Becoming a Family

Parents of newborns focus all their attention on their baby, while often neglecting their own relationship. Pediatricians can use the one-month well child visit to encourage parents to renew their relationship as they focus on their family and child’s lifelong well-being.


  1. Having a baby is a happy but sometimes stressful event, often creating physical, emotional, and financial pressures on parents.
    • Maternal body changes contribute to physical stress.
    • Hormonal shifts and parental lack of sleep contribute to emotional changes.
    • Recognizing that they are now responsible for the life of another individual can also cause stress and pressure for parents.
  2. The natural and intense focus of each parent on meeting the needs of the new baby may detract from the parental relationship.
    • Each parent is so focused on meeting the baby’s needs that he or she may have less ability to recognize each other’s needs.
    • This behavior is normal, natural, and protective for the baby during the first weeks after birth.
  3. Parents need to recognize that their own relationship is also important or the marriage is likely to encounter difficulties.


  1. The nuclear family is the most important unit of a stable society and should be supported.
  2. The pediatrician is in the best position to encourage and support the stability of the family as the newborn is seen for frequent visits in the first several months after birth.
  3. The pediatrician’s influence is significant as today’s mobile families often have no local support system during this important and stressful time.


  • Only 45.8% of children reach 17 years of age while still living with both biological parents who were married at or around the time of the child’s birth. (1)
  • The majority of divorces affect younger children because 72% of divorces occur within the first 14 years of marriage. (2)
  • With the onset of “no fault” divorce laws, marriages can dissolve when partners simply view themselves as unhappy in the relationship.
  • However, partners who viewed themselves as unhappy, but remained married, were likely to have an improved relationship and be happier five years later than those who divorced. (3)



This timing of the conversation is dependent on the age of the child. Ideally, this could become part of a yearly discussion with parents, 

This conversation involves the parents of the child.

What do you think is the best gift you can give your newborn?

  • It isn’t saving for the college fund.
  • It is maintaining your relationship so you are both there together when your child goes off to or graduates from college.

At this point, however, most parents are thinking, “What relationship?”

  • The pediatrician can acknowledge the parents are focusing all of their time and energy on meeting their baby’s needs.
  • The parent has no time or energy to even think about meeting his or her own needs, let alone someone else’s needs.
  • This is normal and typical for parents at this stage.
  • However, it will not be healthy if the behavior continues this way.

Relationships “B.C.”—before children—require little planning.

  • Parents come home from work and talk with each other.
  • Parents do not need to make arrangements to have a relationship.

However, relationships “A.D.”—after diapers—do require planning.

  • Parents actually have to plan a time to talk with each other.

I am going to give you the following homework assignment:

  • Make plans to have a date together—without the baby—before our next office visit.
  • You do not have to spend any money—simply take a walk around the block.
  • You do not have to miss a breastfeeding—you can be gone for just 45 to 60 minutes.
  • Do not go to a movie—the goal is to spend time talking with each other.
  • Remember, you cannot take the baby with you.
    1. This is extremely important.
    2. It is almost impossible to focus on each other if the baby is with you, even if he or she is asleep underneath the restaurant table.
    3. This is a special gift you are giving to each other—to focus exclusively on the other person.
    4. Note: Parents who are unable to complete this assignment should be monitored carefully for their ability to separate and/or differentiate themselves from their child and eventually their ability to appropriately set limits for the child.

Do you have someone you trust to care for your baby for 45 to 60 minutes (or longer if you would like)?

  • If parents do not have someone they trust to babysit, this may be an indication to have a longer conversation with them about possible helpful resources in the community.

Don’t forget to check with the parents at the baby’s next well visit to make sure they have completed their homework assignment. If not, reassign it until it has been completed.

infoParents who are unable to complete this assignment should be monitored carefully for their ability to separate and/or differentiate themselves from their child and eventually their ability to appropriately set limits for the child.


  1. Fagan PF, Zill N. The Second Annual Index of Family Belonging and Rejection. Washington, DC: Marriage and Religion Research Institute; November 2011. ( )
  2. Cohen GJ. Helping children and families deal with divorce and separation. 2002;110:1019-1023. ( )
  3. Waite L, Gallagher M. The Case for Marriage. New York, NY: Doubleday; 2000:148. (Available on )


  1. American College of Pediatricians. Patient Handout, “Helping your child become a big brother or big sister,” Download.