Breastfeeding and meeting the needs of partners

 (September 2015)

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Since qualifying as a Breastfeeding Counsellor I have worked with over 500 fathers in antenatal breastfeeding education. The overwhelming impression I am given from them is that of a desire to be involved and to support their partners throughout the process. This desire is borne out in the research (Sherriff et al 2009; Rempel and Rempel 2010; Brown and Davies 2014) and what is interesting is that it also shows that mothers whose partner are supportive are more likely to have a positive breastfeeding experience (Meedya 2010).


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I have subsequently become increasingly interested in supporting this need, particularly as my class experience shows me that often partners have the view that in order to help their partner they must feed the baby, thus ‘relieving’ the mother of the ‘burden’ of breastfeeding. This realisation has altered the balance of information in my classes in order to ensure I cover the benefits of direct skin to skin breastfeeding as well as discussing the physiology of milk supply and demand. Unpicking the myth of ‘not enough milk’ takes up a considerable amount of time and its presence in the opening round is as inevitable as it is heart-sinking.

This information must be adequately shored up by a discussion about what then is the fathers role in this – if they cannot feed the baby then what can they do? It is of vital importance that the support we are encouraging partners to carry out is able to be viewed as complimentary rather than compensatory (Rempel and Rempel 2010) otherwise the ideas will seem hollow and patronising.

From class activities with fathers, and from my own reading and research on the subject, there are a number of ways partners can be involved. Historically research has indicated that fathers feel excluded from breastfeeding (Jordan and Wall 1990; Gamble and Morse 1993) and some contemporary research seems to suggest that not much has changed (Pontes et al 2009), however some interesting work by Sherriff et al (2009) noted that the fathers who realised they had a role and that there were ways they could bond with the baby did not feel excluded. This in part inspired my own dissertation literature review and I explored father’s feelings about breastfeeding with a view to provide insights into why some fathers found it easier to be supportive of breastfeeding than others.

So this supportive role can include helping with babycare; burping, nappy changing, bath time, calming the baby and recognising the signs of hunger (Rempel and Rempel 2010) as well as household tasks. I had an interesting conversation with a father-to-be recently about the division of labour when the first baby arrives. He was baulking at what he saw was an expectation on his partner to become a ‘50’s housewife’ and the idea that he should ‘help her with the housework’ when the housework is not ‘hers’ it is a role they jointly shared. I held high hopes for a collaborative household with that family.

In the light of conversations like these and excerpts from the literature, ensuring the household chores are met in order to avoid unnecessary tension seems a fairer way of discussing the issue and is a reminder of the need for careful use of language.

Some fathers see providing care the mother as a way of being involved, so providing her with food, drink and physical comfort; ‘re-fuelling’ if you like (Rempel and Rempel 2010). It might be helpful to discuss this in relation to continuing the oxytocin effect which they may have already explored in their antenatal labour sessions, relating this to breastfeeding and their role in facilitating the production of this vital hormone; safety, comfort, low stress, nutrition etc.

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Offering advice, being informed and providing encouragement were all identified by Sherriff et al (2009), with other research highlighting the partners need for specific information (Brown and Davies 2014), this being a challenge to the health care professionals involved in antenatal care and education. Rempel and Rempel (2010) found that some fathers saw themselves as a cheerleader role as well as being the person she used to ‘vent’ to where needed. This vision of an encouraging and safe place can also be linked back to the breastfeeding oxytocin effect.

The same research identified that some fathers found breastfeeding to be convenient, i.e. not having to wake for feeds or make up formula and while the temptation might be to offer this as an incentive, some fathers may find this insulting and see it as an implication that they are lazy with no desire to help (Brown and Davies 2014) and this is unlikely to be the case.

Helping fathers to make the link between supporting the mother and creating their own bond with their new infant may well be the key. Encouraging activities such as baby wearing, partner skin to skin where appropriate, going for walks, singing, talking and playing music to the baby are all enjoyable ways to aid bonding.

My focus in my classes now when I facilitate small group work with fathers is to encourage them to visualise the time they will spend with their babies doing these activities with the aim of helping them to look forward to those times and enable them to realise the vital role they inhabit as the non-feeding parent of a newborn.

References

Brown, A. and R. Davies. 2014. Fathers’ experiences of supporting breastfeeding: challenges for breastfeeding promotion and education. Maternal and Child Nutrition. 10:510-526
Gamble, D., and J. Morse. 1993. Fathers of breastfed infants: postponing and types of involvement. Journal of Obstetrics, Gynecology and Neonatal Nursing. 22:358-365
Jordan, P., and V. Wall. 1990. Breastfeeding and Fathers: Illuminating the darker side. Birth. 17:210-213
Meedya, S., K. Fahy., and A. Kable. 2010. Factors that positively influence breastfeeding duration to 6 months: A literature review. Women Birth 23(4):135-145
Pontes, C., M. Osorio., and A. Alexandrino. 2009. Building a place for the father as an ally for breast feeding. Midwifery. 25:195-202
Rempel, L., and J. Rempel. 2010. The Breastfeeding Team: The Role of Involved Fathers in the Breastfeeding Family. Journal of Human Lactation. 27(2):115-121
Sherriff, N., V. Hall., and M. Pickin. 2009. Fathers perspectives on breastfeeding: ideas for intervention. British Journal of Midwifery. 17:283-287