Father's early behavior linked to child's heart and metabolic health years later

How a new father behaves toward his baby can change family dynamics in a way that affects the child's heart and metabolic health years later, according to a new study by researchers in the Penn State College of Health and Human Development.

In the study, recently published in Health Psychology, the research team found that fathers who were warm and developmentally supportive with their babies at 10 months of age had more positive co-parenting with the child's mother when the child was two years old. In families where this pattern played out, the child's bloodwork indicated better markers of physical health at seven years of age. In contrast, neither the mother's warmth when the child was 10 months old nor her positive or negative co-parenting when the child was two predicted the child's physical health at age seven.

This doesn't mean that mothers do not matter, the researchers said.

Everyone in the family matters a lot. Mothers are often the primary caregivers, and children are experiencing the most growth and development. The takeaway here is that in families with a father in the household, dads affect the environment in ways that can support - or undermine - the health of the child for years to come."

Alp Aytuglu, postdoctoral scholar, Department of Biobehavioral Health, Penn State

Prior research by other scientists demonstrated that children raised in high-conflict or unstable households can be at greater risk for health problems, including elevated inflammation, lower ability to regulate blood sugar and obesity. Those studies primarily examined the effects of mothers on children, according to Aytuglu. In this study, the researchers wanted to examine the entire family and the various interactions within a family.

Using data from the Penn State Family Foundations project, funded by the National Institutes of Health, the researchers examined videos and other information from 399 families in the United States that included a mother, a father and first child. Families in the study were 83% non-Hispanic white and had higher than average levels of education and income.

When each child in the study was 10 and 24 months old, Family Foundations researchers visited the families' homes and recorded 18-minute videos of the parents playing with their child. Researchers then reviewed the video and observed individual parenting behaviors and co-parenting behaviors.

For both videos, trained evaluators assigned codes to the mother's and father's parenting attributes, including whether parents responded to the child in a timely manner, how warmly parents behaved toward the child and how appropriate parents' responses were for a child that age.

Evaluators also examined co-parenting behavior in the video. Specifically, they identified instances where the parents competed for the child's attention - rather than playing with the child together or taking turns with the child more naturally. The researchers observed that when one parent competitively gained the child's attention, the other parent often withdrew from the interaction, disengaging from the play.

When the child was seven years old, the Family Foundations researchers collected a dried blood sample from the child. From that sample, the researchers in this study measured four well-established indicators of heart and metabolic health: cholesterol; glycated hemoglobin (HbA1c), which reflects average blood sugar over two to three months; interleukin-6 (IL-6), a messenger in the immune system that represents inflammation; and C-reactive protein (CRP), a marker of inflammation produced by the liver.

Using structural equation modeling, the researchers in this study discovered a connection between a father's behavior at 10 months and their child's health indicators at age seven.

Fathers who showed less sensitivity to their child at 10 months were more likely to compete for the child's attention and/or withdraw from family play when the child was 24 months old. When fathers displayed higher levels of competitive-withdrawal parenting behavior at 24-months, those children displayed higher levels of HbA1c and CRP at age seven, completing the connection from father's engagement at 10 months to the child's health more than six years later.

"No one will be surprised to learn that treating your children appropriately and with warmth is good for them," said Hannah Schreier, associate professor of biobehavioral health, Penn State Social Science Research Institute co-funded faculty member and senior author of this study. "But it might surprise people that a father's behavior before a baby is old enough to form permanent memories can affect that child's health when they are in second grade. It is generally understood that family dynamics affect development and mental health, but those dynamics affect physical health as well and play out over years."

Much of what made this research novel, according to the researchers, was their ability to use observations of actual parent-child interactions in their own homes.

"Researchers studying parenting are often forced to rely on parents' self-reports of their behavior," said Jennifer Graham-Engeland, Elizabeth Fenton Susman Professor of Biobehavioral Health and co-author of this study. "When any of us self-report something, we can be influenced by what we remember or how we want to be seen - which may not represent how we actually behaved. And, of course, children this young can't report on how their parents acted. The Family Foundations data made possible this intimate look into family lives as well as the connection of those interactions to later biological indicators of health. We believe this allowed us to create a more accurate picture of the influence of fathers than was possible previously."

The researchers said they anticipated that mothers' co-parenting behavior would have an impact similar to fathers' co-parenting behavior, but the results of this study did not reveal a specific impact of mother's warmth at 10 months or competitive-withdrawal co-parenting at age two or on the child's health measures at age seven.

"The lack of clear results based on the mothers' coparenting was not expected," said Graham-Engeland, associate director of the Penn State Center for Healthy Aging. "There could be many reasons for this, but one theory in the literature relates to the father's role in the family that may play out in different ways. In two-parent families like the ones in this study - the mother is frequently the primary caregiver; so, it is possible that whatever the mother's behavior, it tends to represent the norm in the family, whereas the father's role tends to be one that reinforces the norm or disrupts it. It is also likely that mothers affect children's health in ways other than those specifically examined in this study."

According to the researchers, it is important to remember that each family is different, and everyone in a family affects others more than they may know. This study was limited to families with a father, a mother and their first-born child, but the research team noted that there are many other family structures that may involve grandparents, single parents, same-sex parents and more. Additionally, they said that family dynamics change if more children are added or if the parents separate.

"What I hope people will take from this research is that fathers, alongside mothers, have a profound impact on family function that can reverberate through the child's health years later," Aytuglu said. "As a society, supporting fathers - and everyone in a child's household - is an important part of promoting children's health."

Other Penn State researchers contributing to this study include Mark Feinberg, research professor of health and human development and affiliated with the Edna Bennett Pierce Prevention Research Center; Samantha Murray-Perdue, assistant research professor at the Edna Bennett Pierce Prevention Research Center; and C. Andrew Conway, postdoctoral scholar at the Edna Bennett Pierce Prevention Research Center.

The National Institutes of Health funded this research.