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. 2021 Sep 10;21:397. doi: 10.1186/s12887-021-02838-2

Paternal childcare in early childhood and problematic behavior in children: a population-based prospective study in Japan

Manami Ochi 1,2,, Takeo Fujiwara 2
PMCID: PMC8431892  PMID: 34507526

Abstract

Background

There have been numerous reports on the effects of paternal childcare on children’s behavioral development. However, little is known about these effects in Asian countries such as Japan, where fathers do not have sufficient time for childcare due to long working hours. This study explored the association between paternal childcare during toddlerhood in terms of childcare hours and the type of caregiving behavior and subsequent behavioral problems in children aged 5.5 years, stratified by sex.

Methods

We analyzed data from the Longitudinal Survey of Newborns in the twenty-first Century (2001–2006), a population-based cohort survey in Japan (N = 27,870). Paternal childcare was assessed at 18 months in terms of paternal childcare hours on weekdays or weekends and the frequency of each type of childcare (feeding, changing diapers, bathing, putting the child to sleep, playing with the child at home, and taking the child outside). Based on the frequency or lack of paternal involvement, six categories of child behavioral problems were assessed when the children were 5.5 years old. Logistic regression analysis was applied to account for the known confounding variables.

Results

Longer paternal childcare hours, on both weekdays and weekends in toddlerhood, had a protective effect on behavioral problems at 5.5 years of age. The dose-effect relationships were found between the frequency of fathers taking their children outside and behavioral problems in boys, and the frequency of fathers playing with their children at home and behavioral problems in both boys and girls.

Conclusions

Paternal childcare during toddlerhood could prevent subsequent behavioral problems in children. Several specific paternal caregiving behaviors, such as taking their children outside and playing with them at home, may play an important role in preventing subsequent behavioral problems.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-021-02838-2.

Keywords: Father, Behavioral problem, Parenting, Early childhood, Longitudinal data

Background

An increasing body of research has shown that paternal childcare in early childhood can contribute to child socioemotional development and well-being in various ways [1]. While most studies focus on the importance of mother-baby interaction in childcare, increased involvement in childcare by fathers is associated with multiple aspects of child health and well-being, such as higher cognitive skills [2, 3], receptive language skills [3, 4], better anthropometric outcomes [5], improved social competence [6], higher educational attainment [7, 8], and fewer injuries [9].

Although there is evidence to support the positive impact of fathers’ involvement on children’s social and behavioral outcomes [10], other evidence on the specific benefits of paternal engagement with children during toddlerhood and its impact on children’s behavioral outcome remain limited [1113]. Direct engagement with children includes caregiving behaviors, such as feeding, changing diapers, playing, and social activities that promote the socio-psychological development of children [1]. Childcare provided by fathers may lead to increased maternal relaxation time and improved maternal mental health and may eventually affect their interactions with their children. Therefore, future research needs to consider not only the duration but also the extent of paternal childcare [14].

Certain types of paternal involvement with children may be partly determined by the child’s characteristics. For example, previous studies using path analysis found bidirectional associations between paternal involvement and child behavior, and a tendency for children with conduct problems or hyperactivity to have less involved fathers at subsequent ages [13, 15]. Children’s characteristics are also strongly associated with their developmental behaviors. Paternal childcare is responsive to the child’s temperament or disabilities, and children with difficulties may elicit less paternal involvement [15, 16]; however, few studies have taken this into account.

Further, previous studies on paternal childcare and its effect on child behavior have been limited to Western countries [17]. Parental behavior is highly context-dependent and diverse depending on various societal factors: geographical conditions, family characteristics, economic status, work-related factors, societal norms and beliefs, and so on [18, 19]. In Japan, where working and commuting hours are longer than in Western countries, many fathers are unable to spend a satisfactory amount of time with their children [20], and the impact of paternal engagement in childcare on children remains unclear.

This study aims to clarify the impact of paternal childcare during toddlerhood on behavioral problems among preschoolers in Japan, in terms of 1) childcare hours and 2) the type of caregiving in the Japanese population.

Methods

Study sample

We used data from the Longitudinal Survey of Newborns in the twenty-first Century, a population-based survey conducted by the Ministry of Health, Labor, and Welfare in Japan. The study sample included all babies born in Japan between January 10 and 17 or July 10 and 17, 2001, using birth records from national vital statistics. The baseline survey was mailed to parents when their infants were 6 months old (n = 53,575). After the baseline survey, annual surveys were conducted by sending questionnaires to participants by mail. We used data from 2001, 2002, and 2006 survey waves. We included children who lived with both parents and children whose mothers answered the questionnaire to maintain consistency in the assessment of childcare. We excluded responses with missing data for the variables used in the analysis: child problem behavior, paternal involvement in childcare and domestic chores, maternal involvement in childcare and domestic chores, parental education, parental employment, annual household income in 2002, gestational age, weight at birth, and child temperament.

Exposure: paternal childcare

Paternal childcare was assessed at 18 months of age using the following two measurements: paternal childcare hours on weekdays or weekends, and frequency of each type of caregiving (feeding, changing diapers, bathing, putting the child to sleep, playing with the child at home, and taking the child outside).

Paternal childcare hours were ascertained by asking the following questions: How much time does the father spend with his child on average in 1 day, except for sleeping hours? Respondents answered in respect of both weekdays and weekends by choosing from the following options: none, < 0.5 h, 0.5–0.9 h, 1–1.9 h, 2–3.9 h, 4–5.9 h, and ≥ 6 h. In general, working fathers are expected to spend more time in childcare on weekends than on weekdays; therefore, we re-defined the categories into “less than 0.5 hours,” “0.5 to 1.9 hours,” and “2 or more hours” for weekdays, and “less than 4 hours,” “4 to 5.9 hours,” and “6 or more hours” for weekends.

