A study in rural Tanzania involving 38 fathers of babies under 6 months old has gained new insights into how fathers can support exclusive breastfeeding, even in the face of strong cultural and work barriers.

The researchers conclude that fathers should be directly and individually engaged early on in breastfeeding support programs, with flexibility over time and place of the engagement.

Fathers were engaged as part of a wider study also engaging mothers. First, 38 fathers were involved in male-facilitated focus group discussions about gender norms and infant nutrition. Next day, 30 fathers were met in their homes to discuss how they could support exclusive breastfeeding and were offered 2-6 recommendations (picked from a list of 20 suggestions listed at the end of this report) depending on their situation and potential areas of improvement. Two weeks later they were asked how they got on.

Despite strong cultural restrictions on men’s caring roles and heavy demands of work, the study found that some fathers were happy to hear about how important their role in breastfeeding is and were willing to challenge cultural norms on the grounds that their critics in the community did not share their superior knowledge.

The study found that some men were willing to:

• Care directly for the baby, for example, soothing
• Discourage the use of unprescribed medicines
• Take their wives to the clinic
• Support exclusive breastfeeding
• Provide the mother with emotional support
• Help with household tasks, though, mothers and fathers typically disagree about how much this happens
• Provide nutritious food for their wives (most men in the study did this).

The study found that the process of engaging with fathers improved teamwork – more cooperation, less conflict, greater joint decision-making. This surprised the researchers, though it is a widespread finding in programs that support mutual cooperation and care among parents.

“I would like to thank you for coming to my house and visiting me. I worked on the recommendations which led to a peaceful environment in my house-hold.” (Mother)

“There is not peace in the family. My wife was thin but when we started this process and I started helping her with her duties, she gained weight…..I am happy with these lessons. My wife is also happy.” (Father)

In Tanzania, 84% of babies are exclusively breastfed in the first month, 59% in months 2 ad 3 and 27% in months 4 and 5. Key barriers are heavy workloads faced by mothers, as well as the use of unprescribed medicines, particularly in response to mchango (colic-like symptoms). One popular medicine is gripe water – bicarbonate of soda, dill, caraway and spearmint oils dissolved in as much as 9% alcohol.

Suggestions made to fathers about how to support exclusive breastfeeding

1. Ask your wife and other family members not to give medicines not prescribed at the health facility.
2. Assist the mother with soothing or distracting the baby in other ways when colicky.
3. Ask other family members to hold and soothe the baby when colicky.
4. If the baby is sick, go with your wife and baby to see the health workers.
5. Encourage your wife to exclusively breastfeed the baby and reassure her she can produce enough milk.
6. Encourage her to breastfeed more often and longer, to help keep her milk supply up.
7. Praise, encourage and support the mother to breastfeed optimally (various suggestions given).
8. Find ways to help your wife and let her rest more, so she feels more able to breastfeed.
9. To build her breastfeeding confidence, buy and encourage your wife to eat nutritious foods.
10. Explain to other family members that the mother needs time to rest and breastfeed the baby.
11. Help your wife with household chores, cooking or caring for your other children.
12. Ask others to help your wife with household chores, cooking or caring for your other children.
13. Reduce your wife’s time outside the home by taking on tasks such as fetching water for the household.
14. Reduce your wife’s time outside the home by asking someone else to help with tasks.
15. Ask your wife what help or support she needs from you and provide the help she asks for.
16. Encourage your wife to exclusively breastfeed the baby. Reassure her that the baby should have no other foods.
17. Ask your wife not to give porridge or other food to the baby before 6 months.
18. Explain to family members that the baby should be exclusively breastfed and not given other food.
19. Ask you wife not to give water to the baby and to give only breastmilk.
20. Take your wife to the health workers to help solve problems or pain with breastfeeding.

Matare CR et al (2019), Barriers and opportunities for improved exclusive breast-feeding practices in Tanzania: Household trials with mothers and fathers, Food and Nutrition Bulletin

Photo: Ivan Dupont. Creative Commons.