| Summary: | The survival rate of premature infants is increasing. As such protective factors against cognitive and behavioural developmental impairments associated with prematurity need to be identified and understood in order to promote healthy infant development. Quality of parent-infant interaction may be a protective factor over and above other mediators such as sociodemographic and neonatal medical risks. Most research has considered the mothers' experience of having a premature infant and the quality of mother-infant interaction on infant outcomes. Evidence suggests that father involvement and interaction with the infant is also associated with improved developmental outcomes in later childhood. More research is needed of fathers' experiences of interactions with premature infants in order to promote early positive interactions, fostering healthy relationship and infant development. The current study used a qualitative design to investigate fathers' experiences of interacting with their premature infants on UK neonatal intensive care units and after discharge home. Telephone interviews were conducted with ten fathers from across the UK about their experiences of interacting with their premature infants. Thematic analysis identified six themes affecting fathers' experiences of interactions with their infant: i) Fragility of the infant - fathers were nervous and unsure about how to interact with their fragile babies, being scared of hurting them; ii) From self-conscious to self-confident interactions - fathers described the lack of privacy in the hospital contributing to them feeling self-conscious about attempting interactions with their infant, whereas they built confidence in interaction over time and felt interactions were more natural once in the freedom of their own home; iii) Medical equipment as barrier to interaction - the incubator and monitors around the infants acted as physical and emotional barriers to interaction, though the fathers recognised it was needed to keep their babies safe; iv) Passivity of baby - fathers struggled with interacting with their unresponsive infants and adapted their interactions to those which the passive infant did not need to participate in, such as singing to them; v) Not having the envisaged experience of fatherhood - fathers had to readjust their preconceived expectations of what the early days of fatherhood would be like had their infant been born full-term, to the new reality 0809, RES, Research Project, UofN: 4093405, UofL: 08127476 Pageiiof197 of having a premature baby; vi) Nature of information - although staff actively involved fathers in care-giving tasks and provided information about the infants' medical needs, little information was provided about non-care-giving interactions and fathers often had to ask what they could do with their baby. Fathers in this study described facing many challenges and barriers to interacting with their premature infants, and that these resulted in a delay in feeling like a father to the infant and in the development of the father-infant relationship. The findings have implications for the development of father- infant attachment which may influence infant development. The fathers described neonatal staff as excellent and supportive, though there appears to be a lack consistency of information to encourage fathers to interact with their premature infants from the earliest possible stages. Given the importance of this for positive infant outcomes, the experiences reported in this study may help inform support for fathers on UK NICUs to promote early interactions with their infant and foster healthy relationship and infant development.
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