The frequency of each type of paternal caregiving was retrieved using six items: 1) feeding, 2) changing diapers, 3) bathing, 4) putting the child to sleep, 5) playing with the child at home, and 6) taking the child outside. Responses for each question included “not at all,” “rarely,” “sometimes,” and “always” For these categories, we classified “always” and “sometimes” as a high degree of paternal caregiving, and “rarely” and “not at all” as a low degree of paternal caregiving. To calculate the total paternal caregiving scores, each response was scored from 0 to 3 (i.e., “not at all” = 0 and “always” = 3). The measurement and the method of specifying the caregiving variable were in line with previous studies [9, 21]. We divided the total caregiving scores into three groups, namely the “high degree of paternal caregiving” group with more than 1 SD above the mean, the “low degree of paternal caregiving” group with less than 1 SD under the mean, and the “middle degree of paternal caregiving” group.

Outcome: child behavioral problems

Child behavioral problems were assessed when the children were 5.5 years old by asking the following six questions that required a yes/no response: 1) Is your child able to listen without fidgeting? 2) Is your child able to focus on a specific task? 3) Is your child patient? 4) Is your child able to express their emotions appropriately? 5) Is your child able to behave in a group situation? 6) Is your child able to keep promises? These variables were developed to identify early signs of behavioral and developmental problems and have been previously used as a set of measurements for behavioral problems [22, 23]. In addition, we defined children with any of these problem behaviors as “children with behavioral problems.”

Covariates

We selected the following variables as potential confounders: the number of siblings, living with grandparent(s), paternal and maternal age at childbirth (< 25 years, 25–29 years, 30–34 years, 35–39 years, and ≥ 40 years), paternal and maternal education (lower than high school degree, high school degree, 2-year college or vocational school degree, and a college degree or more), annual household income in 2002 (< JPY 4 million, 4–5.9 million, 6–7.9 million, 8–9.9 million, and ≥ 10 million), maternal childcare hours on weekdays or weekends at 18 months old, and total scores of maternal involvement in caregiving. Maternal involvement in caregiving was scored using the same items used to assess fathers’ involvement in caregiving, and the summed score of the six items was used in the analysis.

How fathers are involved with their children is affected by factors relating to the children themselves, such as disabilities and temperament [2426]. Therefore, the baseline characteristics of children should also be considered when estimating the effect of paternal childcare: gestational age (< 37 weeks, 37–41 weeks, and ≥ 42 weeks), multiple birth (singleton, twins, and triplets), child’s history of hospital admission or visits for congenital diseases, and child’s temperament (self-reported dichotomous answers to questions about 18 traits: active, shy of strangers, playful, short-tempered, careful, aggressive, timid, competitive, obedient, independent, stubborn, full of curiosity, fickle, restless, shy, spoilt, easygoing, and impatient).

Statistical analysis

We developed logistic regression models for child behavioral problems as predicted by the paternal childcare duration and caregiving score adjusting for covariates shown above. In addition to the crude models, two adjusted models were used: Model 1 adjusted for all covariates shown above, and Model 2 additionally adjusted for other variables of paternal childcare to examine how each of the paternal childcare variables, that is, paternal childcare hours on weekdays, weekends, and total caregiving scores, affected a child’s behavioral problems. We also examined whether the frequency of each type of paternal caregiving was associated with each type of child behavioral problem after adjusting for paternal childcare hours. Finally, to ascertain any evidence of interaction between the main exposure variables and the child’s sex, we conducted a supplementary analysis in which those interaction terms were added into the model.

All analyses were conducted separately for boys and girls because the effects of paternal childcare may differ due to biologically established sex differences in child development [27]. Analyses were performed using Stata version 15.0 (Stata Corp., College Station, TX, USA).

Approval from the ethics committee of the Tokyo Medical and Dental University was waived because the data were anonymous and available from the Ministry of Health, Labour, and Welfare in Japan upon request. Questionnaire responses from caregivers were considered as informed consent to participate in the study.

Results

A total of 47,015 caregivers responded to the baseline questionnaire in 2001 (response rate: 87.7%), 43,925 (93.4%) caregivers responded in the 2002 survey wave, and 38,540 (82.0%) responded in the 2006 survey wave. We excluded the children who did not live with both parents or whose mothers did not answer the questionnaire (n = 3458, 9.0%). We excluded responses that did not comprise the following values: child problem behavior (n = 1443, 3.7%), paternal involvement in childcare and domestic chores (n = 2533, 6.6%), maternal involvement in childcare and domestic chores (n = 1277, 3.3%), parental education (n = 578, 1.5%), parental employment (n = 807, 2.1%), annual household income in 2002 (n = 2705, 7.0%), gestational age (n = 14, 0.04%), weight at birth (n = 7, 0.02%), and child temperament (n = 374, 1.0%). Finally, 27,870 newborns were included in the analyses (72.3% of the respondents in the 2006 survey wave). Paternal caregiving in one type of activity was not strongly correlated with that in another type of activity (Spearman’s correlation coefficients ranging from 0.27–0.50, Table 1). The total paternal caregiving scores ranged from 0 to 18 (Cronbach’s alpha = 0.77).

Table 1.

Spearman correlation coefficients between specific types of paternal involvement in caregiving

1) 2) 3) 4) 5) 6)
1) Feeding 1.00
2) Changing diaper 0.50 1.00
3) Bathing 0.35 0.31 1.00
4) Putting the child to sleep 0.42 0.42 0.40 1.00
5) Playing with the child at home 0.35 0.31 0.36 0.30 1.00
6) Taking the child outside 0.32 0.30 0.27 0.28 0.44 1.00

Table 2 shows the characteristics of the respondents in total and stratified by child sex. Preterm births and low birth weights accounted for 4.6 and 8.1%, respectively. The mean age of the father and mother at the time of birth was 31.7 (SD = 5.3) and 29.7 (SD = 4.2) years, respectively. Half of the families had older siblings when the participating child was born. One of the five families lived with grandparents. The percentage of the history of hospital visits or admissions due to a child’s congenital diseases was 2.2 and 1.0%, respectively. Large differences in proportion were shown between boys and girls in some of the children’s temperament traits (e.g., 42.8% for playful boys compared to 31.1% for playful girls).

Table 2.

