Views of fathers in Ireland on the experience and challenges of having a breast-feeding partner
Introduction
Ireland has had a breast feeding policy since 1994 (Department of Health, 1994), participated in the WHO-UNICEF Baby-Friendly Hospital Initiative since 1998, and implemented a national breast feeding strategy since 2005 (Department of Health and Children, 2005). Despite these measures, and despite the widely promoted physical and emotional benefits of breastfeeding for mother and infant (Gartner et al., 2005), rates of breast feeding initiation and duration in Ireland remain well below those of our European counterparts (Brick and Nolan, 2013).
Ireland has not had a breast feeding culture for several generations (Curtin, 1954, Kevany et al., 1975, McSweeney and Kevany, 1982, Fitzpatrick et al., 1994, Brick and Nolan, 2013). As such, the skill of breast feeding has been lost to the social and cultural network of many women in Ireland. Health professionals have been identified as important to the success of breast feeding (Begley et al., 2008, Brown et al., 2011, Tarrant et al., 2011), but with shorter hospital stays, the potential contribution of a mother's family network to the success of breast feeding cannot be dismissed.
The support offered by a woman's partner affects her decision to initiate and continue breast feeding (Scott et al., 2001, Pisacane et al., 2005, Pontes et al., 2008, Susin and Giugliani, 2008). The only Irish study to date which assesses the attitude of fathers to breast feeding (Kenosi et al., 2011) reported that while most of the fathers surveyed discussed infant feeding methods with their partner, only a third felt that it was a shared decision between both parents. Brown and Davies (2014) similarly reported that while fathers were positive about breast feeding, most ultimately referred to breast feeding as their partner's choice. It is inarguably important that a woman's autonomy to choose is respected. However, fathers who are removed from the breast feeding process can feel frustrated, alienated and helpless when it comes to supporting the needs of their breast-feeding partner and infant (Barclay and Lupton, 1999; Goodman, 2005; Pontes et al., 2009; Brown and Davies, 2014). Therefore, it's also important that fathers feel included in, and necessary to, the breastfeeding process from the outset.
Several studies have investigated reasons why mothers in Ireland never initiate, or discontinue, breast feeding. These reasons most commonly relate to the perceived negative impact of breast feeding on lifestyle, maternal fatigue, difficulty with breast feeding techniques and perceived milk insufficiency (Begley et al., 2008, Tarrant et al., 2009, Tarrant et al., 2011, Layte and McCrory, 2014). Therefore, mothers in Ireland often avoid or discontinue breast feeding due to technical difficulties and inadequate practical and emotional support.
The results of studies investigating the impact of paternal involvement on breast feeding have been somewhat mixed to date. However, most have shown that supportive paternal involvement has a significant positive impact on some aspect of breast feeding, whether it is initiation (Wolfberg et al., 2004), feeding on discharge (Scott et al., 2001, Tarrant et al., 2011), duration (Pisacane et al., 2005, Tarrant et al., 2011, Maycock et al., 2013), or coping with breast feeding difficulties (Pisacane et al., 2005).
The Irish study by Kenosi et al. (2011) reported that only 55.2% of fathers had enough information on breast feeding. Irish women who breast feed are in the minority from the early postpartum period, with only 42.5% of Irish mothers doing any breast feeding on discharge from hospital (Layte and McCrory, 2014). If breast feeding rates are to increase, a better understanding of male attitudes and needs around breast feeding is needed to help men to offer adequate technical, practical and emotional support to their breast-feeding partners.
To the authors’ knowledge, only one study (Kenosi et al., 2011) has been conducted to date on the attitude of fathers in Ireland towards breastfeeding. This study had a small sample of 67 fathers who answered the study questionnaire within two days of the birth of their child. As such, very little is known about the experience of fathers in Ireland with breast feeding. Much work remains to be done to increase Irish breast feeding rates; this work must include recognition of the role that fathers can play as cornerstones of breast feeding support. Therefore, this study aimed to gain insight into the relationship between men and breast feeding in Ireland, by investigating the:
- •
Role of fathers in the breast feeding decision;
- •
Aspects of breast feeding for which fathers felt unprepared;
- •
Perceived advantages and disadvantages to having a breast-feeding partner; and
- •
Views of fathers on breast feeding in public.
Section snippets
Methodology
Ethical approval for this study was obtained from the Coombe Women and Infants University Hospital and Dublin Institute of Technology.
Findings
Five hundred and eighty-three questionnaires were returned, giving a 42% response rate. The majority (71.5%, n417) of fathers who returned a questionnaire had a partner who initiated breast feeding. The results which follow relate to the 417 fathers with a breast-feeding partner. Table 1 summarises the socio-demographic characteristics of respondents.
The mean age of fathers was 36.3 (SD±4.7) years and the majority (62.6%, n261) had at least one other child (mean 1.6 other children). Most
Discussion
With breastfeeding initiation and maintenance rates amongst Irish mothers being some of the lowest globally (Gallagher et al., 2015), ongoing investigation into breastfeeding support for women in Ireland is warranted. Fathers can provide a continuity of care which other sources of breastfeeding support cannot, and it is therefore important to heed the views and concerns of fathers in Ireland on their role in breastfeeding. The findings of this study indicate that while fathers are largely
Conflict of interest
The authors report no conflict of interest.
Acknowledgements
We would like to thank all the fathers who kindly completed the survey and shared their experiences of the early postpartum period.
