Despite policy commitments to family-centred care, neonatal services often remain implicitly structured around maternal presence. Fathers, although increasingly acknowledged as vital to early child development, frequently experience feelings of exclusion throughout the neonatal journey, from antenatal care through to the neonatal intensive care unit. This review explores how fathers experience involvement and psychological wellbeing during their infant's admission to a neonatal intensive care unit. A narrative review of qualitative studies was conducted using the SPIDER framework to guide the search strategy. The nine included studies, which met the inclusion criteria were identified via searching the databases CINAHL, PubMed, and PsycINFO. Studies were appraised using the CASP (2018) checklist, and findings were synthesised thematically. Thematic synthesis identified four key themes: ‘Exclusion from the NICU Environment’; ‘ Emotional Suppression and Psychological Strain’; ‘Reclaiming Fatherhood Through Caregiving’ and ‘Coping and Support Mechanisms’. Findings highlight how fathers navigate a system not designed with their needs in mind, often suppressing their own emotions whilst seeking meaningful ways to engage. Fathers often remain peripheral within neonatal care, shaped not only by entrenched gender norms but also by structural barriers that limit their involvement and emotional expression. Without deliberate shifts in practice and policy, fathers risk continued exclusion, with implications for their wellbeing and the wider family dynamic. There is a pressing need for more inclusive and emotionally responsive care practices that recognise fathers as equal partners in neonatal care.

The premature birth of a child is a stressful experience for fathers and represents a threat to their parental self-efficacy. This longitudinal study aimed to examine the contribution of fathers’ participation in Kangaroo Care (KC) for their preterm infant to the increase of their self-efficacy over time. 42 fathers of premature infants (up to 33 weeks) were recruited from a Quebec NICU. Paternal self-efficacy was measured using the 'Parenting Sense of Competence Scale' on three occasions: before KC, at NICU discharge, and three months post-discharge. Path analysis showed that the father-to-mother KC frequency ratio in the NICU predicted greater paternal self-efficacy after hospitalization (controlling for baseline), and its persistence three months post-discharge. Results highlight the importance of fathers' involvement with their preterm infant through KC to enhance their parental self-efficacy. Mothers and medical staff can facilitate this by encouraging fathers’ active care in the NICU.