Characteristics of the participants

Total Boy Girl
n = 27,870 n = 14,429 n = 13,441
No. or mean % or SD No. or mean % or SD No. or mean % or SD
Gestational age (week)
  < 37 1277 4.6 764 5.3 513 3.8
 37–41 26,357 94.6 13,542 93.9 12,815 95.3
  ≥ 42 236 0.8 123 0.9 113 0.8
Birth weight (g)
  ≥ 2500 25,616 91.9 13,384 92.8 12,232 91.0
  < 2500 2254 8.1 1045 7.2 1209 9.0
 Paternal age at child birth (years old) 31.7 5.3 31.8 5.3 31.7 5.3
  < 25 1822 6.5 922 6.4 900 6.7
 25–29 8060 28.9 4151 28.8 3909 29.1
 30–34 10,236 36.7 5332 37.0 4904 36.5
 35–39 5583 20.0 2887 20.0 2696 20.1
 40+ 2105 7.6 1100 7.6 1005 7.5
 unknown 64 0.2 37 0.3 27 0.2
 Maternal age at child birth (years old) 29.7 4.2 29.7 4.2 29.7 4.2
  < 25 2843 10.2 1465 10.2 1378 10.3
 25–29 11,059 39.7 5747 39.8 5312 39.5
 30–34 10,414 37.4 5402 37.4 5012 37.3
 35–39 3204 11.5 1629 11.3 1575 11.7
  ≥ 40 350 1.3 186 1.3 164 1.2
Paternal education
 less than high school 1936 6.9 1019 7.1 917 6.8
 high school 10,773 38.7 5588 38.7 5185 38.6
 some college 4461 16.0 2308 16.0 2153 16.0
 college or higher 10,700 38.4 5514 38.2 5186 38.6
Maternal education
 less than high school 1076 3.9 539 3.7 537 4.0
 high school 10,470 37.6 5414 37.5 5056 37.6
 some college 12,074 43.3 6330 43.9 5744 42.7
 college or higher 4250 15.2 2146 14.9 2104 15.7
Number of siblings
 none 12,772 45.8 6488 45.0 6284 46.8
 1 11,048 39.6 5841 40.5 5207 38.7
  ≥ 2 4050 14.5 2100 14.6 1950 14.5
 Living with grandparent(s) (answer = yes) 5866 21.0 3065 21.2 2801 20.8
Annual household income (JPY million)
  <  4 7966 28.6 4150 28.8 3816 28.4
 4–5.9 10,811 38.8 5576 38.6 5235 38.9
 6–7.9 5544 19.9 2845 19.7 2699 20.1
 8–9.9 2099 7.5 1127 7.8 972 7.2
  ≥ 10 1450 5.2 731 5.1 719 5.3
Multiple birth
 singleton 27,314 98.0 14,129 97.9 13,185 98.1
 twin 546 2.0 295 2.0 251 1.9
 triplet 10 0.04 5 0.03 5 0.03
 History of hospital visits for child’s congenital diseases (answer = yes) 624 2.2 344 2.4 280 2.1
 History of hospital admissions for child’s congenital diseases (answer = yes) 267 1.0 164 1.1 103 0.8
Child’s temperament (answer = yes)
 active 14,737 52.9 7405 51.3 7332 54.5
 shy of strangers 2891 10.4 1181 8.2 1710 12.7
 playful 10,360 37.2 6182 42.8 4178 31.1
 short temper 4551 16.3 2445 16.9 2106 15.7
 careful 4172 15.0 2323 16.1 1849 13.8
 aggressive 12,169 43.7 5254 36.4 6915 51.4
 timid 2084 7.5 1476 10.2 608 4.5
 obedient 6513 23.4 3603 25.0 2910 21.7
 competitive 8094 29.0 3700 25.6 4394 32.7
 independent 12,378 44.4 5465 37.9 6913 51.4
 stubborn 3994 14.3 2361 16.4 1633 12.1
 full of curiosity 11,305 40.6 5967 41.4 5338 39.7
 fickle 4346 15.6 2164 15.0 2182 16.2
 restless 6318 22.7 3845 26.6 2473 18.4
 shy 9400 33.7 4663 32.3 4737 35.2
 spoilt 15,849 56.9 9150 63.4 6699 49.8
 easygoing 2142 7.7 1214 8.4 928 6.9
 impatient 1622 5.8 845 5.9 777 5.8

SD Standard deviation

The distribution of paternal childcare hours and the frequency of each type of caregiving are shown in Table 3. On weekdays, 47.9% of the fathers spent two or more hours with their children. On weekends, 70.1% of the fathers spent six or more hours with their children. Little difference was found in these proportions between boys and girls. The total score of paternal caregiving was distributed normally, with a mean of 11.1 and a standard error of 0.02. For half of the types of caregiving (i.e., bathing, putting the child to sleep, and taking the child outside), the proportion of fathers who were involved in caregiving “sometimes” or “always,” was higher in case of boys than girls.

Table 3.

