Beyond the Breadwinner: Reframing Fatherhood in Asia for Family and Child Health

Across Asia, fatherhood is changing. Many fathers are no longer content to remain only the financial provider, standing at the margins of pregnancy, birth, feeding, and child-rearing. They want to be present, informed, and useful. Yet our health systems, family norms, and social expectations have not always caught up with this shift. Too often, fathers are still treated as visitors in maternity spaces, occasional helpers at home, or silent supporters whose own needs are secondary to those of the mother and infant. This is a missed opportunity.

Fathers influence family and child health from the earliest stages of life. During pregnancy and childbirth, fathers can offer emotional reassurance, participate in shared decision-making, and support mothers in developing realistic birth plans. Evidence from a scoping review on birth plans showed that fathers’ involvement can enhance childbirth experiences, yet their participation is often restricted by knowledge gaps, unclear roles, and healthcare environments that remain primarily mother-focused (Nazeer et al., 2024). Fathers are more likely to engage when healthcare professionals actively invite them into discussions, explain their role, and acknowledge their presence as meaningful rather than incidental. The review also showed that fathers’ participation in birth planning was shaped by how healthcare providers from maternity and child health settings treated them and by the cultural context in which childbirth decisions occurred.

The same applies to breastfeeding. A mixed-studies review of fathers’ breastfeeding knowledge, attitudes, and involvement in Asia identified fathers as important sources of support, with influence over infant-feeding preferences and family decisions (Pereira et al., 2024). However, Asian fathers’ understanding of breastfeeding was varied and shaped by personal, cultural, religious, social, and environmental factors. The review highlighted the need for father-friendly breastfeeding education, better preparation of perinatal professionals to engage fathers, and more flexible paternal leave policies (Pereira et al., 2024). Fathers do not need to breastfeed to be central to breastfeeding. They can protect maternal rest, encourage persistence during difficulties, help problem-solve, manage household tasks, and create an emotionally safe environment for mothers. These recommendations are consistent with the review’s conclusion that perinatal care professionals and policymakers must do more to make breastfeeding support inclusive of fathers.

Fatherhood also matters beyond infancy. In a Singaporean study on paternal feeding practices, fathers’ behaviours were associated with children’s eating patterns across developmental stages (Ng et al., 2025). For example, healthy food availability at home, paternal monitoring, pressure to eat, using food as a reward, and using food for emotional regulation were all linked in different ways to children’s food approach or food avoidance behaviours (Ng et al., 2025). These findings remind us that fathers shape children’s health not only through provision, but also through everyday interactions: what food is bought, how meals are structured, how emotions are soothed, and how healthy habits are modelled. Paternal feeding practices are therefore potentially modifiable targets for family-based interventions to support healthier eating habits from early childhood through adolescence.

However, asking fathers to be more involved without attending to their own needs is incomplete and unfair. Recent work on paternal postpartum depression in Singapore found that fathers are also vulnerable during the perinatal period. In one prospective study, 5.26% of fathers screened positive for paternal postpartum depression using the Edinburgh Postpartum Depression Scale at one month postpartum, while 14.3% had moderate depressive symptoms using the Gotland Male Depression Scale (Chua et al., 2025). Baseline depressive symptoms, perceived social support, and parental self-efficacy were important predictors, underscoring the need for early screening and support (Chua et al., 2025). The study further recommended culturally adapted tools and father-specific interventions to better identify and support fathers at risk of postpartum depression.

Qualitative work has deepened this understanding. In a study of multi-racial fathers in Singapore during the postpartum period, fathers described great expectations and self-blame, the dual role of provider-caregiver, tensions when family support both helped and hurt, and the invisibility of fathers’ mental health (Aayisha et al., 2025). Many fathers suppressed emotional struggles because of masculine ideals of being strong, silent, and dependable. They were expected to provide financially, remain emotionally steady, support their wives, bond with the baby, and learn caregiving quickly, often without equivalent support from services. In Asian societies, where filial piety, extended family involvement, and traditional gender norms remain influential, fathers may experience additional tension between evidence-based parenting, older family expectations, and their own emerging identity as involved caregivers (Aayisha et al., 2025). The study highlighted the need for discreet, gender-sensitive mental health support, routine check-ins, and male-oriented services tailored to fathers’ needs.

Fatherhood interventions, therefore, need to be designed differently. A qualitative systematic review of fathers’ experiences with supportive parenting interventions found that fathers value programmes that create belonging, offer culturally sensitive peer support, and help them negotiate evolving fatherhood roles without shaming or threatening their masculine identity (Shorey et al., 2024). Men may not always seek help in conventional ways; therefore, services must be accessible, practical, strength-based, and discreet. Father-inclusive care should not simply mean adding fathers’ names to appointment forms. It means designing antenatal classes, breastfeeding support, birth planning, mental health screening, parenting education, and child health interventions with fathers in mind from the outset. The review showed that group-based, culturally adapted interventions can help fathers feel accepted, supported, and more confident in their caregiving role.

For Asia, the way forward is clear. First, fathers should be routinely and respectfully included in antenatal, intrapartum, postnatal, and child health services. Second, father-specific mental health screening and referral pathways should be developed and culturally adapted. Third, perinatal professionals should be trained to communicate with fathers, not around them. Fourth, paternity leave and workplace cultures must support fathers’ caregiving roles in practical and economically realistic ways. Finally, research must continue to generate Asian evidence, because fatherhood is deeply shaped by culture, religion, class, family structure, and gender norms (Aayisha et al., 2025; Pereira et al., 2024; Shorey et al., 2024).

Fathers are not secondary parents. They are co-architects of family health. When fathers are informed, emotionally supported, and practically enabled to participate, mothers are better supported, children are more likely to thrive, and families become more resilient. In Asia, strengthening fatherhood is not a departure from family values; it is a renewal of them.

References

Aayisha, Ng, J. Q. X., Chee, C. Y. I., Dennis, C.-L., Choolani, M., & Shorey, S. (2025). Beyond the breadwinner: A descriptive qualitative study of the experiences, challenges, and mental health needs of fathers in Singapore during the postpartum period. Family Process, 64, e70065.

Chua, J. S., Ng, J. Q. X., Chee, C. Y. I., Shen, L., Dennis, C.-L., Chong, Y. S., & Shorey, S. (2025). Struggles of fatherhood: A prospective study on the incidence of paternal postpartum depression and associated factors. Journal of Clinical Nursing, 34, 2248–2261.

Nazeer, N. S. b. M., Chua, J. S., & Shorey, S. (2024). Birth plan and fathers: A scoping review. Midwifery, 135, 104053.

Ng, N. B. H., Ng, J. Q. X., Shen, L., & Shorey, S. (2025). Redefining roles-Fathers play a crucial role in shaping children’s healthy eating behaviors: Cross-sectional observational study. Nutrients, 17(5), 860.

Pereira, T. L.-B., Rajendran, P. D. O., Nantsupawat, A., & Shorey, S. (2024). Fathers’ breastfeeding knowledge, attitudes, and involvement in the Asian context: A mixed-studies review. Midwifery, 131, 103956.

Shorey, S., Chee, C., Sambhi, S. K., Chong, S. C., & Choolani, M. (2024). Fathers’ experiences with supportive parenting interventions: A qualitative systematic review. Family Process, 63, 2037–2057.