Breastfeeding as Family Teamwork

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By: Duncan Fisher, The Family Initiative

Families play a crucial role in breastfeeding practices. Research has shown that women who have support from their family, partner and broader social network are more likely to initiate and continue breastfeeding. Nevertheless, health care providers do not always engage with families very effectively. Studies in diverse global settings have demonstrated the benefit of engaging partners and families on breastfeeding practices.

A team of researchers in Vietnam documented a large increase in breastfeeding by engaging fathers using breastfeeding education materials, counselling services at community health centers and home visits. The rates of early breastfeeding initiation and exclusive breastfeeding at 4 months were twice as high among families who received these services compared to those who did not.

When families in China received information about how fathers can support breastfeeding, exclusive breastfeeding increased from 26% to 51% at 4 months, and 18% to 40% at 6 months. A similar Turkish trial increased exclusive breastfeeding at 6 months from 33% to 56%. In Indonesia, the inclusion of fathers, grandmothers and community leaders resulted in a six-fold increase in exclusive breastfeeding at 5 months.

Following their own trials in Canada, Jennifer Abbass-Dick and Cindy-Lee Dennis developed a Breastfeeding Co-parenting Framework that includes five basic principles:

  1. Setting breastfeeding goals together
  2. Shared responsibility
  3. Mutual support
  4. Bonding between the baby and other family members
  5. Good communication

Lynn and John Rempel in Canada study the nature of breastfeeding support and have found that not all types of family support are helpful. Knowledge on the part of family members may not be enough and can even be counter-productive. They found that breastfeeding rates were higher among mothers who reported that the father of the baby was not only knowledgeable, but also “present” and “responsive to their needs”. A component of responsiveness is knowing when one is not needed and letting the mother become confident and skilled in her own way. Supporting the autonomy of women should be a foundation for family inclusive breastfeeding support.

More research and evaluation are needed. A 2012 Cochrane systematic review of breastfeeding support programs did not include any family inclusive programming. As exemplified in Pakistan, in many cases, partners and family members are willing to learn about and support breastfeeding but do not receive the information or services they need. To maximize impact, efforts to promote breastfeeding should leverage the relationships that mothers have with their partners, family and loved ones. How can providers, researchers and public health professionals encourage family inclusive breastfeeding while respecting women’s autonomy?

This post is based on a recent review published by the Family Initiative by a team of breastfeeding researchers: Jennifer Abbass-Dick, Tran Huu Bich, Lynn Rempel, John Rempel and Duncan Fisher

Read more about Duncan Fisher’s work on family inclusive maternal health care.

Learn about the role of breastfeeding in the Sustainable Development Goals agenda.