A Controlled Trial of the Father's Role in Breastfeeding Promotion

Alfredo Pisacane; Grazia Isabella Continisio; Maria Aldinucci; Stefania D'Amora; Paola Continisio

doi:10.1542/peds.2005-0479

Article Figures & Data

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TABLE 1.

Main Points Discussed With the Fathers of the Intervention Group

1. Why “breast is best” for the mother and the infant

2. The special role of the father as a champion for the mother, the infant, and breastfeeding

3. The main concerns of the fathers about breastfeeding: feelings of inadequacy, jealousy, diminished relationship with the mate, feeling left out of feeding the infant

4. How breastfeeding works: good breastfeeding positioning, infant latching and suckling, frequency of feeding

5. How to reinforce the confidence of the mother in her ability to breastfeed, how to give practical help, and how to support and encourage her to go on with breastfeeding when she is tired

6. What to do if the mother is convinced that the milk is not sufficient: how to check urine output and weight gain to evaluate whether breast milk is sufficient and how to promote more frequent feeding

7. What to do when the infant refuses the breast

8. How to manage sore and inverted nipples, breast engorgement, and mastitis

9. How to express the milk because of return to work and how to store it

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TABLE 2.

Baseline Comparison of Intervention and Control Groups

Variable	Intervention Group (n = 140)	Control Group (n = 140)
Maternal age, y
<20	6 (4)	4 (3)
20–35	118 (84)	116 (83)
>35	16 (11)	20 (14)
First pregnancy	64 (46)	62 (44)
Type of delivery
Vaginal	64 (46)	59 (42)
Cesarean	76 (54)	81 (58)
Maternal education, y
≤8	55 (39)	56 (40)
>8	85 (61)	84 (60)
Planned return to outside employment after childbirth	33 (24)	37 (26)
Maternal smoking
Before pregnancy	49 (35)	46 (33)
During pregnancy	19 (14)	25 (18)
After birth	33 (24)	37 (26)
Father's education, y
≤8	64 (46)	66 (47)
>8	76 (54)	73 (53)
Father's smoking	69 (49)	64 (46)
Previous children breastfed	66/76 (87)	62/78 (79)
Mothers breastfed during infancy	111 (79)	109 (78)
Fathers breastfed during infancy	103 (74)	94 (67)
Early (<2 h) mother–newborn contact after delivery	2 (1)	–
Rooming-in	140 (100)	140 (100)

Data are n (%).

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TABLE 3.

Prevalence of Breastfeeding at Discharge From the hospital, at 6 Months, and at 12 Months

	Intervention Group, n (n = 140)	Control Group, n (n = 140)	Relative Risk (95% CI)	P
At the discharge from the hospital
Full	127 (91)	124 (88.6)	1.02 (0.9–1.1)	.7
Complementary	7 (5)	5 (3.6)	1.4 (0.46–4.3)	.8
Bottle	6 (4)	11 (7.8)	0.5 (0.2–1.4)	.3
At 6 mo
Full	35 (25)	21 (15)	1.67 (1.02–2.71)	<.05
Complementary*	40 (33)	41 (34)	0.98 (0.68–1.39)	1.0
At 12 mo
Complementary	27 (19)	16 (11)	1.69 (0.95–2.99)	.09

Data are n (%). CI indicates confidence interval.
↵* Not included were women who fully breastfed.

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TABLE 4.

Difficulties With Lactation and Support to Breastfeeding Referred by the Mothers at 6 Months

Difficulties/Problems	Intervention Group (n = 140)	Control Group (n = 140)	P
No problems referred	44 (31)	51 (36)
Received help from their partner
With home work	12 (27)	11 (22)
With the care of the infant	40 (91)	43 (84)
With breastfeeding management	36 (82)	18 (35)	<.001
Full breastfeeding at 6 mo	12 (27)	17 (33)	.7
Problems referred	96 (69)	89 (64)
Type of difficulty/problem*
Stress/tiredness	60 (62)	28 (31)	<.001
Perceived milk insufficiency	12 (12)	38 (43)	<.001
Illness of the infant	7 (7)	4 (4)
Illness of the mother	3 (3)	4 (4)
Breast problems	3 (3)	8 (9)
Return to work	17 (18)	8 (9)
Other	1 (1)	4 (4)
Supplemented other foods because of such difficulties	10 (10)	29 (33)	<.001
Stopped breastfeeding because of such difficulties	6 (6)	25 (28)	<.001
Received help from their partner
With home work	17 (18)	10 (11)
With the care of the infant	82 (85)	70 (79)
With breastfeeding management	92 (96)	30 (34)	<.001
Full breastfeeding at 6 mo	23 (24)	4 (4.5)	<.001

Data are n (%).
↵* Percentages are calculated inside each subgroup (problems/no problems). Some values in the Results and in the abstract are reported as percentages in the 2 groups (intervention/control).