Effectiveness of breastfeeding interventions delivered to fathers in low‐ and middle‐income countries: A systematic review

Abstract

Adequate support for lactating mothers is crucial to improve the rates of early initiation, exclusive, and continued breastfeeding. Maternal breastfeeding intention and ongoing breastfeeding duration are strongly predicted by their partners' breastfeeding beliefs. Partner support has a significant effect on improving rates of any and exclusive breastfeeding, when compared with professional support, particularly in low-income populations. This systematic review investigates the effectiveness of breastfeeding interventions targeting fathers in low- and middle-income countries (LMIC). A systematic literature search was undertaken on Medline (EBSCOhost), PsycInfo, CINAHL, and Scopus databases and via manual searching. Inclusion criteria were experimental or quasiexperimental designs targeting fathers from LMIC, which measured either breastfeeding initiation, breastfeeding exclusivity, or duration of breastfeeding as the main outcomes. No time restriction was put in place, and all articles were published in English. The quality of selected papers was assessed using the Joanna Briggs Institute tool. A total of 8 articles were included from 6 interventions: 2 quasiexperimental and 4 randomized control trials. All interventions involved breastfeeding education targeting fathers; 2 were given only to fathers, and 4 delivered to both fathers and mothers. Among these interventions, 2 measured both early initiation and exclusive breastfeeding; one exclusive breastfeeding only; one exclusive breastfeeding, knowledge, and attitudes; one exclusive breastfeeding and knowledge; and one breastfeeding, continued breastfeeding, and awareness. Across all interventions, breastfeeding education showed significant improvement in breastfeeding outcomes in the intervention compared with the control groups. In summary, breastfeeding education interventions targeting fathers in LMIC are effective in improving early initiation of breastfeeding, exclusive breastfeeding, and continued breastfeeding. Thus, breastfeeding promotion should consider the education and involvement of fathers in the intervention.

A cross-sectional comparison of breastfeeding knowledge, attitudes, and perceived partners’ support among expectant couples in Mekelle Ethiopia

“…Improving the understanding of optimal infant and child feeding could improve the likelihood of exclusive breastfeeding practice (46). A systematic review from low-and middle-income countries also revealed that parents who received breastfeeding education to improve awareness were more likely to initiate breastfeeding early, exclusively breastfeed, and practice continued breastfeeding to at least two years of age (47).…”

Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance

“…Early initiation of breastfeeding can reduce both neonatal and early infant mortality [31][32][33] . Many factors are associated with early breastfeeding initiation, and skin-to-skin contact and health education have been proven effectively [34][35][36] . A recent review from the US concluded that baby-friendly practices can help increase prevalence of EIBF and EBF [37] .…”

A cross-sectional comparison of breastfeeding knowledge, attitudes, and perceived partners’ support among expectant couples in Mekelle Ethiopia

“…Improving the understanding of optimal infant and child feeding could improve the likelihood of exclusive breastfeeding practice [47]. A systematic review from low-and middle-income countries also revealed that parents who received breastfeeding education to improve awareness were more likely to initiate breastfeeding early, exclusively breastfeed, and practice continued breastfeeding to at least two years of age [48].…”