Clin Exp Pediatr.  2024 Jul;67(7):358-367. 10.3345/cep.2023.01375.

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach

• Sartika RAD
• Wirawan F
• Gunawan W
• Putri PN
• Shukri NHM

• KMID: 2556972
• DOI: http://doi.org/10.3345/cep.2023.01375

Abstract

Background
The exclusive breastfeeding (EBF) rate in Indonesia is lower than expected. Among the key factors affecting breastfeeding practices, paternal support has been suggested. Purpose: To explore the role of paternal support in EBF failure among 3-month-old infants.
Methods
This sequential mixed-methods study, part of an ongoing cohort study in West Java in early 2022, included 225 infants. The parents of 3-month-old infants were interviewed. Paternal support was assessed using a 15-point validated questionnaire for a total score of 15–60 points. Multivariate binary regression was used to determine adjusted odds ratios (aORs). The qualitative exploration was based on in-depth interviews (IDIs) and forum group discussions (FGDs) following the quantitative survey.
Results
Of the 225 infants, 52.2% were no longer EBF. High paternal support (greater than the mean score) of breastfeeding was determined in 52.9% of cases (mean± standard deviation, 38.7±6.7 for the overall population vs. 37.5±6.3 and 40.2±6.8 for infants who were and were not EBF at 3 months of age, respectively). Low paternal support was associated with an increased EBF failure rate (aOR, 2.84; 95% confidence interval [CI], 1.46–5.54). Other variables that remained as predictors in the final model were a low birth rate (aOR, 7.35; 95% CI, 1.73–31.20), negative maternal attitude (aOR, 3.31; 95% CI, 1.63–6.75), lower self-efficacy (aOR, 4.82; 95% CI, 2.43–9.57), and lower maternal education level (aOR, 2.87; 95% CI, 1.03– 8.03). The IDIs and FGD observed the importance of the father’s support of the mother and EBF. The qualitative exploration revealed a lack of knowledge about EBF as a parental support barrier.
Conclusion
Paternal support is important for EBF. Paternal involvement in EBF planning encouraged themother to continue. Plans that include fathers in breastfeeding education may help increase paternal support.

Keyword

Breast feeding; Fathers; Social support