JMIR Publications

ABSTRACT

Background:

Despite the recognized health and economic benefits of exclusive breastfeeding, few Australian infants are exclusively breastfed beyond 5 months of age. Social support for breastfeeding, and in particular the support of an infant’s father, has been identified as crucial elements for successful breastfeeding.

Objective:

The objective of this study was to determine the effectiveness of various father-focused breastfeeding interventions in terms of key infant feeding outcomes.

Methods:

The study was a four arm, factorial, cluster-randomized controlled trial conducted in Perth, Australia. The trial arms included a control group and three interventions consisting of a face-to-face father-focused antenatal breastfeeding class facilitated by a male peer facilitator, Milk Man a breastfeeding smartphone app designed specifically for fathers, and a combination of both interventions. Expecting couples were recruited from hospital-based antenatal classes and randomized to one of the four arms. Both partners completed surveys on recruitment and at 6 and 26 weeks postpartum. Primary outcomes were duration of exclusive and any breastfeeding. Secondary outcomes included age of introduction of formula, age of introduction of complementary foods, maternal breastfeeding self-efficacy and partner postpartum support.

Results:

A total of 1426 couples were recruited from public (n=443, 31%) and private (n=983, 69%) hospitals. Of these, 1092 (76.6%) fathers completed the baseline questionnaire, 836 (58.6%) completed the 6 weeks follow-up questionnaire, and 702 (49.2%) completed the 26 weeks follow-up questionnaire. The average age of fathers who completed the baseline questionnaire was 33.6 (± 5.2 SD) years, the majority were born in Australia (76.4%) and had attended university (61.8%). There were no significant differences between the control and intervention groups in any of the infant feeding outcomes or the level of breastfeeding confidence and postpartum partner support reported by mothers

Conclusions:

This study did not demonstrate that any intervention was superior to another, nor that any intervention was inferior to the standard care delivered in routine antenatal classes. Previously reported process evaluation findings indicate that both interventions were acceptable to, and valued by, participant fathers. The Milk Man smartphone app, in particular, provides a potentially cost-effective and sustainable means of reaching large numbers of geographically and demographically diverse fathers. Further studies in different populations are needed. Clinical Trial: ACTRN:12614000605695