A review of 39 research articles on fathers and breastfeeding, with a combined sample of 57,334 families, has shown what factors influence how supportive fathers are of breastfeeding. Some of these are amenable to change, and on this basis, the reviewers recommend three things:

• Health professionals to improve fathers’ knowledge of breastfeeding, particularly how to deal with difficulties.
• Health services to include breastfeeding in antenatal education.
• Health professionals to play their part in changing cultural attitudes about the role of fathers in supporting breastfeeding.
• Paternity leave, so that fathers are available to support breastfeeding and infant care.

The reviewers identified eight influences on fathers’ roles.

• When fathers are more knowledgeable about breastfeeding, they tend to be more involved in supporting it and have more positive attitudes to it. Fathers typically desire to be well informed.
• When fathers have more positive attitudes towards breastfeeding, they are more likely to be involved in support, and mothers are more likely to initiate breastfeeding and to breastfeed for longer. Some of the studies find the father to be the main influencer of the mother.
• When fathers are faced with social expectations that they should not be involved in breastfeeding (Jordanian study), they are less involved in supporting it.
• Fathers who are more confident in their role and capacity to support breastfeeding are more likely to be involved, particularly when the mother faces difficulties.
• When the mother-father relationship is better, fathers are likely to be more involved in supporting breastfeeding and mothers are more likely to be receptive to this support. When mothers feel happier and more supported, they are likely to breastfeed for longer.
• When fathers take paternity leave, babies are likely to breastfeed for longer.
• A large study in Sweden (51,671 families) found that fathers with higher incomes were more likely to have partners who breastfeed for longer, even when the education level of the mothers was controlled for.
• Fathers who attend breastfeeding antenatal classes are more likely to support breastfeeding when there are difficulties.

Most of the participants in the research projects reviewed were from middle to upper-middle class income levels. The 39 studies came from Canada, USA, Mexico, SE Asia, Jordan, Pakistan, Turkey and South Africa.

Ng RWL, Shorey S & He H-G (2019), Integrative review of the factors that influence fathers’ involvement in the breastfeeding of their infants, Journal of Obstetric, Gynecologic, & Neonatal Nursing 48

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