by Anne Eglash MD, IBCLC, FABM
To what extent do the father’s breastfeeding preferences influence maternal breastfeeding behavior?
Several studies have shown that family and other social support are very important to breastfeeding success. In fact, The Lancet, in its 2016 landmark series on the importance of breastfeeding, published its issue with the following quote on the cover ‘Success in breastfeeding is not the sole responsibility of a woman - the promotion of breastfeeding is a collective societal responsibility’.
A recent study used 2005-2007 survey data with 2903 participants from the USA Infant Practices Study II to evaluate how joint feeding preferences of both mother and father influence initiation and duration of breastfeeding. The survey asked questions during pregnancy about the mother’s perception of the expectant father’s breastfeeding preferences, and examined the responses in relation to the mother’s breastfeeding outcomes. The mothers were sent surveys postpartum on a monthly basis to find out how they were feeding their infants. The vast majority of the participants (84.8%) were non-hispanic white, married (80%), educated beyond high school (80%), and 100% over the federal poverty line (85%).
What do you think the authors found regarding the father’s and mother’s breastfeeding preferences, and breastfeeding outcomes? Choose 1 or more:
- If the mother desired exclusive breastfeeding but the father did not, her rate of exclusive breastfeeding was unchanged by the father’s preference.
- Exclusive breastfeeding rates were highest for infants whose mother and father preferred exclusive breastfeeding.
- If the father preferred exclusive breastfeeding but the mother did not, the mother was more likely to exclusively breastfeed.
- The lowest rates of exclusive breastfeeding occurred for infants whose mother and father both preferred non-exclusive breastfeeding.
See the Answer
Answers: B, C, and D (not A)
Matern Child Health J. 2018 Jun 30. doi: 10.1007/s10995-018-2566-2.
When Fathers are Perceived to Share in the Maternal Decision to Breastfeed: Outcomes from the Infant Feeding Practices Study II.
Wang S, Guendelman S, Harley K, Eskenazi B.
The present study investigates the influence of joint feeding preferences of both the mother and father on initiation and duration of breastfeeding.
Data from the Infant Feeding Practices Study II was analyzed. Female participants in a national consumer opinion panel were followed from pregnancy through 1 year postpartum, and were asked about infant feeding practices. We examined the association between maternal prenatal perception of the expectant father's breastfeeding preferences and breastfeeding outcomes (initiation, duration of exclusive breastfeeding and any breastfeeding) and whether concordance between the parents' infant feeding preferences influenced breastfeeding.
Mothers who perceived that the father preferred exclusive breastfeeding (vs. no preference) were more likely to initiate breastfeeding [adjusted odds ratio (aOR) = 1.9; 95% confidence interval (95% CI) 1.0-3.7], and they had a lower hazard of stopping exclusive and any breastfeeding at any given time [exclusive breastfeeding: adjusted hazard ratio (aHR) = 0.8; 95% CI 0.6-0.9; any breastfeeding: aHR = 0.6; 95% CI 0.5-0.7]. When both the mother and the father preferred exclusive breastfeeding, the hazard of breastfeeding cessation at any given time was lowest (exclusive breastfeeding: aHR = 0.4; 95% CI 0.3-0.5; any breastfeeding: aHR = 0.4; 95% CI 0.3-0.5). The risk of breastfeeding cessation remained lower even when only the father preferred exclusive breastfeeding.
For Practice Mothers tend to breastfeed for a longer duration when they perceive that the expectant father prefers exclusive breastfeeding and, even more so, when both parental preferences for exclusive breastfeeding concur. Efforts are needed to involve expectant fathers in breastfeeding decision-making and education to achieve breastfeeding success.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
It is clear from this article, as well as previous studies, that the father’s preference for infant feeding plays an important role in duration of breastfeeding. When the mother perceived that the father preferred exclusive breastfeeding, she was less likely to stop exclusive breastfeeding, even if she didn’t necessarily want to exclusively breastfeed.
Women who preferred exclusive breastfeeding were more likely to have a shortened duration of exclusive breastfeeding if the fathers preferred nonexclusive breastfeeding.
According to the authors, research shows that educating fathers on breastfeeding increases breastfeeding rates.
Unfortunately, the findings in this study cannot be generalized to the entire US population because of the study design as a survey, and the fact that participants were not representative of our diverse US population.
One other point is that exclusive breastfeeding rates fell from 100% to 75% by 1 month postpartum for infants whose mother and father both desired exclusive breastfeeding. Clearly there are many other factors that lead 25% of families to stop exclusive breastfeeding early despite strong intentions from both parents.