Background

It is well known that breastfeeding provides the best nutrition for infants; thus, it is recommended that infants are exclusively breastfed for the first 6 months and continue breastfeeding for 2 years or longer. Most women plan to breastfeed during pregnancy, but many stop earlier than they intend to. In Sweden, exclusive breastfeeding among two-month-old infants has declined from 80% in 2000 to 60% in 2020.

The World Health Organization states that women and their families need breastfeeding support from the healthcare system. However, the healthcare system does not currently meet these support needs. It is important that expectant parents and breastfeeding families have equal access to parental support for breastfeeding. Nevertheless, socio-economically vulnerable groups and families with more than one child are reached to a lesser extent by parental support groups.

Women believe that their partner's attitude and support are essential for exclusively breastfeeding for 6 months. They appreciate it when their partner shares household chores, cares for them, and does not pressure them to use commercial milk formula. At the same time, previous research on partners' perspectives and experiences with breastfeeding shows that their primary goal is to bond closely with the infant. Partners often perceive breastfeeding as a barrier to bonding and feel left out during the breastfeeding period. They describe feeling excluded from breastfeeding decisions and are unsure of their role in making decisions about breastfeeding and providing support.

Partner support can influence breastfeeding, but there is a lack of knowledge about the most effective ways to involve partners in breastfeeding. The aim of the study was to explore partners’ experiences regarding breastfeeding while participating in The Breastfeeding Study.

The Intervention

A structured breastfeeding support programme was implemented in Region Sörmland, Sweden. In order to reach all parents, we offered reflective talks about breastfeeding during regular visits to the midwife at the antenatal clinic and the child healthcare nurse at the child healthcare centre. Parents received breastfeeding support both during the woman's pregnancy and after the infant was born. This support was provided to both first-time and experienced parents and included watching videos about breastfeeding. These videos covered topics such as recognising newborns' signals for breastfeeding and what to do if breastfeeding is challenging. Parents also learned about the benefits of breastfeeding and skin-to-skin contact between parent and infant.

Expectant parents discussed their preferences with healthcare professionals and created a breastfeeding plan, considering their expectations and previous experiences with breastfeeding, as well as the help they desired from each other, relatives, and healthcare professionals. The support also included tips on how the partner could be involved in breastfeeding, such as skin-to-skin contact with the infant, bathing the infant, singing to the infant, or taking the infant for walks.

Results

Both partners in the intervention and control groups felt it was important to be part of the family and that the family's everyday life was well-functioning. Partners who participated in the support programme reported feeling involved and that they cooperated with the mother during the breastfeeding period:

I have taken him out in the pram myself and sit with him a lot. It has been great fun. I have been able to be very involved. There is no difference between us. (Interview IG, Informant 12).

We have been able to... communicate in a good way... you talk so that you are on the same page all the time. But also that you share the practical because it has to work as well. So we have to pump. But that’s not a disadvantage; it’s just that you have to be a little organised.” (Interview IG, Informant 7).

Partners in the intervention group also described how the support from healthcare professionals made them feel secure:

I think it feels safe to have that guidance, and she has been positive about breastfeeding, our nurse; it has felt good. (Interview IG, Informant 14).

However, partners in the intervention group said it was convenient when both parents could share feedings, since it simplified everyday life. They preferred bottle feeding with breast milk in the first place, but it could be topped up with commercial milk formula  when the breast milk was not enough:

Practically - If there’s a moment when it’s just me at home. We think it’s important that he gets as much breast milk as possible and it’s good that...she has time to pump and that there is...in a bottle. (Interview IG, Informant 7).

Knowledge about the health benefits of breastfeeding helped partners to make informed decisions about whether to give breastfeeding or commercial milk formula to the infant:

As much antibodies as possible. Before, I probably thought that it was just a matter of supplementing with formula. But it doesn’t feel like that anymore, considering that we have come to understand that breast milk contains a lot more than just energy. (Interview IG, Informant 9).

Conclusion

The theme for the World Breastfeeding Week 2024 is Closing the gap: Breastfeeding support for all. It is important for healthcare professionals to offer structured support so that it reaches all parents, which means working with the whole family and having a reflective dialogue about how breastfeeding works. That dialogue has revealed that partners are keen to feed the infant. It's important to involve the partner, to explain how they can be involved without feeding the infant explains the researchers Ingrid Blixt, Eva-Lotta Funkquist and Ove Axelsson.

For single mothers, it is crucial for healthcare professionals to involve other relatives, such as grandparents, in the support programme.