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It is important that healthcare providers understand the difference between the fathers' and mothers' worries about their child with a cleft lip and palate. Specific support services should be offered to fathers with a high level of resilience, in terms of the acceptance of reality and problem-solving, which could increase their parenting ability.

Aims To examine characteristics of parents of children with acute, albeit mild, illnesses who used ambulance transport unnecessarily. Design A cross‐sectional study. Methods From 2016 ‐ 2017, we recruited parents who visited the emergency room of a Japanese paediatric hospital and whose children were discharged without hospitalization. Participants whose children arrived by ambulance were classified as using ambulance services unnecessarily. Participants answered a questionnaire consisting of parents’ characteristics, including health literacy scales and the Parents’ Uncertainty regarding their Children with Acute Illness Scale. We conducted a receiver operating characteristic analysis to convert the Parents’ Uncertainty regarding their Children with Acute Illness Scale results to binary scores. We analysed questionnaire responses using logistic regression analysis. Results Analysed data were from 171 participants. The cut‐off score was 59 for the Parents’ Uncertainty regarding their Children with Acute Illness Scale. Results of the logistic regression indicated that parents who did not use resources to obtain information regarding their child's illness, had low health literacy, were observing presenting symptoms for the first time in their child, or had high uncertainty, were significantly more likely to unnecessarily use ambulances. Conclusion Publicizing available resources regarding child health information, social healthcare activities to raise parents’ health literacy and providing explanations in accordance with parents’ uncertainty, especially when confronting new symptoms in their child, might reduce unnecessary ambulance use. Impact Of patients transported to hospitals by ambulance, the rate of paediatric parents with mild conditions has been found to be high. The study findings could contribute to the appropriateness of using ambulances and have implications for policymakers and healthcare providers, particularly in the Japanese paediatric emergency system. In particular, parental uncertainty, one of four significant characteristics, could be resolved in clinical settings. Generalization for global health services requires further research.

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With a worldwide prevalence of approximately 9.92 per 10,000 newborn births, 1 cleft lip and/or cleft palate (CL/P), which includes cleft lip only (CL), cleft lip and palate (CLP), and cleft palate only (CP), is one of the most common congenital orofacial anomalies in humans. 2 Japan reports the highest prevalence worldwide (20.4 per 10,000 births). 1 Children with CL/P experience effects on their speech, hearing, appearance, and cognition that can lead to long-lasting adverse outcomes for their health and social integration. 3 Recent research into the psychological influence of these adversities, such as behavioural problems,