Table 2 Basic characteristics and quality assessment of the included studies
From: The role of paternal support in breastfeeding outcomes: a meta-analytic review
First author, Date of publication | Abstract | Sample size | Intervention measure | Intervenor | Intervention frequency | Primary outcome | Quality grade | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
Intervention group | Control group | Intervention group | Control group | ||||||||
Abbass-Dick et al. Canada, 2015 [8] | Objective: To evaluate the effectiveness of a coparenting intervention on exclusive breastfeeding among primiparous mothers and fathers Methods: An RCT was conducted in a large teaching hospital in Toronto, Canada. Couples were randomized to receive either usual care (n = 107) or a coparenting breastfeeding support intervention (n = 107). Follow-up of exclusive breastfeeding and diverse secondary outcomes was conducted at 6 and 12 weeks postpartum Results: Significantly more mothers in the intervention group than in the control group continued to breastfeed at 12 weeks postpartum (96.2% vs. 87.6%, P = 0.02). Although proportionately more mothers in the intervention group were exclusively breastfeeding at 6 and 12 weeks, these differences were not significant. Fathers in the intervention group had a significantly greater increase in breastfeeding self-efficacy scores from baseline to 6 weeks postpartum compared with fathers in the control group (p = 0.03). In addition, significantly more mothers in the intervention group than in the control group reported that their partners provided them with breastfeeding help in the first 6 weeks (71% vs. 52%, p = 0.02) and that they were satisfied with their partner’involvement with breastfeeding (89% vs. 78.1%, pp = 0.04). Mothers in the intervention group were also more satisfied with the breastfeeding information they received (81% vs. 62.5%, p, 0.001) Conclusions: The significant improvements in breastfeeding duration, paternal breastfeeding self-efficacy, and maternal perceptions of paternal involvement and assistance with breastfeeding suggest that a coparenting intervention involving fathers warrants additional investigation | 107 | 107 | 1, 2, 3, 4, 6 | Usual care | Research assistant | At one, two, three, six and twelve weeks after birth | Rate of exclusive breastfeeding at 6 and 12 weeks after birth | B | ||
Daniele et al, UK, 2018 [4] | Objective: To determine whether an intervention to involve the male partners of pregnant women in maternity care influenced care-seeking, healthy breastfeeding and contraceptive practices after childbirth in urban Burkina Faso Methods: In a non-blinded, multicenter, parallel-group, superiority trial, 1144 women were assigned by simple randomization to two study arms: 583 entered the intervention arm and 561 entered the control arm. All women were cohabiting with a male partner and had a low-risk pregnancy. Recruitment took place at 20 to 36 weeks’ gestation at five primary health centers in Bobo-Dioulasso. The intervention comprised three educational sessions: (i) an interactive group session during pregnancy with male partners only, to discuss their role; (ii) a counselling session during pregnancy for individual couples; and (iii) a postnatal couple counselling session. The control group received routine care only. Participants followed-up at 3 and 8 months postpartum Findings: The follow-up rate was over 96% at both times. In the intervention arm, 74% (432 / 583) of couples or men attended at least two study sessions. Attendance at two or more outpatient postnatal care consultations was more frequent in the intervention than the control group (risk difference, RD: 11.7%; 95% CI 6.0 to 17.5), as was exclusive breastfeeding 3 months postpartum (RD: 11.4%; 95% CI 5.8 to 17.2) and effective modern contraception use 8 months postpartum (RD: 6.4%; 95% CI 0.5 to 12.3) Conclusion: Involving men as supportive partners in maternity care was associated with better adherence to recommended healthy practices after childbirth | 583 | 561 | 2, 5 | Usual care | Midwife | Six hours after birth, and every Saturday morning: a total of 52 meetings | Rate of exclusive breastfeeding for 3 months after birth | B | ||