The distributions of paternal childcare

Total
n = 27,870
Boy
n = 14,429
Girl
n = 13,441
p value*
No. or mean % or SE No. or mean % or SE No. or mean % or SE
Childcare hour on weekdays (hour)
  <  0.5 4747 17.0 2456 17 2291 17.0 0.89
 0.5–0.9 3654 13.1 1905 13.2 1749 13.0
 1–1.9 6104 21.9 3141 21.8 2963 22.0
 2–3.9 9432 33.8 4864 33.7 4568 34.0
 4–5.9 3348 12.0 1749 12.1 1599 11.9
  ≥ 6 585 2.1 314 2.2 271 2.0
Childcare hour on weekends (hour)
  <  0.5 299 1.1 158 1.1 141 1.0 0.77
 0.5–0.9 470 1.7 243 1.7 227 1.7
 1–1.9 1027 3.7 521 3.6 506 3.8
 2–3.9 2521 9.0 1326 9.2 1195 8.9
 4–5.9 4014 14.4 2044 14.2 1970 14.7
  ≥ 6 19,539 70.1 10,137 70.3 9402 70.0
 Total caregiving score (range: 0 to 18) 11.1 0.02 11.2 0.03 11.0 0.03 <  0.001
Frequency of feeding
 not at all 3336 12.0 1733 12.0 1603 11.9 0.28
 rarely 7346 26.4 3738 25.9 3608 26.8
 sometimes 14,593 52.4 7586 52.6 7007 52.1
 always 2595 9.3 1372 9.5 1223 9.1
Frequency of changing diaper
 not at all 3416 12.3 1763 12.2 1653 12.3 0.72
 rarely 6571 23.6 3396 23.5 3175 23.6
 sometimes 15,631 56.1 8078 56.0 7553 56.2
 always 2252 8.1 1192 8.3 1060 7.9
Frequency of bathing
 not at all 1337 4.8 612 4.2 725 5.4 <  0.001
 rarely 2612 9.4 1291 8.9 1321 9.8
 sometimes 13,954 50.1 7181 49.8 6773 50.4
 always 9967 35.8 5345 37.0 4622 34.4
Frequency of putting the child to sleep
 not at all 5601 20.1 2703 18.7 2898 21.6 <  0.001
 rarely 8268 29.7 4218 29.2 4050 30.1
 sometimes 10,950 39.3 5803 40.2 5147 38.3
 always 3051 10.9 1705 11.8 1346 10.0
Frequency of playing with the child at home
 not at all 165 0.6 82 0.6 83 0.6 0.61
 rarely 1126 4.0 582 4.0 544 4.0
 sometimes 13,846 49.7 7120 49.3 6726 50.0
 always 12,733 45.7 6645 46.1 6088 45.3
Frequency of taking the child outside
 not at all 917 3.3 457 3.2 460 3.4 <  0.001
 rarely 3717 13.3 1826 12.7 1891 14.1
 sometimes 18,882 67.8 9805 68.0 9077 67.5
 always 4354 15.6 2341 16.2 2013 15.0

SE Standard error, * Chi-square test

Table 4 shows the mean of the number of behavioral problems and the percentage of each behavioral problem by sex. Being unable to focus on a specific task was the most observed behavioral problem: 23.9% of the children. Being unable to express emotions appropriately was the second highest (22.9%), followed by being unable to keep promises (18.9%) and being unable to listen without fidgeting (17%). Boys were more likely to have behavioral problems than girls (1.2 vs. 0.8) and had a significantly higher proportion of behavioral problems than girls, except for “being unable to focus on a specific task.”

Table 4.

The number of children with behavioral problems

Total
n = 27,870
Boy
n = 14,429
Girl
n = 13,441
p value*
mean or No. SE or % mean or No. SE or % mean or No. SE or %
Number of behavioral problem 1.0 0.01 1.2 0.01 0.8 0.01 <  0.001
Any of behavioral problems 13,995 50.2 7980 55.3 6015 44.8 <  0.001
Unable to listen without fidgeting 4751 17.0 3131 21.7 1620 12.1 <  0.001
Unable to focus on a specific task 3463 12.4 1833 12.7 1630 12.1 0.15
Unable to be patient 6656 23.9 3930 27.2 2726 20.3 <  0.001
Unable to express emotions appropriately 6375 22.9 3672 25.4 2703 20.1 <  0.001
Unable to behave in a group situation 1656 5.9 1086 7.5 570 4.2 <  0.001
Unable to keep promises 5270 18.9 3117 21.6 2153 16.0 <  0.001

SE Standard error, * t-test or Chi-square test

Table 5 shows the results of the logistic regression analysis to estimate how paternal childcare contributed to behavioral problems in boys and girls. In Model 1, adjusting for covariates, children whose fathers spent two or more hours on weekdays with them had a smaller number of behavioral problems (for boys: OR: 0.70, 95% CI: 0.60 to 0.82; for girls: OR: 0.81, 95% CI: 0.70 to 0.95) as compared with children whose fathers spent less than half an hour on weekdays with them. In addition, children whose fathers spent six or more hours with them on weekends had fewer behavioral problems (for boys: OR: 0.81, 95% CI: 0.73 to 0.90; for girls: OR: 0.85, 95% CI: 0.76 to 0.94) than children whose fathers spent less than 4 h with them on weekends. Children who received a high degree of paternal caregiving, defined as more than 1 SD above the mean of the total paternal caregiving score (i.e., 14.3 points), were observed to have a smaller number of behavioral problems (for boys: OR: 0.76, 95% CI: 0.67 to 0.88; for girls: OR: 0.77, 95% CI: 0.67 to 0.89) as compared with children who received a low degree of paternal caregiving. When paternal childcare hours and paternal caregiving scores were adjusted simultaneously in Model 2, the association between paternal childcare hours and problem behaviors remained in boys (for weekdays: OR: 0.71, 95% CI: 0.60 to 0.84; for weekends: 0.86, 95% CI: 0.76 to 0.96 in Table 5), but there was no significant association between total caregiving score and problem behaviors in boys. For girls, the association between paternal childcare hours on weekdays and problem behaviors remained (OR: 0.83, 95% CI: 0.71 to 0.99). Paternal childcare hours on weekends were protective against problem behaviors in girls, although the difference was not statistically significant (OR: 0.89, 95% CI: 0.79 to 1.00). There was no significant multicollinearity among the variables adjusted for in Model 2. The coefficients of covariates adjusted in Models 1 and 2 of Table 5 are shown in the Additional Tables 1, 2, 3, and 4.

Table 5.

The effects of paternal childcare-hour and caregiving score on behavioral problems in 5.5 year-old children; result of the logistic regression model

