A few evenings each week, Bill Williams, RN, stands at the head of a classroom while his students work busily at tables strategically arranged in a horseshoe shape allowing Williams to maintain eye contact with his students and offer assistance when necessary. Though many of his pupils excel in their chosen professions, most are lost when it comes to changing an infant's diaper.

So, Williams presides over a group of 10 men who are about to become first-time fathers as they each diaper a baby doll. While there's typically a bit of awkwardness in the beginning, by the end of the 3-hour class called Sons to Dads, these guys will not only be able to diaper an infant, they'll be knowledgeable about breastfeeding, know how to interpret their new baby's cries, and have the tools to be supportive fathers and partners in the postpartum period.

Old Dog, New Tricks
Williams wasn't always an expert in infant care. After serving in the military for 22 years, he chose to become a nurse in his "retirement." Even though he has three grown children, he admitted that when they were small, he changed one diaper. In fact, he was so hesitant to be around infants that when it came time to complete his NICU clinicals, he had an argument with his instructor. But when he finally walked onto the unit, something clicked.

"There was a baby under a bili light on a vent, with a cellophane blanket over her crib to keep her body temperature up," Williams recalled. "That's where it started - Dec. 4, 1989 - I knew this was what I had to do."

Over his years as a NICU nurse, most recently for Baptist Health System in San Antonio, Williams became interested in the communication, or lack thereof, between healthcare professionals and fathers. By that time, he was an experienced dad and grandfather himself, and knew a little something about how men approach the birth of a baby.

"We anticipate the coming of our baby, but can't comprehend it until we feel, touch and smell the baby. Then, we go into provider mode, thinking of responsibilities and obligations," Williams said. "I saw that a bonding process was needed. Changing diapers and putting up with crying are not that appetizing to a new dad, because we think differently."

Williams wanted to change that, and began developing a father education program that would not only teach basic infant care, but give men the "OK" to truly experience birth on an emotional level. He threw out the binders of educational materials, ditched the videos that showed young mothers bathing newborns, and started at the beginning.

Bonding Moment
Williams developed the Sons to Dads class with bonding as the cornerstone. For instance, while kangaroo care, where skin to skin contact is encouraged, is prevalent with premature infants and with mothers, Williams wanted dads to do it, too.

"This is the No. 1 tool for dads and babies to bond, and guys have been responsive to it," he said. Williams suggests dads keep a button-down shirt ready to go with the mother's overnight bag for the hospital. As long as the baby's temperature and vital signs are good, Williams encourages new dads to don the shirt, keeping the front open, or go shirtless if they wish, and hold their new baby skin to skin in the delivery room - after mom gets a first chance at breastfeeding, of course.

Williams also teaches men that they have an active role in breastfeeding.

"I tell my dads: you hold the key to mother's success as a breastfeeder," he said. "I help them realize they can and do have an active part in this, that with breastfeeding, they are going to be a sideline coach. They can see things mother cannot see, and help direct the baby to mom when she's trying to get the baby to latch on."

In the PowerPoint slides that Williams uses during the class, he shows pictures of an infant latching on from the side, instead of from the mother's perspective. "Lips should be flanged outward, and baby should be calm," is the mantra the students learn.

Williams uses sports analogies - like the sideline coach - and pneumonics in the class, always in easily remembered groups of three. He teaches men about the three cries, or three amigos - fussy, hungry and hurt - and the three C's of breastfeeding - calm, comfortable and close.

"If this old dog could learn this, you pups can," Williams is fond of telling his classes as they first attempt swaddling and diapering their doll. "I try to keep it light-hearted. This is the place to make mistakes."

Great Rewards
In addition to lots of positive feedback from Sons to Dads participants, Williams hears accolades from the men's families, partners and his own colleagues.

"All the guys that go to my class are dubbed 'Bill's Dads,'" he said with a smile in his voice. "The staff says they can always tell one of mine - they are more involved and they ask good questions."

While Williams has a lot of infant-care knowledge to impart in the 3 hours he has the students' undivided attention, he manages to include one final element he considers crucial. A nurse manager once mentioned to him that after the baby is born, all the excitement and attention follows the baby and the mother is left alone. She thought it would be great if the new dad took a moment to share his feelings with his partner, and Williams agreed.

"I suggest the dads bring a little card with them, just something he can make a statement on about how he's feeling," he said. "He can go over and slip the card into mom's hand, maybe give her a kiss, and then go back to the baby and taking pictures. That little gesture has been one of the powerful things I've ever seen."

Barbara Mercer is senior associate editor at ADVANCE.