Maycock et al. Australia, 2013 [9] | Background: Studies have identified numerous factors affecting breastfeeding initiation and duration, including maternal education, mode of delivery, birth weight, socioeconomic status, and support of the infants’ father Objective: The objective was to investigate the effects of an antenatal education session and postnatal support targeted to fathers Methods: The Fathers Infant Feeding Initiative (FIFI Study) is an RCT to increase the initiation and duration of breastfeeding that was conducted in 8 public maternity hospitals in Perth, Western Australia. A total of 699 couples were randomized within hospitals to either intervention or control groups. The intervention consisted of a 2-hour antenatal education session and postnatal support provided to fathers Results: The any breastfeeding rate for the intervention group was significantly greater at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group, OR 1.46; 95% CI 1.01, 2.13. After adjustment for age and hospital, the OR for any breastfeeding in the intervention group was 1.58 (1.06–2.35) and for socioeconomic status (SES), 1.56 (1.06–2.30). The infants of older fathers were more likely to be breastfed at 6 weeks compared to infants of younger fathers (p < 0.01), and infants of fathers with high SES more likely than infants of fathers with low SES (p = 0.013) Conclusion: Even a small increase in breastfeeding rates brings public health benefits. In this study, a minimal intervention was found to significantly increase any breastfeeding at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group | 517 | 431 | 2, 9 | Usual care | Male guide | 6 weeks and 6 months after birth | 6-week feeding pattern, 6-week exclusive breastfeeding rate | B | ||
Chen et al. China, 2021 [10] | Objective: To explore the influence of enhanced father’s participation in supportive nursing on the rate of breastfeeding and growth and development of newborns. Methods: A total of 96 newborns hospitalized in Jiangmen Central Hospital from January 2019 to December 2019 were selected and divided into a control group and an observation group according to the random number table method, with 48 newborns in each group. The control group was given routine nursing, and the observation group was given enhanced father’s participation in supportive nursing. The growth and development of neonates, the rate of breastfeeding and the satisfaction of fathers were compared between the two groups. Results: There were statistically significant differences between the observation group and the control group in terms of body mass, head circumference, body length and other growth and development after 1 month (pp < 0.05). The breastfeeding rate in the observation group was higher than that in the control group, and the difference was statistically significant p < 0.05. The satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant p< 0.05. Conclusions: Enhanced father’s participation in supportive nursing is beneficial to improve the rate of breastfeeding, promote the growth and development of the newborn, and improve the satisfaction of the newborn | 48 | 48 | 2, 4, 6 | Usual care | Nursing staff | 72 h after birth, 1 month after discharge | Exclusive breastfeeding rate 2 h after birth and at discharge | B | ||
Wang et al. China, 2022 [11] | Objective: To explore the influence of father participatory nursing on breastfeeding rate and growth and development of neonates. Methods: 110 neonates born in our hospital from May 2019 to May 2021 were selected and randomly divided into control group and experimental group, with 55 cases in each group. The control group was given routine nursing, and the experimental group was given father participatory nursing on the basis of the control group. The breastfeeding rate and the growth and development in the two groups were compared. Results: After 3 days and 1 month of birth, the breastfeeding rates of the experimental group were higher than those of the control group (p < 0.05). At birth, no statistical difference was found in the weight, head circumference and body length between the two groups (p > 0.05). 1 month after birth, the weight, head circumference and body length of the experimental group were higher than those of the control group (p < 0.05) Conclusions: Father participatory nursing can effectively improve the breastfeeding rate, and promote the growth and development of neonates, which is worthy of clinical promotion and application | 55 | 55 | 1, 3, 6, 7, 8 | Usual care | Nursing staff | Prenatal, hospitalization, 3 days after birth, 1 month after birth | Breastfeeding rate 3 days after birth and 1month after birth | B | ||
Xia et al. China, 2022 [12] | Objective: To investigate the effect of father’s participatory care on primiparous women’s breastfeeding self-efficacy and newborn care skills. Methods: 96 cases of primigravid women who gave birth in the obstetrics department of the hospital from January 2020 to June 2021 were randomly divided into 48 cases in the observation group and 48 cases in the control group. The control group was given routine perinatal care, and the observation group implemented father-participatory care on the basis of the control group. The two groups were compared in terms of self-efficacy for breastfeeding, knowledge and skills related to newborn care, and exclusive breastfeeding rates before hospital discharge and 42 days postpartum Results: Maternal breastfeeding self-efficacy and newborn care knowledge and skills were higher in the observation group than in the control group, with statistically significant differences (p < 0.05); the exclusive breastfeeding