Literature review for - Flourish Paediatrics

ethnicity or maternal age cannot be changed. But even with these variables the identification
of ‘at risk’ groups can assist in the targeting of support programs.
There is strong evidence that fathers can influence the initiation of breastfeeding, (Scott,
Binns et al. 1997; Scott, Binns et al. 1997; Wolfberg, Michels et al. 2004) contribute to
maternal breastfeeding confidence (Ekstrom, Widstrom et al. 2003), and impact decisions
regarding duration and weaning (Hauck and Irurita 2003; Hauck 2004; Swanson and Power
2005). Without fathers’ support mothers are more likely to breastfeed for a shorter duration
(Scott, Aitkin et al. 1999). Focus group, cohort and longitudinal studies have shown that the
support of fathers is critical for initiation and continuance of breastfeeding (Scott, Binns et al.
1997; Sharma and Petosa 1997; Scott, Landers et al. 2001).
Sharma and Petosa (Sharma and Petosa 1997) identified fathers’ support as one of the
strongest and most consistent variables associated with women’s willingness to breastfeed
and yet there are few programs that have sought to enhance this support. There has been little
research in this area, with little known about the nature of a father’s support required by the
mother and there have been few programs that have specifically targeted fathers. While some
programs targeting the father’s role in promoting breastfeeding have been effective in
increasing initiation rates (Stremler and Lovera 2004; Wolfberg, Michels et al. 2004), less
success has been achieved regarding impact on duration.
An Italian randomised control trial that provided a breastfeeding training session for fathers
resulted in a 10% increase (25% versus 15%) in breastfeeding prevalence rates six months
after birth. The intervention aimed to provide support and education about management of the
most common lactation difficulties (Pisacane, Continisio et al. 2005). In contrast, an
American randomised controlled trial of a paternal education intervention did not have a
significant impact upon breastfeeding prevalence rates at eight weeks post-birth. However,
this intervention class on breastfeeding promotion did influence initiation rates (74% versus
41%) as more women whose partners attended classes chose to commence breastfeeding
compared to a control group who were only offered a baby care class.(Wolfberg, Michels et
al. 2004) Evidence regarding effective strategies to assist fathers in their supportive role with
their breastfeeding partner has been piloted in the Perth Infant Feeding III project from herein
called FIFI and the results will soon be available.
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