Crude model Model 1 Model 2
OR 95%CI OR 95%CI OR 95%CI
Boys
 Childcare-hour on weekdays (ref. <  0.5 h)
  0.5 to 1.9 h 0.91 0.78 1.05 0.82 0.70 0.96 0.82 0.70 0.96
   ≥ 2 h 0.87 0.75 1.01 0.70 0.60 0.82 0.71 0.60 0.84
(p for trend) 0.07 (p for trend) <  0.001 (p for trend) < 0.001
 Childcare-hour on weekends (ref. <  4 h)
  4 to 5.9 h 0.93 0.82 1.05 0.92 0.81 1.05 0.96 0.84 1.10
   ≥ 6 h 0.79 0.72 0.87 0.81 0.73 0.90 0.86 0.76 0.96
(p for trend) < 0.001 (p for trend) < 0.001 (p for trend) 0.004
 Total caregiving score (ref. low)
  middle 0.92 0.83 1.02 0.87 0.78 0.97 0.98 0.87 1.10
  high 0.86 0.76 0.98 0.76 0.67 0.88 0.92 0.79 1.07
(p for trend) 0.03 (p for trend) < 0.001 (p for trend) 0.29
Girls
 Childcare-hour on weekdays (ref. < 0.5 h)
  0.5 to 1.9 h 0.94 0.81 1.09 0.90 0.77 1.05 0.91 0.78 1.06
   ≥ 2 h 0.95 0.82 1.11 0.81 0.70 0.95 0.83 0.71 0.99
(p for trend) (p for trend) 0.001 (p for trend) 0.02
 Childcare-hour on weekends (ref. <  4 h)
  4 to 5.9 h 0.99 0.88 1.12 1.00 0.88 1.14 1.05 0.91 1.20
   ≥ 6 h 0.79 0.72 0.87 0.85 0.76 0.94 0.89 0.79 1.00
(p for trend) < 0.001 (p for trend) < 0.001 (p for trend) 0.01
 Total caregiving score (ref. low)
  middle 0.91 0.82 1.00 0.85 0.76 0.94 0.91 0.81 1.01
  high 0.90 0.78 1.02 0.77 0.67 0.89 0.88 0.75 1.03
(p for trend) 0.10 (p for trend) < 0.001 (p for trend) 0.11

aModel 1 adjusted covariates variables (number of siblings, living with grandparent(s), paternal and maternal age at child birth, paternal and maternal education, annual household income, maternal childcare-hours on weekdays or weekends at 18 months old, and the total scores of maternal involvement in caregiving, multiple birth, gestational age, child’s history of hospital admission or visits for congenital diseases, child’s temperament).

bModel 2 adjusted for Model 1 and other veriables of paternal childcare.

cBold values denote statistical significance at the p < 0.05

OR Odds ratio; CI Confidence interval

Several paternal caregiving behaviors decreased specific problem behaviors in children, as shown in Tables 6 and 7. For example, boys whose fathers always fed them had fewer behavioral problems, such as not listening without fidgeting (OR: 0.74, 95% CI: 0.61 to 0.90), not being patient (OR: 0.76, 95% CI: 0.63 to 0.90), and not keeping promises (OR: 0.82, 95% CI: 0.68 to 0.99, Table 6). In addition, boys whose fathers always changed their diapers had fewer behavioral problems such as not listening without fidgeting (OR: 0.73, 95% CI: 0.60 to 0.90), not focusing on a specific task (OR: 0.74, 95% CI: 0.58 to 0.95), and not expressing their emotions appropriately (OR: 0.80, 95% CI: 0.66 to 0.97). Paternal childcare, such as playing with their children at home or taking their children outside, had a protective dose-effect on most behavioral problems in boys at age 5.5 (all p for trend < 0.05, except for expressing emotions appropriately).

Table 6.

The effects of paternal childcare on behavioral problems in 5.5 year-old boys; result of the logistic regression model

Behavioral problem Unable to listen without fidgeting Unable to focus on a specific task Unable to be patient Unable to express emotions appropriately Unable to behave in a group situation Unable to keep promises
OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI
Frequency of feeding (ref. not at all)
 rarely 0.85 0.76 0.97 0.80 0.70 0.93 0.99 0.83 1.19 0.81 0.71 0.93 0.88 0.77 1.01 0.89 0.72 1.10 0.93 0.80 1.07
 sometimes 0.86 0.77 0.97 0.86 0.75 0.98 1.02 0.86 1.21 0.82 0.72 0.93 0.88 0.78 1.00 0.90 0.74 1.10 0.92 0.81 1.06
 always 0.85 0.73 0.99 0.74 0.61 0.90 0.87 0.69 1.11 0.76 0.63 0.90 0.87 0.73 1.04 0.91 0.68 1.21 0.82 0.68 0.99
(p for trend) 0.07 (p for trend) 0.04 (p for trend) 0.55 (p for trend) 0.004 (p for trend) 0.12 (p for trend) 0.51 (p for trend) 0.09
Frequency of changing diaper (ref. not at all)
 rarely 0.90 0.80 1.02 0.84 0.72 0.97 0.87 0.73 1.04 0.90 0.79 1.03 0.97 0.85 1.11 0.99 0.79 1.24 0.96 0.83 1.11
 sometimes 0.94 0.84 1.05 0.84 0.73 0.96 0.95 0.81 1.13 0.96 0.85 1.09 0.90 0.79 1.02 1.07 0.87 1.32 1.03 0.90 1.18
 always 0.82 0.70 0.97 0.73 0.60 0.90 0.74 0.58 0.95 0.88 0.74 1.06 0.80 0.66 0.97 1.14 0.84 1.54 0.87 0.71 1.06
(p for trend) 0.14 (p for trend) 0.01 (p for trend) 0.27 (p for trend) 0.58 (p for trend) 0.01 (p for trend) 0.26 (p for trend) 0.80
Frequency of bathing (ref. not at all)
 rarely 0.92 0.75 1.13 1.18 0.92 1.51 0.89 0.66 1.20 1.17 0.94 1.46 0.81 0.65 1.02 0.93 0.66 1.30 1.03 0.81 1.31
 sometimes 1.00 0.83 1.19 1.09 0.88 1.35 0.96 0.74 1.24 1.01 0.83 1.23 0.88 0.73 1.07 0.80 0.59 1.08 1.10 0.89 1.37
 always 0.88 0.73 1.07 1.00 0.79 1.24 0.81 0.62 1.05 0.94 0.76 1.15 0.79 0.64 0.96 0.81 0.59 1.11 1.13 0.90 1.40
(p for trend) 0.14 (p for trend) 0.17 (p for trend) 0.06 (p for trend) 0.03 (p for trend) 0.04 (p for trend) 0.16 (p for trend) 0.20
Frequency of putting the child to sleep (ref. not at all)
 rarely 0.99 0.89 1.10 1.01 0.89 1.14 0.92 0.78 1.07 0.93 0.83 1.04 0.91 0.81 1.02 0.88 0.72 1.06 1.13 1.00 1.28
 sometimes 0.97 0.88 1.07 1.06 0.94 1.20 1.05 0.90 1.21 0.93 0.83 1.04 0.88 0.78 0.98 0.92 0.76 1.10 1.08 0.96 1.22
 always 1.04 0.91 1.19 1.06 0.90 1.25 0.89 0.72 1.09 0.90 0.77 1.04 0.94 0.80 1.09 1.14 0.90 1.45 1.20 1.02 1.41
(p for trend) 0.93 (p for trend) 0.31 (p for trend) 0.99 (p for trend) 0.20 (p for trend) 0.13 (p for trend) 0.46 (p for trend) 0.11
Frequency of playing with the child at home (ref. not at all)
 rarely 1.15 0.70 1.89 1.05 0.60 1.82 0.95 0.48 1.90 0.97 0.58 1.62 0.74 0.44 1.23 0.78 0.39 1.55 0.98 0.56 1.72
 sometimes 1.06 0.66 1.70 0.73 0.43 1.23 0.81 0.42 1.57 0.86 0.53 1.40 0.77 0.48 1.25 0.55 0.29 1.06 0.90 0.53 1.53
 always 0.95 0.59 1.51 0.64 0.38 1.10 0.75 0.38 1.45 0.79 0.48 1.30 0.65 0.40 1.05 0.50 0.26 0.98 0.82 0.48 1.40
(p for trend) 0.002 (p for trend) < 0.001 (p for trend) 0.04 (p for trend) 0.02 (p for trend) < 0.001 (p for trend) 0.01 (p for trend) 0.02
Frequency of taking the child outside (ref. not at all)
 rarely 1.05 0.84 1.31 0.85 0.66 1.09 1.03 0.76 1.41 0.91 0.72 1.15 0.90 0.71 1.15 0.88 0.62 1.25 1.01 0.79 1.29
 sometimes 0.92 0.75 1.13 0.75 0.60 0.95 0.86 0.64 1.15 0.80 0.65 1.00 0.89 0.71 1.11 0.76 0.54 1.05 0.86 0.69 1.09
 always 0.89 0.71 1.11 0.78 0.60 1.00 0.83 0.61 1.15 0.78 0.62 0.99 0.82 0.64 1.04 0.73 0.51 1.06 0.80 0.62 1.03
(p for trend) 0.02 (p for trend) 0.05 (p for trend) 0.04 (p for trend) 0.01 (p for trend) 0.08 (p for trend) 0.05 (p for trend) 0.004

