Expanding Community Support for Breastfeeding: The Role of Fathers

In 2016, Promundo released the State of America's Fathers. Fathers have increased time they spend with their children by 65% over past 30 years. Women spend average of 66 minutes a day providing physical care to children; men spend less than half that. Sixty percent of men report work-life conflict, nearly double from 30 years ago. ¹

Within that story, there is a tale of two fatherhoods. Eight to ten million is the estimate of the total number of nonresident fathers in the United States. Two million seven hundred thousand children have an incarcerated parent; 10% of children have a parent who has been in prison. This represents many challenges to foster healthy fatherhood and family relationships. ¹

Of note, when we engage men in maternal health, women exhibit more positive breastfeeding practices. ² Women experience less pain in labor and delivery. ³ Women attend more prenatal and postpartum visits and more likely to have a skilled attendant. ⁴ Other specific outcomes happen as well. When you involve men in prenatal care and the birthing process, fathers are usually involved in the long term. Child development outcomes are improved. Household incomes are usually higher. Households are more gender equitable. Overall, the health of the family is better.

Internationally, Promundo has found that men are more likely to be involved in caregiving if they have more equitable attitudes and have some secondary education. Men are more likely to be involved in caregiving if they were taught to care for siblings and were not exposed to interpersonal violence (IPV) as child. They usually work fewer hours and are younger. They are more likely to take paternity leave. They are more likely to have a partner (child's mother) who also worked and have had their own father participated more in caregiving.

When men are caregivers, women's income goes up. Children show more gender equitable attitudes and better cognitive and social development. Men involved in caregiving are more likely to be involved in reproductive health. Men's lives are better when they are involved in caregiving. Violence is often reduced when caregiving goes up.

In Promundo's “Men Who Care” study, 83 men in 5 countries had life history interviews. They were selected for their primary caregiving roles and professional caregiving roles. More men are doing more care work, but they lack references for men doing care work. They stress the importance of female partners' attitudes toward men's caregiving. They had a strong sense of identity in being caregivers but often the feelings were mixed with confusion, depression, and isolation. Caregiving roles served as pathways to new ways of expressing connection and emotions. This is much healthier for the men. However, this poses a challenge to women and social institutions to accept men in new workplace care roles. One interesting part of the story, it is easier for men to take on caregiving if they also were providers; there was sense of shame for those who were only caregivers. Institutional support is important. When governments provide paid paternity leave, fathers take it. In Denmark, Sweden, Iceland, Norway, and Canada, close to 90% of fathers take paternity leave.

Let's now focus on breastfeeding. Studies show that when a nursing mother has a “significant other” who is educated about and supports her choice to breastfeed she is much more likely to be successful at it. ² For many mothers, this significant other is the baby's father. ⁵ A father's support is important to successful breastfeeding. The first few weeks of breastfeeding are the most challenging. Mothers are often exhausted and/or are experiencing discomfort from childbirth. It is during this time that fathers can be most helpful.

To support and engage fathers, educate them about the benefits of breastfeeding. Once fathers realize that breast milk is by far the best for their babies, they usually encourage the mother to nurse. We need to answer common questions he may have: Is baby getting enough? Is breastfeeding painful? How can she nurse without exposing herself in public? Clearly state to fathers, just because they are not the specific person breastfeeding they can take a very important role in the process. They can help by assisting with positioning the infant, by placing pillows appropriately to support the mother's arm, by ensuring that she gets rest and proper nutrition and hydration, by spending time with the infant, and sharing skin to skin time with the infant to facilitate bonding and breastfeeding (see Appendix for more ways to include fathers).

There is much more to nurturing a baby than just feeding. Fathers are the first persons usually to demonstrate to baby that food does not always equate love. Fathers can often enhance bonding by having eye-to-eye contact, taking their babies for walks, holding baby close and talking to him or her, rocking, calming, cuddling, playing and bathing the baby, changing, and burping the baby.

So, as we move forward to support women to breastfeed, we should engage men—engage the fathers. We should not assume that they know about breastfeeding or how they can support their partners. Engaging them proactively and positively will help their partners be successful in breastfeeding.