AEB was supported by a Dublin Institute of Technology Fiosraigh Scholarship which is funded by Dublin Institute of Technology and Danone Nutricia (PB03874). Danone Nutricia had no role in the: study design; collection, analysis, and interpretation of data; writing of the manuscript; and decision to submit the manuscript for publication.
AEB was responsible for study
References (57)
“The way to break the taboo is to do the taboo thing” breastfeeding in public and citizen-activism in the UK
Health and Place
(2011)- et al.
Young mothers who choose to breast feed: the importance of being part of a supportive breast-feeding community
Midwifery
(2011) - et al.
Artificial milk-feeding women's views of their feeding choice in Ireland
Midwifery
(2015) Becoming an involved father of an infant
Journal of Obstetric, Gynecologic and Neonatal Nursing
(2005)- et al.
‘Oh no, no, no, we haven't got time to be doing that’: challenges encountered introducing a breast-feeding support intervention on a postnatal ward
Midwifery
(2015) - et al.
A feasibility study of an intervention to enhance family support for breast feeding in a deprived area in Bristol, UK
Midwifery
(2004) - et al.
Barriers to breast-feeding in obese women: a qualitative exploration
Midwifery
(2015) - et al.
Fathers in the birth room: what are they expecting and experiencing? A phenomenological study
Midwifery
(2011) - et al.
Building a place for the father as an ally for breastfeeding
Midwifery
(2009) - et al.
Dads as breastfeeding advocates: results from a randomized controlled trial of an educational intervention
American Journal of Obstetrics and Gynecology
(2004)
Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System
Pediatrics
Major factors influencing breastfeeding rates: mother's perception of father's attitude and milk supply
Pediatrics
The experiences of new fatherhood: a socio-cultural analysis
Journal of Advanced Nursing
Breastfeeding: reasons for starting, reasons for stopping and problems along the way
Breastfeeding Review
Explaining the increase in breastfeeding at hospital discharge in Ireland, 2004–2010
Irish Journal of Medical Science
Fathers’ experiences of supporting breastfeeding: challenges for breastfeeding promotion and education
Maternal and Child Nutrition
Failure to breastfeed: a review of the feeding history of 1007 infants
Irish Journal of Medical Science
“The best moment of my life”: a literature review of fathers’ experience of childbirth
Australian Journal of Midwifery
A National Breastfeeding Policy for Ireland
Breastfeeding in Ireland: A Five-Year Strategic Action Plan
Factors affecting the initiation of breastfeeding: implications for breastfeeding promotion
Health Promotion International
Increasing response rates to postal questionnaires: a systematic review
British Medical Journal
Factors associated with the decision to breastfeed among Irish women
Irish Medical Journal
Determinants of breastfeeding initiation in Ireland
Irish Journal of Medical Science
Breastfeeding and the use of human milk
Pediatrics
Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland
Journal of Human Lactation
Cited by (29)
Prevent postpartum blues with the implementation of breastfeeding father education model to increase the frequency of breastfeeding in mothers: A systematic review
2021, Gaceta SanitariaCitation Excerpt :Some of the studies recommended to find out some risk factors and treat them as well as preventing postpartum blues occurrence. From all the identified causes, the father's support act as the most relatable, and a modifiable risk factor also can be treated by giving much more education.1,7,8 Other relevant studies have implemented a breastfeeding father method in which the father helps the mother to breastfeed in some ways that can influence the mother's decision to start and maintain breastfeeding.7,9
A review of the influence of fathers on children's eating behaviours and dietary intake
2020, AppetiteCitation Excerpt :The role as a support person is of utmost importance, with evidence suggesting that fathers support for their breastfeeding partner is an important component in ensuring a positive breastfeeding experience for both the mother and child (Brown & Davies, 2014; Rempel & Rempel, 2011). Overall, despite this it is commonly reported by fathers that breastfeeding can make fathers feel left out or unimportant in the child's life and deprive them of bonding time with their child (Bennett et al., 2016, pp. 169–176; Rempel & Rempel, 2011). Overall, it is clear that the role of fathers of breastfed infants differ to the role of fathers of formula-fed infants, in terms of having a choice whether to be physically involved or not.
Integrative Review of Fathers’ Perspectives on Breastfeeding Support
2020, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal NursingCitation Excerpt :Fathers often felt discomfort and shame when their partners breastfed in front of family members or in public because of the sexualization of breasts in the media (Bennett et al., 2016; Brown & Davies, 2014; Mitchell-Box & Braun, 2012). Fathers obtained knowledge about breastfeeding from their partners, supportive health care professionals, and the Internet (Bennett et al., 2016; Brown & Davies, 2014). Although most fathers focused on the benefits of breastfeeding for their infants, they had only superficial knowledge about the other benefits of breastfeeding, including the positive effect on the mother–infant relationship, financial savings related to the decreased need for infant formula, immune-boosting properties, and positive effect on infant growth and development (Azevedo et al., 2016; Bennett et al., 2016; Brown & Davies, 2014; Datta et al., 2012; Hounsome & Dowling, 2018; Merritt et al., 2019; Mgolozeli et al., 2018; Mitchell-Box & Braun, 2012; Mithani et al., 2015; Muda et al., 2017; Palmqvist et al., 2015; Rempel & Rempel, 2011; Sherriff & Hall, 2011).