rates of the observation group were higher than those of the control group before hospital discharge and 42 days postpartum, with statistically significant differences (p < 0.05). Conclusions: The father-participatory care program included fathers as the target of health education, and provided guidance and training to mothers and their spouses on breastfeeding and newborn care, which effectively improved the mothers’ mastery of newborn care-related knowledge and skills, and strengthened the mothers’ confidence in breastfeeding, which has positive significance for promoting breastfeeding and improving the quality of postpartum health education | 48 | 48 | 1, 10 | Usual care | Nursing staff | Prenatal and postnatal | Rate of exclusive breastfeeding before discharge and 42 days after birth | B | ||
Li, China, 2021 [13] | Objective: To explore the application of father’s participatory health education in maternal postpartum recovery Methods: 76 mothers admitted to the Obstetrics Department of the hospital from January to December 2020 were selected for the study, and were randomly divided into the observation group and the control group, with 38 cases in each group. The control group was given routine perinatal care and health education, and the observation group was given father-participation health education. The two groups were observed and compared in terms of postpartum recovery and the implementation of exclusive breastfeeding Results: The postnatal recovery of the observation group was better than that of the control group, with a statistically significant difference (p < 0.05); the exclusive breastfeeding rate of newborns in the observation group was higher than that of the control group, with a statistically significant difference (p < 0.05) Conclusion: Participatory health education for fathers plays a positive role in postpartum recovery and breastfeeding by mobilizing fathers to participate in postpartum recovery and newborn care, and giving effective support to mothers | 38 | 38 | 1, 2, 10 | Usual care | Nursing staff | Prenatal and postnatal | Exclusive breastfeeding for 42 days after birth | B | ||
Shi et al. China, 2020 [14] | Objective: To explore the effect of father-participated nursing interventions on self-efficacy and behavior of breastfeeding mothers based on self-efficacy theory. Methods: A total of 250 pregnant women in Shaoxing Central Hospital from January 2018 to January 2019 were divided into control group and observation group according to the random number table method, 125 cases in each group. In the control group, the parturients were given routine nursing. In the observation group, the parturients were given father’s participation nursing based on self-efficacy theory. The self-efficacy happiness score and nursing satisfaction of the two groups were compared by various scales, and the rates of exclusive breastfeeding were calculated Results: At 3 days, 1 month, and 3 months postpartum, the maternal breastfeeding self-efficacy scores in both groups were significantly higher than that before nursing ( all p < 0.05). At 1 and 3 months postpartum, the maternal breastfeeding self-efficacy scores in both groups significantly higher than that at 3 days postpartum ( all p < 0.05). At 3 months postpartum, the breastfeeding self-efficacy scores of the two groups were significantly higher than that at 1 month postpartum ( all p < 0.05). At 3 days, 1 month and 3 months postpartum, the breastfeeding self-efficacy scores in the observation group were significantly higher than that in the control group ( p <0.05). At 3 months postpartum, the rate of exclusive breastfeeding of the parturients in the two groups was significantly lower than that of the 3 days postpartum ( p < 0.05) ; at 3 days postpartum and 3 months postpartum, the rate of exclusive breastfeeding of the observation group was significantly higher than that of the control group ( p<0.05). At 3 months postpartum, maternal happiness score of the two groups was significantly higher than that before nursing ( all p < 0.05). At 3 months postpartum, the scores of independence, personal growth, self-acceptance, life goals, good relationship and environmental control of parturients in the observation group were significantly higher than those in the control group ( all p < 0.05). After nursing, the satisfaction rate of the parturients in the observation group ( 96.8% ) was significantly higher than that in the control group ( 81.6%, p < 0.05) Conclusion: Participatory nursing of fathers based on self-efficacy theory can significantly improve the self-efficacy of breastfeeding and the rate of exclusive breastfeeding, and enhance maternal well-being and satisfaction with nursing | 125 | 125 | 1, 2, 6, 8 | Usual care | Nursing staff | Push popular science content every day within 100 days after birth; regular telephone follow-up | Rate of exclusive breastfeeding for 3 days and 3 months after birth | B | ||