Elsevier

Midwifery

Volume 40, September 2016, Pages 169-176
Midwifery

Views of fathers in Ireland on the experience and challenges of having a breast-feeding partner

https://doi.org/10.1016/j.midw.2016.07.004Get rights and content

Highlights

  • Fathers are largely supportive of the concept of breast feeding.

  • Fathers lack the necessary knowledge to support their breast-feeding partner.

  • Fathers feel deprived of quality bonding time with their breast-fed infant.

  • Fathers have reservations about their partner breast feeding in public in Ireland.

  • Greater recognition of a father's importance to breast feeding is needed.

Abstract

Objective

this study investigated the relationship between fathers and breast feeding in Ireland.

Design and method

a cross-sectional semi-quantitative questionnaire with closed-ended and open-ended questions was posted to 1398 men with an Irish partner who had given birth 4–7 months previously. Fathers who specified that their partner breast fed their last or only child were questioned about their: influence on the breast feeding decision; ability to assist with breast feeding challenges; preferred type of information on breast feeding; perceived advantages and disadvantages to breast feeding; and views on breastfeeding in public. Data from closed-ended questions on breast feeding were presented using frequencies and associated percentages. Answers to open-ended questions on breast feeding were categorised into themes using content analysis. Each theme was assigned a numerical code and the themes developed were quantitatively counted and presented as frequencies and percentages.

Findings

of the 583 respondents (42% response rate), 417 (71.5%) had a partner who had breast-fed their last or only child. Most of the 417 fathers were employed (95.7%, n399), college-educated (76.7%, n320) and married (87.8%, n366). Most (75.5%, n315) fathers were involved in the breast feeding decision. The majority (77.5%, n323) of fathers were unprepared for at least one aspect of breast feeding, most commonly that their partner encountered difficulties in establishing breast feeding. Of those fathers with a partner who experienced difficulties with breastfeeding (56.8%, n237), half (49.4%, n117) were unable to help their partner to overcome her breast feeding difficulties. Two-fifths (41.0%, n133) of fathers felt deprived of bonding time. Almost one in ten (9.4%, n39) fathers felt uncomfortable with an unrelated woman breast feeding in public, and this increased to three in ten or one third (34.3%, n143) if the woman in question was their partner.

Key conclusion

while fathers in a well-educated and socially advantaged sample are largely supportive of breast feeding, significant challenges remain in terms of their ability to support breast feeding in an informed and practical manner.

Implications for practice

women who are practically and emotionally supported by their partners are more likely to successfully breast feed, but the male perspective of breast feeding in Ireland has been given little attention. This study supports earlier and more effective engagement of fathers throughout the breast feeding process, and highlights areas of concern with respect to the role of fathers in breast feeding.

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

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