Fathers' role in supporting breastfeeding

Fathers can make a significant difference in whether or not an infant is nursed and safely placed to sleep, according to a recent survey of new fathers conducted by the Pregnancy Risk Assessment Monitoring System (PRAMS for Dads).

This new method is based on an annual monitoring method used by the Centres for Disease Control and Prevention (CDC) and public health agencies to poll new mothers for more than 35 years. The first study to use PRAMS for Dads to describe father-reported rates of newborn nursing and sleep practices in a state-representative sample.

The study's findings have been published in the journal 'Paediatrics.'

Breastfeeding was initiated by 95 percent of fathers who wanted their infant's mother to breastfeed and 78 percent reported nursing at eight weeks.

This is significantly higher than the rates reported by fathers who had no opinion or did not want their infant's mother to nurse - 69 percent acknowledged breastfeeding initiation and 33 percent reported nursing at eight weeks.

Researchers also discovered that while 99 percent of fathers reported putting their infant to sleep, only 16 percent followed all three recommended infant sleep practices (back sleep position, approved sleep surface, and avoidance of soft bedding). Almost one-third of the fathers polled were missing at least one critical component of safe sleep education.

Black fathers were less likely to use the back sleep position and more likely to use soft bedding than White fathers. Nationally, the rate of sudden unexpected infant death of Black infants is more than twice that of White infants, and unsafe sleep practices may contribute to this disparity.

"Our findings underscore that new fathers are a critical audience to promote breastfeeding and safe infant sleep," said lead author John James Parker, MD, a pediatrician at Ann & Robert H Lurie Children's Hospital of Chicago, an internist at Northwestern Medicine, and an Instructor of Pediatrics at Northwestern University Feinberg School of Medicine.

"Many families do not gain the health benefits from breastfeeding because they are not provided with the support to breastfeed successfully. Fathers need to be directly engaged in breastfeeding discussions and providers need to describe the important role fathers play in breastfeeding success. Additionally, fathers need to receive counseling on all of the safe sleep practices for their infants. To reduce racial disparities in sudden unexpected infant death, we need tailored strategies to increase safe infant sleep practices in the Black community, including public campaigns to increase awareness and home visiting programs. These interventions must involve both parents to be most effective."

The study included 250 fathers who were surveyed two to six months after their infant's birth.

"As pediatricians, we focus on how to ensure the best health outcomes for children, with successful breastfeeding and safe sleep practices being two key behaviors that impact children's health," said senior author Craig Garfield, MD, MAPP, founder of the Family & Child Health Innovations Program (FCHIP) at Lurie Children's. He is Professor of Pediatrics and Medical Social Sciences at Northwestern University Feinberg School of Medicine.

"Our study highlights the fact that fathers play a big role in both these behaviors but there is more to be done to support fathers. For example, we found that fathers with college degrees were more likely to report that their baby breastfed, and they were more likely to receive guidance on infant sleep safety. To improve child health outcomes, we need to make sure that breastfeeding and safe sleep guidance reaches all new parents equitably."