Abstract
Maternally targeted breastfeeding support programs, be they antenatal, intrapartum, or postpartum in their timing have repeatedly demonstrated that they will increase the rate and duration of exclusive breastfeeding.1,2 Of interest, as regard to antennal programs no one specific program or educational format has been shown to be more effective than another, but rather the deliverance of basic information along with the additional attention the mothers receive from both professional and peers apparently is the key to success.
What is striking in these reviews is the relative absence of information as to the specific role and value that paternal education levels play in breastfeeding support and outcome. Thus, the report in this month's issue of Breastfeeding Medicine from Hackman et al. is of particular interest and importance. These investigators prospectively followed >3,000 pregnancies of primiparous mothers and analyzed the outcome utilizing comprehensive logistic regression models (controlling for basic demographic variable) and other covariates such as maternal education, marital relationship and status, household poverty level, and postpartum work pattern.
The results of their study clearly documented that the paternal educational level was independently associated with increased breastfeeding initiation and duration. When one combines these data with the reports of the success of the small number of targeted paternal educational programs such as those summarized by Abbas-Dick et al. 3 it is clear that the role of the male partner needs a greater degree of attention by breastfeeding supporters and advocates.
Most importantly Abbas-Dick et al. reported that the inclusion of fathers/partners in breastfeeding interventions programs improved breastfeeding initiation, duration, and exclusivity rates when they are designed in a culturally appropriate manner and pegged to the appropriate educational level of the father.
The role of the father is of particular importance in primiparous pregnancies, as beyond the obvious changes physiologically, psychologically, and socially that the mother inevitably endures, there is a similar challenging transition process that these first time fathers also undergo. Baldwin et al.
4
reviewed the existing literature on this subject and summarized this process emphasizing the “mental health and wellbeing” challenges that such frequently young males face. They identified three factors and challenges that affected their behavior:
The need for formation of a fatherhood identity. Balancing the competing challenges and demands of fatherhood along with existing responsibilities. Addressing negative feelings and fears that result from the new role.
In particular, the investigators emphasized the stress that occurs in these new fathers that occurs from the restriction and demands of the new life style resulting in turn in a pattern of denial and escape activities.
Understanding and appreciating these psychosocial dynamics is thus critical to developing appropriate breastfeeding support programs that regularly include design fathers/partners as active participants. Such an involvement is the best guarantee for breastfeeding success and the potential for improved metal health of the newly minted fathers.