aAdjusted covariates (number of siblings, living with grandparent(s), paternal and maternal age at child birth, paternal and maternal education, annual household income, maternal childcare hours on weekdays or weekends at 18 months old, and the total scores of maternal involvement in caregiving, gestational age, multiple birth, child’s history of hospital admission or visits for congenital diseases, child’s temperament), and parental spending hours with children.

b Bold values denote statistical significance at the p < 0.05

OR Odds ratio; CI Confidence interval

Table 7.

The effects of paternal childcare on behavioral problems in 5.5 year-old girls; result of the logistic regression model

Behavioral problem Unable to listen without fidgeting Unable to focus on a specific task Unable to be patient Unable to express emotions appropriately Unable to behave in a group situation Unable to keep promises
OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI OR   95%CI
Frequency of feeding (ref. not at all)
 rarely 1.05 0.92 1.18 0.96 0.79 1.16 0.95 0.79 1.15 0.96 0.82 1.11 1.02 0.88 1.18 0.87 0.65 1.15 1.15 0.97 1.36
 sometimes 0.94 0.84 1.06 0.96 0.80 1.16 0.86 0.72 1.03 0.87 0.76 1.01 0.96 0.83 1.11 0.89 0.68 1.16 1.04 0.88 1.22
 always 1.01 0.85 1.19 0.85 0.66 1.10 0.97 0.76 1.24 0.74 0.60 0.91 1.05 0.86 1.29 1.10 0.75 1.61 1.15 0.92 1.44
(p for trend) 0.23 (p for trend) 0.38 (p for trend) 0.22 (p for trend) 0.002 (p for trend) 0.78 (p for trend) 0.92 (p for trend) 0.86
Frequency of changing diaper (ref. not at all)
 rarely 0.99 0.88 1.13 0.95 0.78 1.15 0.91 0.76 1.11 0.87 0.75 1.01 1.06 0.91 1.24 1.12 0.84 1.50 1.05 0.89 1.24
 sometimes 0.93 0.83 1.05 0.90 0.76 1.08 0.95 0.80 1.14 0.85 0.74 0.98 0.97 0.84 1.13 1.00 0.76 1.32 0.99 0.85 1.16
 always 0.97 0.81 1.15 0.88 0.68 1.14 0.97 0.75 1.25 0.74 0.60 0.92 1.13 0.92 1.40 1.08 0.71 1.64 1.00 0.80 1.25
(p for trend) 0.21 (p for trend) 0.22 (p for trend) 0.92 (p for trend) 0.01 (p for trend) 0.97 (p for trend) 0.83 (p for trend) 0.73
Frequency of bathing (ref. not at all)
 rarely 0.95 0.79 1.15 1.11 0.84 1.48 1.03 0.78 1.36 0.91 0.73 1.15 0.95 0.76 1.19 1.09 0.72 1.63 0.84 0.66 1.08
 sometimes 0.91 0.77 1.07 0.86 0.67 1.10 0.87 0.68 1.11 0.92 0.76 1.12 0.93 0.77 1.13 0.82 0.57 1.17 0.82 0.66 1.01
 always 0.88 0.74 1.05 0.82 0.63 1.07 0.88 0.69 1.15 0.92 0.75 1.14 0.92 0.75 1.14 0.76 0.52 1.12 0.93 0.75 1.16
(p for trend) 0.13 (p for trend) 0.01 (p for trend) 0.19 (p for trend) 0.67 (p for trend) 0.46 (p for trend) 0.03 (p for trend) 0.67
Frequency of putting the child to sleep (ref. not at all)
 rarely 1.02 0.92 1.13 1.01 0.86 1.19 0.93 0.80 1.08 0.97 0.86 1.10 1.09 0.97 1.24 1.02 0.80 1.29 0.99 0.86 1.13
 sometimes 1.03 0.93 1.14 1.20 1.03 1.40 0.87 0.75 1.02 0.93 0.82 1.05 1.14 1.01 1.29 1.05 0.83 1.33 0.95 0.83 1.09
 always 0.96 0.83 1.11 1.04 0.83 1.30 0.88 0.71 1.10 0.90 0.76 1.08 1.07 0.90 1.28 0.86 0.60 1.24 0.89 0.73 1.08
(p for trend) 0.94 (p for trend) 0.08 (p for trend) 0.11 (p for trend) 0.16 (p for trend) 0.14 (p for trend) 0.78 (p for trend) 0.21
Frequency of playing with the child at home (ref. not at all)
 rarely 0.88 0.54 1.43 0.95 0.48 1.89 0.86 0.44 1.65 0.63 0.38 1.06 1.27 0.70 2.32 0.89 0.36 2.23 0.97 0.52 1.81
 sometimes 0.86 0.54 1.35 0.75 0.39 1.44 0.72 0.39 1.34 0.54 0.33 0.88 1.10 0.62 1.95 0.66 0.28 1.56 0.97 0.54 1.75
 always 0.75 0.47 1.20 0.64 0.33 1.25 0.67 0.36 1.25 0.48 0.29 0.78 0.96 0.54 1.70 0.56 0.23 1.36 0.83 0.46 1.50
(p for trend) 0.002 (p for trend) 0.001 (p for trend) 0.05 (p for trend) < 0.001 (p for trend) 0.003 (p for trend) 0.02 (p for trend) 0.01
Frequency of taking the child outside (ref. not at all)
 rarely 0.78 0.63 0.97 0.85 0.62 1.17 0.99 0.71 1.36 0.85 0.66 1.09 0.90 0.70 1.15 0.76 0.49 1.17 0.96 0.73 1.25
 sometimes 0.75 0.62 0.92 0.82 0.61 1.11 0.95 0.70 1.29 0.89 0.70 1.13 0.83 0.65 1.05 0.69 0.46 1.04 0.80 0.62 1.03
 always 0.71 0.57 0.89 0.79 0.57 1.11 0.90 0.64 1.26 0.82 0.63 1.07 0.77 0.59 1.00 0.73 0.46 1.16 0.67 0.51 0.90
(p for trend) 0.01 (p for trend) 0.24 (p for trend) 0.38 (p for trend) 0.39 (p for trend) 0.03 (p for trend) 0.24 (p for trend) < 0.001

