Feeding attitudes of fathers in the United States are associated with breastfeeding success: A cross-sectional study

Background/Aims: Fathers are increasingly recognized as a source of breastfeeding support. This online cross-sectional study examined the relationship between fathers’ feeding attitudes and breastfeeding outcomes (initiation, duration, exclusivity) and factors influencing breastfeeding. Methods: Demographic characteristics, anthropometric measurements, and infant feeding methods were self-reported. The Iowa Infant Feeding Attitude Scale (IIFAS) assessed the feeding attitudes of 509 fathers in the USA (34.4 ± 5.2 years). Significance was determined using chi-square tests and analysis of variance (p <.05). Results: The IIFAS categorized participants into feeding attitude groups (positive to formula feeding (PFF), n = 142; neutral feeding (NF), n = 270; positive to breastfeeding (PBF), n = 97). The mean IIFAS score (55.7 ± 16.0) suggested fathers have a neutral attitude toward breastfeeding. The PBF group reported a longer duration of breastfeeding (17.1 ± 7.1 months) compared to the PFF (6.1 ± 3.0 months) or NF (12.7 ± 7.3 months) groups (p <.001). The PFF group reported that their child initiated complementary liquids earlier (18.0 ± 5.8 weeks) compared to the NF or PBF groups (NF = 21.5 ± 13.8; PBF = 24.5 ± 9.2 weeks; p <.001). Initiation of complementary solids was statistically different between the PFF group (21.3 ± 5.4 weeks) and the NF and PBF groups (NF = 26.4 ± 12.0; PBF = 26.4 ± 6.1 weeks; p <.001). Breastfeeding initiation was associated with the feeding attitude group (p <.001). Among those that reported their partner initiated breastfeeding, the feeding source (breastmilk, breastmilk + formula) was associated with the feeding attitude group (p <.001). Reasons for not breastfeeding exclusively or breastfeeding cessation were related to concerns about maternal/child health, convenience, and processes associated with breastfeeding. Conclusions: Fathers’ feeding attitudes are related to breastfeeding success. Research should explore education and interventions for fathers to improve breastfeeding rates.