From Mother-Infant Dyad to Mother-Father-Infant Triad: A Cross-Sectional Study on Fathers’ Breastfeeding Attitudes and Participation

Abstract

Spanish

Background and Aim:

It is important to include fathers in the evaluation of the breastfeeding process. This study aimed to assess fathers’ breastfeeding attitudes and participation.

Methods:

The cross-sectional study data were collected between March and June 2024 in a maternity and child hospital and completed with the participation of 194 fathers. The study data were collected using the Personal Information Form, Fathers’ Breastfeeding Attitude Scale (F-BA), and Fathers’ Participation in Breastfeeding Process Scale (F-PB). Descriptive statistics, one-way ANOVA, independent t-tests, and Pearson correlation were used in the analysis.

Results:

It was determined that the fathers’ total F-BA mean score was 58.24 ± 5.62, and the total F-PB mean score was 57.09 ± 6.84. A total of 81% of fathers stated that breastfeeding was healthy for the baby. No statistical significance was found between the fathers’ sociodemographic and breastfeeding characteristics and F-BA (p > 0.05). A statistical significance was found between the child’s age, the child’s nutritional method in the first 6 months, the effect of the father figure during the breastfeeding process, and F-PB (p < 0.05). A positive, moderate, highly significant correlation was found between the total F-BA and the total F-PB (r = 0.476, p < 0.001).

Conclusion:

Fathers in this study exhibited generally favorable attitudes toward breastfeeding. However, mean scores were close to the scale’s cutoff value. Their level of participation varied based on contextual factors. These findings emphasize that positive attitudes are not necessarily associated with higher levels of active participation and highlight the importance of a deeper understanding of fathers’ roles in the breastfeeding process.

Keywords

Breastfeeding family-centered care fathers’ attitudes infant feeding paternal involvement

Get full access to this article

View all access options for this article.

References

Abbass-Dick

Brown

H. K.

Jackson

K. T.

Rempel

Dennis

C. L.

(2019). Perinatal breastfeeding interventions including fathers/partners: A systematic review of the literature. Midwifery, 75, 41–51. https://doi.org/10.1016/j.midw.2019.04.001

Abu-abbas

M. W.

Kallash

M. I.

Shelash

K. I.

(2016). Fathers and breastfeeding process: Determining their role and attitudes. European Scientific Journal, 12(18), 327–336. https://doi.org/10.19044/esj.2016.v12n18p327

Aktaş

Reyhan, F

. (2025). The effect of breastfeeding education with digital storytelling on fathers’ breastfeeding self-efficacy. Journal of Evaluation in Clinical Practice, 31(1), Article e14102. https://doi.org/10.1111/jep.14102

Arifin

S. R. M.

Zaki

N. F. M.

Daud

Abd Aziz

K. H.

(2022). Knowledge and attitude towards breastfeeding among fathers working at higher learning institutions in the East Coast of Malaysia. Jurnal Islam dan Masyarakat Kontemporari, 23(1), 236–243.

Atkinson

Silverio

S. A.

Bick

Fallon

(2021). Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: Mixed-methods findings from a global online survey of English-speaking fathers. Maternal & Child Nutrition, 17(Suppl 1), Article e13147. https://doi.org/10.1111/mcn.13147

Çerçer

Nazik

(2023). The effects of the breastfeeding problems management model on breastfeeding problems, breastfeeding motivation, and breastfeeding success: A randomized controlled trial. Journal of Pediatric Nursing, 73, e116–e124. https://doi.org/10.1016/j.pedn.2023.07.021

Cheng

Akkerman

Kong

Walvoort

M. T. C.

de Vos

(2021). More than sugar in the milk: Human milk oligosaccharides as essential bioactive molecules in breast milk and current insight in beneficial effects. Critical Reviews in Food Science and Nutrition, 61(7), 1184–1200. https://doi.org/10.1080/10408398.2020.1754756

Çiçekli

İ.