aAdjusted covariates (number of siblings, living with grandparent(s), paternal and maternal age at child birth, paternal and maternal education, annual household income, maternal childcare hours on weekdays or weekends at 18 months old, and the total scores of maternal involvement in caregiving, gestational age, multiple birth, child’s history of hospital admission or visits for congenital diseases, child’s temperament), and parental spending hours with children.

bBold values denote statistical significance at the p < 0.05

OR Odds ratio; CI Confidence interval

Girls whose fathers always fed them or changed their diapers had fewer problems with patience (OR: 0.74, 95% CI: 0.60 to 0.92) (Table 7). Fathers playing at home with their children had a protective dose-effect on all types of problem behaviors in girls at age 5 (all p for trend < 0.05). Interestingly, girls whose fathers sometimes put them to sleep had more problematic behaviors, such as always fidgeting while listening (OR: 1.20, 95% CI: 1.03 to 1.40) and not expressing their emotions appropriately (OR: 1.14, 95% CI: 1.01 to 1.29) than girls whose fathers never put them to sleep.

Additional Tables 5 and 6 show the results of adding to the model the interaction terms between each main exposure and sex. Most results confirm the main effect that girls have less problematic behavior than boys, although the effects of interaction were not clear.

Discussion

The present study examined the association between paternal childcare during toddlerhood and behavioral problems at 5.5 years of age using a Japanese nationwide population-based longitudinal cohort. Our findings suggest that longer paternal childcare hours in the toddler period were associated with a lower risk of behavioral problems at 5.5 years of age, even after adjusting for paternal parenting behaviors in toddlerhood. We also found that several paternal caregiving behaviors showed a strong preventive effect on specific problem behaviors in children, such as taking the child outside for boys and playing at home for both boys and girls.

The protective effect of paternal involvement in childcare on children’s subsequent behavioral problems is consistent with previous studies that reported that child appropriate behavior was positively associated with parenting by the father, after adjusting for other confounders, including parenting by the mother [10, 12, 28, 29]. The current study also revealed the effect of paternal time spent with children on respective weekdays and weekends on preschooler’s behavior. Previous studies have suggested that paternal behavior is likely to be influenced by the characteristics of employment and workplace [30, 31]. Therefore, these studies noted the importance of separately considering the fathers’ weekday and weekend involvement with their children. However, research thus far has not examined the extent to which childcare on weekdays and weekends predict child behavioral outcomes. The results have important policy implications for populations in Japan, where fathers work long hours, even when their children are infants/toddlers, and thus do not have sufficient time for childcare. On the other hand, the overall frequency of paternal childcare during toddlerhood was not independently associated with behavioral problems in children at 5.5 years of age, after adjusting for the amount of time fathers spent with their children, suggesting that the duration matters for children’s subsequent behavioral problems. Previous studies have reported that fathers’ parenting quality, as well as the quantity of routine care provided, are associated with a lower risk of child behavioral problems [12, 28]. In addition, fathers who spend more time on child caregiving have a higher quality of interaction with their children, because primary caregiving fathers have a better understanding of how to care for and play with their children as a result of the greater time they have spent with them [32]. This study did not directly measure the quality of parenting; however, spending more time with children on weekdays and weekends could improve paternal caregiving skills, which may have a positive impact on children’s behavior.

