WHO’s revised Ten Steps to Successful Breastfeeding includes the family in prenatal breastfeeding education (Step 3). In response to this, researchers in Canada have conducted a systematic review of research to see what works in this regard. 12 studies were identified and analysed. All found that including fathers/partners improves breastfeeding outcomes and, in the 7 studies where mothers’ perceptions of being supported were measured, all showed improvements.
Positive outcomes included:
- More breastfeeding initiation: improved in 3 out of 4 studies measuring this.
- More exclusive breastfeeding: improved in 8 out of 10 studies measuring this. Some showed increased exclusivity at 24 weeks.
- Longer breastfeeding duration: 5 studies found this.
There was considerable diversity of approach between the different programmes described and more research is needed to determine what could be definitively recommended as the best methods. Important elements seem to be a face-to-face format and the involvement of health professionals/lay supporters. Future work should look at digital tools – only one of the 12 studies included such a tool.
The need for cultural sensitivity was suggested by one study in Brazil where including fathers resulted in lower breastfeeding rates. This method emphasised fathers doing housework, and perhaps this emphasis had the opposite of the intended influence. Considerable cultural diversity is seen across the different interventions described:
- Including clerics and village heads in a Muslim context
- Organising a competitive public event for fathers – “Who loves their wives and children more?” (Vietnam)
- Giving fathers a beer can holder with the project logo (Australia)
- Treating mothers and fathers as equal partners (Canada)
- Involving peer father supporters (USA)
- Providing incentives for fathers – football game tickets and tools (Italy)
- Organising group sessions reflecting on patriarchal norms (Burkina Faso)
Most of the studies involved mothers and fathers together, in groups and/or individually as couples, using the same materials for both and encouraging partnership between them. This approach enables the couples to consider problem-solving strategies together should difficulties be encountered.
Abbass-Dick J, Brown HK, Jackson KT, Rempel L & Dennis C-L (2019), Perinatal breastfeeding interventions including fathers/partners: A systematic review of the literature, Midwifery 75
Photo: UNICEF. Creative Commons.