dr. Henry Harlow and his monkeys in the 1950's. Basically, baby monkeys preferred a terry cloth surrogate mother over a wire mesh mother with food--i.e., they preferred the comfort instead of nutrition. There are many more reasons and much more research that supports that, but Dr. Harlow was one of the first to identify the importance.

I would like to add a third important point/tip for dads, which I also emphasize in The DAD Project. Dads are critically important in the lives of their children. And it starts NOW, during infancy. Unfortunately, there's still some thinking that fathers can just "wait" for their child to be older and more interactive, e.g., be able to throw a ball back and forth, before they will become "involved."  (By the way, I despise the term "father involvement" and I have reserved a soapbox about my thoughts.)  From the child's perspective, who didn't have his father present during his formative infant/toddler years (the period with the most rapid brain growth across the entire lifespan), why would he have any interest in this person who just showed up? What is their relationship based on? How much trust has been established? What history do they have together that has endeared the child to him? In contrast, this is a significant reason I make such a big deal of dads and infants spending time together, encouraging that, fostering that, jumping up and down about that, etc. And all I really need to do is point out to a dad the look his baby gives him, then explain why that is so critically important "in the personal/social/emotional domain." And they get it.

There's much more I could say about this question, but I'll stop here. :-)

Do you have experience working with men experiencing paternal postpartum or perinatal mood disorders? 

I'm not a licensed professional, so I don't work with individuals in a therapeutic way. However, I've discovered my providing The DAD Project is an opportune time and place to educate, support, and possibly identify dads who may be experiencing it. It is now a regular topic that I cover in the first session, including giving dads a screening tool (just like moms), explaining what it means, and what support resources are available. Some conversations brought into groups are about mom potentially having it, and I've also had some groups where a dad has realized he may have it (not knowing about it before), as well as a few times that a dad has asked me about it in private, after everyone else has left the room. There was a meta-analysis published in JAMA 2010 that identified the prevalence for Dads to be as high as 25.6% during the 3-6-month time period after birth of baby--and most of the participants in The DAD Project are in that range. We also know from research that if mom has been diagnosed with a PMAD, then dad has a higher likelihood to have it as well. In the last session, #5, I hand the screening out to the dads again, since it's more than a month later, and ask them to take it home and review every month or so. In addition, I encourage them to have a conversation with their partner to establish an agreement should either of them recognize that something isn't right with the other. That way, they can each support each other to get help, rather than suffer the consequences.

Are there particular PMAD resources or services you share with the dads who participate in your program? 

Absolutely. I introduce them to the Perinatal Support of WA organization, I explain their warm line and how that works, including a male volunteer if they choose. I have the list of Father Resources that PS-WA has compiled , along with all the support groups they offer around metro Seattle. I believe this ties in nicely with my suggestion of the dads having a recurrent conversation with their partners--so if mom happened to have symptoms of a PMAD, then dad knows a resource from which to get help. I also tell them about the " Chat with an Expert " every month with Dr. Dan Singley through "Postpartum Support International," and I certainly give them contact information about the Swedish Center for Perinatal Bonding and Support . In my mind, I share all of that to ensure they know there is a lot of support should they need it AND to make attempts to normalize it. We're in 2017--we shouldn't have the stigma about PMADs that we used to have even five years ago. It's time to shift the perspective.

Are there other general resources you offer to the dads in your program?

First, I encourage dads (and moms) to be careful with their sources and to scrutinize carefully, since not all information is helpful or relevant to all babies. Just because something worked for another baby doesn't mean it will work for your baby. With that in mind, I strongly recommend Zero to Three's website for parents ( www.zerotothree.org ) as they are a committed group of researchers, providers, and policy makers whose efforts art targeted to the age range from birth to 3 years old. Also, they provide a parent's newsletter called "Baby to Big Kid" where families can sign up with their child's birthdate (or due date) and receive monthly emails that explain what is happening developmentally. This one is my preference because they focus on the personal/social/emotional domain of development, which is the MOST important for the developing child (have I said that yet?). Also, their information is based on research and best practice, whereas some other sites may only be parents' personal experiences, which often don't translate to all children. Secondly, I also recommend (strongly) The Center on the Developing Child at Harvard University ( www.developingchild.harvard.edu ). This may be for those with higher educational needs, but some parents are interested in the research. They too are focused on the birth to 3 years range and work with translational research, meaning they look at what research says then try to put it into words and practice that "translates" to providers. For example, they have produced videos on the 3 Core Concepts of Early Development, found on YouTube:  https://youtu.be/VNNsN9IJkws?list=PL0DB506DEF92B6347


To learn more about Nicholas and his work, visit his website or Facebook page:


Additionally, Nicholas will be offering another set of 4 groups--The DAD Projects:Toddlers, which is a 3-week series starting June 18 and running through the summer.
Resources For and About Dads

Perinatal Support Washington has an extensive resource and referral handout of local and national resources for dads, covering everything from local dad meetups to recommended twitter feeds to how to know if you may have a paternal mood or anxiety disorder. Check it out!









Research
Depression and Expectant Fathers
 

In 2015, researchers from the Research Institute of the McGill University Health Centre released the first study to report the prevalence of antenatal (prenatal) depression symptoms among Canadian men. Results of the study indicated that a significant number of first-time fathers experience depression during their partner's pregnancy. 


Over a period of 18 months, 622 expectant fathers in Quebec completed online questionnaires during their partner's third trimester. Researchers measured a variety of factors including mood, physical activity, sleep quality, social support, marital adjustment, financial stress, and demographics; they found that 13.3 percent of expectant fathers experienced depressive symptoms. Specifically, sleep difficulties presented a greater risk for depression.

Because prenatal depression is a strong predictor for postpartum depression, screening fathers-to-be, and providing tools and support early on, are important parts of the effort to prevent and/or mitigate depression during the postpartum period.

Events

New Moms Connect Study: Nurturing Emotional Wellbeing. Are you expecting your first baby? You could be part of a study that aims to help soon-to-be moms manage stress, enjoy your baby, and increase your sense of well-being. The 8-week program includes: Practical skills for managing the joys and challenges of becoming a parent; Mindfulness-based stress management that can be applied to birth or parenting; Self-care tools that support calm and connected parenting; Six classes plus two individual consultation sessions to address your concerns one-on-one. The classes and individual sessions will be held in South/Central Seattle. You also will be asked to meet with research staff at the University of Washington for four assessment meetings, where you will complete surveys and participate in activities with your baby. You will be paid at least $90 for each assessment meeting you attend. You will receive a total of $420 if you attend all four meetings. Parking or transportation costs will also be covered. To be eligible: You need to be expecting your first baby, be less than 33 weeks pregnant, and have household income of less than $45,000. For more information: Contact Anna at 206.221.7049 or [email protected]


PS-WA is seeking volunteers. We are looking specifically for those who would like to volunteer on our Warm Line. Our next Warm Line training will be September 30. We are also always looking for volunteers for discrete projects throughout the year. Please fill out the form at  http://perinatalsupport.org/contribute/volunteer/ to get started. 
Giving to Perinatal Support Washington
Employee Giving
Are you a Microsoft or King County employee or spouse of one?  
Please consider supporting us through your respective workplace giving programs. For King County employees, our code is 9187. Our tax ID is 91-1448669. If you are looking for us, be sure to check our old and new name (Postpartum Support International of Washington) if you don't see us--we are there.

Warm Line: 1-888-404-7763 (PPMD)

Support Education, Referral
(formerly Postpartum Support International of Washington)