Durusoy

. (2022). Breastfeeding, nutrition, and type 1 diabetes: A case-control study in Izmir, Turkey. International Breastfeeding Journal, 17(1), 42. https://doi.org/10.1186/s13006-022-00470-z

Çiftçi

Sönmez Düzkaya

(2022). The relationship between breastfeeding attitudes of mothers with 0-24 months babies and the effects of fathers on breastfeeding. Izmir Katip Celebi University Faculty of Health Sciences Journal, 7(3), 481–487.

10.

Cohen

(2013). Statistical power analysis for the behavioral sciences. Academic Press.

11.

Crippa

B. L.

Consales

Morniroli

Lunetto

Bettinelli

M. E.

Sannino

Rampini

Zanotta

Marchisio

Plevani

Giannì

M. L.

Mosca

Colombo

(2021). From dyad to triad: A survey on fathers’ knowledge and attitudes toward breastfeeding. European Journal of Pediatrics, 180(9), 2861–2869. https://doi.org/10.1007/s00431-021-04034-x

12.

deMontigny

Gervais

Larivière-Bastien

St-Arneault

(2018). The role of fathers during breastfeeding. Midwifery, 58, 6–12. https://doi.org/10.1016/j.midw.2017.12.001

13.

Ergezen

Efe

Çalışkan

Dikmen

. (2021). The relationship between mothers’ breastfeeding self-efficacy perceptions and breastfeeding success in postpartum period. Dokuz Eylül University Faculty Nursing Electronic Journal, 14(3), 217–223. https://doi.org/10.46483/deuhfed.675733

14.

Evgin

Özdil

(2022). The effect of fathers’ support for breastfeeding process on mothers’ breastfeeding self-efficacy and father-baby attachment: A cross-sectional and correlational study. Türkiye Klinikleri Journal of Nursing Sciences, 14(3), 659–671.

15.

Gayesa

R. T.

Xie

Y. J.

Ngai

F. W.

(2025). Measuring the role of fathers on breastfeeding success: Psychometric properties of Ethiopia’s Afaan Oromo version of the partner breastfeeding influence scale. Journal of Pediatric Nursing, 80, e264–e271. https://doi.org/10.1016/j.pedn.2025.01.005

16.

Gebremariam

K. T.

Wynter

Zheng

Rawstorn

J. C.

Denney-Wilson

Laws

(2024). Breastfeeding - A survey of fathers’ support needs and preferred sources of information. International Breastfeeding Journal, 19(1), 50. https://doi.org/10.1186/s13006-024-00654-9

17.

Gültekin

(2021). Babaların emzirmeye ilişkin tutumları, emzirme sürecine katılımları ve bunları etkileyen faktörler [Master Thesis, Aydın Adnan Menderes University Health Sciences Institute, Midwifery Sağlık Bilimleri Enstitüsü, Midwifery Department, Aydın/Türkiye].

18.

Hansen

Tesch

Ayton

(2018). “They’re born to get breastfed” - how fathers view breastfeeding: A mixed-method study. BMC Pregnancy and Childbirth, 18(1), 238. https://doi.org/10.1186/s12884-018-1827-9

19.

Koksal

Acikgoz

Cakirli

(2022). The effect of a father’s support on breastfeeding: A systematic review. Breastfeeding Medicine, 17(9), 711–722. https://doi.org/10.1089/bfm.2022.0058

20.

Leng

R. N. W.

Shorey

Yin

S. L. K.

Chan

C. P. P.

H. G.

(2019). Fathers’ involvement in their wives’/partners’ breastfeeding: A descriptive correlational study. Journal of Human Lactation, 35(4), 801–812. https://doi.org/10.1177/0890334419830988

21.

Mat Nawi

N. I.

Abdul Hamid

S. B

. (2021). Determinants of fathers’ involvement in breastfeeding practices in Kuala Selangor. Malaysian Journal of Nutrition, 27(1), 15–26. https://doi.org/10.31246/mjn-2020-0070

22.

Meek

J. Y.

Noble

(2022). Technical report: Breastfeeding and the use of human milk. Pediatrics, 150(1), Article e2022057989. https://doi.org/10.1542/peds.2022-057989

23.