Previous studies have consistently reported that mothers typically spend a significant number of hours caring for their children, whereas fathers spend a greater number of hours playing with their children. Our findings highlight that the impact of fathers’ involvement on their children’s behavior can differ depending on what type of parenting fathers engage in, such as essential routine cares or play with the child. Children whose fathers were always involved in some type of essential childcare, such as feeding and changing diapers, had fewer problems in specific behaviors. Possibly, paternal childcare, which is essential for a child’s life, might help reduce the mothers’ childcare burdens and contribute to lower maternal stress, which is considered as a risk for behavioral problems in children [33, 34]. On the other hand, playing with children at home or taking them outside is a more complex type of interaction between fathers and children, which is an important stimulus for the child’s socioemotional development [35]. Therefore, in this study, we found that these types of paternal caregiving could have preventive effects on a variety of problem behaviors in children.

We estimated the sex-specific effects of paternal childcare on behavioral problems in children. Our results did not confirm the sex difference in paternal time spent with the child on weekdays and weekends. Fathers of boys, however, were involved slightly more frequently than those of girls in several types of caregiving, such as bathing, putting their children to sleep, and taking them outside. These sex differences in paternal involvement have been found in previous studies and are considered to be induced in response to underlying biological or psychosocial differences in children [27, 36]. Moreover, the influence of paternal caregiving on the child’s behavior differed depending on the child’s sex in this study. For example, boys showed reduced behavioral problems when their fathers often took them outside, while girls showed reduced behavioral problems when their fathers often played with them at home. The reason for these sex-specific effects might be explained by the well-established gender differences in behavior [3638]; however, further research is required.

This study has several strengths. First, in our analysis, we considered the child’s original temperament and congenital disabilities, which could be related to the involvement of fathers in parenting as well as behavioral problems in their children. Therefore, the present study provides robust evidence that paternal childcare has a positive effect on children’s behavioral problems. Second, these results were obtained from a representative sample in Japan, in which fathers typically spend long hours commuting and working and, therefore, spend less time with their children than fathers in Western countries [39, 40]. This study provided a test of the generalizability of the hypothesis that paternal childcare would have a protective effect on child behavior. Third, we used a prospective cohort study; thus, reverse causation was unlikely.

Despite its strengths, this study also has some limitations. First, we used maternal reports to evaluate paternal childcare because of the lack of precise measures. In addition, our survey did not ask about the actual amount of time spent on each type of paternal caregiving behavior. According to previous studies, mothers’ evaluations of paternal childcare are susceptible to influence by marital satisfaction and maternal emotional well-being [41, 42]. Other objective measures of paternal childcare should be used in future studies. Second, the outcome in this study, that is, behavioral problems in 5.5-year-old children, were also self-reported by their mothers. Mothers may be one of the primary caregivers for children in most cases; however, they may not be able to fully observe their child’s behavior in situations other than at home. Furthermore, the measurements for child problem behavior in this study are not sufficiently validated although they are used in previous studies [22, 23]. However, the behavioral questions in this study are similar to those on the Strengths and Difficulties Questionnaire (SDQ), which is a validated child behavioral screening instrument. The SDQ consists of 25 questions with five subscales: emotional problems, conduct problems, hyperactivity/inattention, peer problems, and prosocial behavior [43, 44]. For example, “unable to focus on a specific task” in our questionnaire is similar to “Restless, overactive, cannot stay still for long” on SDQ, and “behave in a group situation” in our questionnaire is similar to “Shares readily with other children (treats, toys, and pencils, etc.)” on SDQ. Third, our results could still be biased by residual confounding that we could not measure in this survey, such as marital relationships or paternal mental health. Data about the father’s health or relationships with their partners are scarce, so their potential effects on paternal childcare and child development are not widely recognized [45]. Researchers and practitioners would need to take these family factors into account when considering the interactions between fathers and children.

Conclusions

Despite these limitations, the present study suggests that paternal childcare in the toddlerhood could prevent subsequent behavioral problems in children based on a national prospective study in Japan. Our study also showed that several specific caregiving behaviors by fathers, such as playing with their children at home or taking them outside, may play an important role in appropriate behavioral development in early childhood, which depends on the child’s sex. Promoting paternal childcare support would augment the quantity and quality of paternal caregiving, which in turn could have a beneficial effect on child behavioral development. The policies that support child-rearing fathers, including the promotion of work environments that facilitate paid parental leave, restriction of overtime work, and incentives for remote or flex-time work, could be linked to the prevention of behavioral problems in children. Further studies using more detailed data on paternal childcare are required to elucidate the mechanisms by which fathers’ involvement in childcare could have a protective effect on early childhood behavior.

Supplementary Information

Acknowledgements

Not applicable.

Abbreviations

OR

Odds ratio

CI

Confidence interval

SD

Standard deviation

SE

Standard error

Authors’ contributions

MO conceptualized and designed the study, coordinated the study, analyzed data, drafted the initial manuscript, and reviewed and revised the manuscript. TF conceptualized and designed the study, coordinated and supervised the study, reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Funding

Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS KAKENHI Grant Number 16H03276).

Availability of data and materials

The data that support the findings of this study are available from the Ministry of Health, Labor, and Welfare in Japan (MHLW) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. The point of contact in MHLW from the data can be requested: Examination and Analysis Office, Director-General for Statistics and Information Policy. Central Joint Government Building No.5, 1–2-2 Kasumigaseki, Chiyoda-ku, Tokyo. 100–8916. Tel: + 81-3-5253-1111 (ext. 7391), Email: mokutekigai@mhlw.go.jp

Declarations

Ethics approval and consent to participate

All procedures were conducted in accordance with the Declaration of Helsinki and Ethical Guidelines for Medical and Health Research Involving Human Subjects. Approval from the ethics committee of the Tokyo Medical and Dental University was waived because the data were anonymous and available from the Ministry of Health, Labour, and Welfare in Japan upon request. Questionnaire responses from participants were considered as informed consent to participate in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Data Availability Statement

The data that support the findings of this study are available from the Ministry of Health, Labor, and Welfare in Japan (MHLW) but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. The point of contact in MHLW from the data can be requested: Examination and Analysis Office, Director-General for Statistics and Information Policy. Central Joint Government Building No.5, 1–2-2 Kasumigaseki, Chiyoda-ku, Tokyo. 100–8916. Tel: + 81-3-5253-1111 (ext. 7391), Email: mokutekigai@mhlw.go.jp


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