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Does Breastfeeding Really Push Dads to the Sidelines?

Professional discussion about fathers and breastfeeding tends to focus on two main themes: the importance of fathers' support for successful breastfeeding, (1, 2) and breastfeeding as a challenge or hindrance to men's involvement with babies. (3,4)  Research by Francine de Montigny,  professor of nursing at the Université du Québec en Outaouais, and Canadian Research Chair in psychosocial family health, provides a number of insights on the latter theme.

Past research has found that even though most fathers believe that breastfeeding is best for their child, many report that their inability to participate in feeding inhibits their ability to form a bond with their infant and gives rise to feelings of inadequacy. (5,6) Findings from de Montigny's research program, The Fatherhood and Infant Feeding Project, deepen our understanding of fathers' ambivalent feelings about breastfeeding and also challenge the common assumption that bottlefeeding helps fathers be more involved with babies.

The Fatherhood and Infant Feeding Project

 "In our research, fathers of breastfed babies scored just as high as fathers of bottlefed babies on scales of father involvement, and in fact the dads of breastfed babies were involved in a greater variety of activities than dads of formula-fed babies," says de Montigny. "The men with breastfed infants were holding and comforting their babies, giving baths and baby massages, while the involvement of the fathers of bottlefed children tended to be more centred around giving the baby a bottle. I think fathers imagine that being able to give the baby a bottle will help them become involved in lots of other ctivities, but in our study this was not the case." (7)

Moreover, fathers who were invested in breastfeeding  (strong belief in the value of breastfeeding combined with support for partner) said that breastfeeding created a feeling of closeness in the family and that it did not interfere with their fathering.  However, what's interesting is that even these invested fathers still said breastfeeding made them feel inadequate on a certain level. "These fathers felt that their babies had this one crucially important need that they were unable to meet, because it could only be met through breastfeeding,"  says de Montigny. "It was sad to hear some fathers say, ‘I can't do the most important thing." (7)

Educating Dads About Nurturing and Connecting with Babies

This, says de Montigny, points to a gap in the messages parents are getting about the essential needs of infants.  "It seems that when it comes to meeting the needs of an infant, for some parents the whole focus is on breastfeeding.  These fathers did not seem to be aware that all the things they were doing - the skin-to-skin contact and other physical contact that occurs during comforting, bathing, infant massage and other kinds of routine baby care - are also very, very important for their baby's well-being and brain development," she says. "We need to do a better job of communicating this to parents in general but fathers in particular."

A quick review of online advice for fathers of breastfed babies shows that, while it does tend to stress all the other things fathers can do apart from breastfeeding such as holding, bathing, changing or comforting the baby, these are presented as alternative ways to bond with a baby. That's true, of course, but, de Montigny argues that advice for fathers should also spell out the ways in which the physical contact and interaction that take place during non-feeding aspects of baby care make vital contributions to an infant's neurological, emotional and social development." (8) We need to make this clearer to fathers in public health messaging," says de Montigny.

Other Findings from the Fathers and Infant Feeding Project

Not all dads are invested in breastfeeding.  Some are highly invested, that is they believe strongly in the importance of breastfeeding and want their partner to breastfeed: others are less personally invested in breastfeeding, but still very supportive of their partners, while others are neither invested nor highly supportive of their partners. "But what all these fathers had in common was that they wanted to be involved with their children," says de Montigny. (7)

Breastfeeding problems are stressful for fathers as well as mothers. It is well known that breastfeeding problems are stressful for mothers, but de Montigny's research shows the stress extends to fathers as well. (9) Some fathers reported feeling devastated when their wives stopped breastfeeding early because of problems.  It also turns out that stress related to breastfeeding can affect a father's sense of competence in parenting, which, in turn, can affect his involvement." (10) In our model we did not find a direct relationship between stress and involvement but we found an indirect relationship," says de Montigny. "The more stress fathers felt, the less competent they felt, and fathers who felt less competent tended to be less involved." Surprisingly, higher levels of breastfeeding support were associated with higher levels of stress in fathers. This might be partly because parents who are having problems, which, as noted, are stressful, are more likely to seek out breastfeeding support than those for whom things are going smoothly. 

Dads give thumbs down to breastfeeding help The connection between support and stress in fathers can also be partly explained, de Montigny says, by her finding that fathers in her sample almost universally rated breastfeeding help as unhelpful. "When the help you get with breastfeeding problems isn't helpful, that, in itself, is stressful," she says.

Over 80% of fathers in de Montigny's most recent paper reported that breastfeeding help they received from professionals was not helpful.10 She believes this may be partly because breastfeeding support and advice is almost always focused on or addressed to the mother. "We had fathers tell us that during home visits nurses talked only to the mother, even though, in some cases it was the father who had called asking for help." The only breastfeeding help fathers rated as helpful was the support they got from their partners, a finding that is consistent with other research which shows that fathers' involvement tends to be highly influenced by the level of support they get from their partners. (11,12)

References:

1. Arora, S., McJunkin, C., Wehrer, J., Kuhn P. Major factors influencing breastfeeding rates: mother's perception of father's attitude and milk supply. Pediatrics, 2000;106(5):e67-e71.

2. Pisacane, A., Continisio, G.I., Aldinucci, M., D'Amora, S., Continisio, P. A controlled trial of the father's role in breastfeeding promotion. Pediatrics, 2005;116(4):e494-e498.

3. Gamble. D., Morse, J. Fathers of breastfed infants: postponing and types of involvement. Journal of Obstetrical and Gynecological Neontal Nursing. 1993; 22(4): 358-365.

4. Littman, H., Medendorp, S., Goldfarb, J. The decision to breastfeed: the importance of a father's approval. Clinical Pediatrics. 1994;33(4):214-219.

5. Bar-Yam N.B., Darby L. Father and breastfeeding: a review of the literature. Journal of Human Lactation. 1997;13(1):45-50.

6. Jordan P.L., Wall V.R. Breastfeeding and fathers: illuminating the darker side. Birth. 1990; 17(4): 210- 213.

7.  de Montigny, F., Devault, A., Miron J. Lacharité, C., Goudreau, J., Brin, M., Groulx. A., P., Gervais. C., Langlois. C.,A., Robichaud. F., Baker., M., Salesse-Gauthier, E., Demet., S., Meilleur. N., Gauthier. M., Gauthier., S.  L'expérience des pères de l'Outaouais de l'allaitement maternel et de la relation père-enfant. Research report presented in 2007 to the cadre du Programme de subventions en santé publique de l'Agence de Santé et des Services Sociaux de l'Outaouais.

8. McCain M.N., Mustard, J.F.,  Shanker, S. Early Years Study 2. Putting Science into Action. 2007, Council for Early Child Development

9. deMontigny F., Lacharité C., Fathers' Perceptions of the Immediate Postpartal Period.  Journal of Gynecological and Neonatal Nursing, 2004: 33(3): 328-339

10. deMontigny F., Lacharité C., Devault, A. Transition to Fatherhood. Modeling the experience of fathers of breastfed infants. Advances in Nursing Science. 2012; 35(3): e11-e22

11. Hoffman. J.A. Father Factors What social science research tells us about fathers and how to work with them. ( Chapter 2: The Mother of All Influences. How Dads are Shaped by Moms) Father Involvement Research Alliance, 2011. www.fira.ca/cms/documents/211/FatherFactorsFinal.pdf

12. deMontigny F., Lacharité C., Amyrot. E. The Transition to Fatherhood: The role of formal and informal support structures during the post-partum period. Texto, Contexto Enferm, Florianopolis, 2006: 15(4) 601-609.