Merritt

Vogel

Ladbury

Johnson

(2019). A qualitative study to explore fathers’ attitudes towards breastfeeding in South West England. Primary Health Care Research & Development, 20, Article e24. https://doi.org/10.1017/S1463423618000877

24.

Metin

Altınkaynak

(2020). Impact of father’s socio-demographic characteristics on partner support and breastfeeding success. Journal of Academic Research in Nursing, 6(1), 109–116.

25.

Muelbert

Giugliani

E. R. J.

(2018). Factors associated with the maintenance of breastfeeding for 6, 12, and 24 months in adolescent mothers. BMC Public Health, 18(1), 675. https://doi.org/10.1186/s12889-018-5585-4

26.

Mulinge

M. M.

Abisi

H. K.

Kabahweza

H. M.

Okutoyi

Wamalwa

D. C.

Nduati

R. W.

(2024). The role of maternal secretor status and human milk oligosaccharides on early childhood development: A systematic review and meta-analysis. Breastfeeding Medicine, 19(6), 409–424. https://doi.org/10.1089/bfm.2023.0274

27.

Pereira

T. L.

Rajendran

P. D.

Nantsupawat

Shorey

(2024). Fathers’ breastfeeding knowledge, attitudes, and involvement in the Asian context: A mixed-studies review. Midwifery, 131, Article 103956. https://doi.org/10.1016/j.midw.2024.103956

28.

Phua

H. W.

Razak

N. A. A. A.

Shukri

N. H. M.

(2020). Associations of father’s breastfeeding attitude and support with the duration of exclusive breastfeeding among first-time mothers. Malaysian Journal of Medicine & Health Sciences, 16(6), 84–89.

29.

Sezer

H. K.

Ceran

M. A.

Demirsoz

Kucukoglu

(2024). Development and psychometric evaluation of the paternal support scale of breastfeeding. Journal of Pediatric Nursing, 75, 149–157. https://doi.org/10.1016/j.pedn.2023.12.004

30.

Srisopa

Lucas

(2021). Maternal perception of paternal breastfeeding support: A secondary qualitative analysis. Midwifery, 102, Article 103067. https://doi.org/10.1016/j.midw.2021.103067

31.

TDHS. (2018). Hacettepe University ınstitute of populationstudies. Ankara, Türkiye. Retrieved February 20, 2025,from https://fs.hacettepe.edu.tr/hips/dosyalar/Ara%C5%9Ft%C4%B1rmalar%20-%20raporlar/2018%20TNSA/TNSA2018_ana_Rapor_compressed.pdf

32.

UNICEF. (2022). Breastfeeding: A mother’s gift, for every child. Retrieved February 19, 2025, from https://www.unicef.org/media/48046/file/UNICEF_Breastfeeding_A_Mothers_Gift_for_Every_Child.pdf

33.

Uyar Hazar

Gültekin

. (2023). Validation of a Turkish version of the fathers’ breastfeeding attitude and participation scale. Revista da Associação Médica Brasileira, 69(9), Article e20230416. https://doi.org/10.1590/1806-9282.20230416

34.

World Health Organization (WHO). (2022). Breastfeeding. Retrieved February 19, 2025, from https://www.who.int/health-topics/breastfeeding#tab=tab_2

35.

Yuan

Z. W.

Chen

Y. L.

W. L.

Zhao

X. X.

(2024). Knowledge and attitude of spouses of puerperas towards breastfeeding. BMC Women’s Health, 24(1), 289. https://doi.org/10.1186/s12905-024-03116-w (Erratum in: BMC Women’s Health, 24(1),404. https://doi.org/10.1186/s12905-024-03252-3).

36.

Zhou

S. S.

Qin

Wang

Gao

Rao

(2024). The role of paternal support in breastfeeding outcomes: A meta-analytic review. International Breastfeeding Journal, 19(1), 84. https://doi.org/10.1186/s13006-024-00694-1