This month a new study was published from northern Viet Nam showing that engaging with fathers – education materials, counselling services, home visits and a breastfeeding promotion social event – doubled the rate of breastfeeding initiation (40% to 81%) (Bich et al 2015). This follows an earlier study by the same team showing that this approach increased the rate of exclusive breastfeeding at 6 months by over four times (3.9% to 16.0%), and the rate of at 4 months by 82% (11.3% to 20.6%) (Bich et al 2013).
Also this month, a new study is announced in Perth, Australia (Maycock et al 2015) that will investigate in even more detail what works in relation to father engagement. It will compare the results of three approaches:
- Partners are provided with education and information antenatally.
- Partners are provided with support postnatally, including the use of mobile communications.
- Partners are provided with both.
In the background section of the Australian paper, the authors review research on breastfeeding and fathers, the key findings of which are:
- father’s support for breastfeeding is the most important factor for initiation
- father’s presence after labour impacts on the duration and amount of breastfeeding
- a mother’s confidence in her partner correlates with her confidence in breastfeeding
- teenage mothers are more influenced by their families than their peers
- feelings of fathers influence the decision of mothers to breastfeed in public
- when the father is pro-breastfeeding, more breastfeeding happens beyond 6 weeks
- a father can hold negative beliefs and fears about breastfeeding but these diminish if he is well informed
- fathers want to be informed and often feel helpless when not
The paper quotes a number of studies that have looked at the efficacy of breastfeeding education programmes that include fathers, including the earlier Viet Nam study quoted above.
A Canadian randomised controlled trial (Abbass-Dick et al 2015) found that a light-touch co-parenting approach to breastfeeding – education for fathers and weekly information till 6 weeks after birth – resulted in significant improvements in breastfeeding duration, paternal breastfeeding self-efficacy, and maternal perceptions of paternal involvement and assistance with breastfeeding. Breastfeeding at 12 weeks continued in 10% more families then they had had received co-parenting support (87.6% to 96.2%). The rate of exclusive breastfeeding at 6 and 12 weeks, however, was not significantly different in the control and intervention groups.
An earlier trial in Australia (Maycock et al 2013), with a large sample of 699 families, shows an increase in breastfeeding at 6 weeks of 9% (75.2 % to 81.6%).
An Italian trial (Pisacane et al 2005) with 280 couples found that education for fathers increased exclusive breastfeeding at 6 months by 67% (15% to 25%). The rate of any breastfeeding at 12 months increased by 73% (11% to 19%).
Other smaller studies are quoted, all showing, in varying degrees, that engaging with fathers improves breastfeeding rates. It would be interesting to study how cultural factors in each community influence the degree to which breastfeeding education for fathers changes outcomes. Why, for example, was the impact so much bigger in a country like Viet Nam than in Australia and Canada?
Abbass-Dick J, Stern SB, Nelson LE, Watson W &Dennis CL (2015), Coparenting Breastfeeding Support and Exclusive Breastfeeding: A Randomized Controlled Trial, Pediatrics
Bich T, Hoa D, Ha N, Le Vui, Nghia D & Målqvist M (2015), Fathers’s involvement and its effect on early breastfeeding practices in Viet Nam, Maternal & Child Nutrition
Bich T, Hoa D & Målqvist M (2013), Fathers as Supporters for Improved Exclusive Breastfeeding in Viet Nam, Journal of Maternal Child Health
Maycock BR, Binns CW, Dhaliwal S, Tohotoa J, Hauck Y, Burns S & Howat P (2013), Education and Support for Fathers Improves Breastfeeding Rates: A Randomized Controlled Trial, Journal of Human Lactation
Maycock BR et al. (2015), A study to prolong breastfeeding duration: design and rationale of the Parent Infant Feeding Initiative (PIFI) randomised controlled trial, BMC Pregnancy and Childbirth
Pisacane A, Continisio GI, Aldinucci M, D’Amora S & Continisio P (2005), A controlled trial of the father’s role in breastfeeding promotion, Pediatrics
Photo: Andrew3000. Creative Commons.