COLUMBUS, Ohio -- Three out of four mothers feel that their partner's opinion greatly influences their decision to breast-feed, according to a study at Ohio State University.
While health care professionals often educate expectant mothers about the benefits of breast-feeding, this new research suggests that they should also educate expectant fathers, said Rick Petosa, co-author of the study and associate professor of physical activity and educational services.
Researchers analyzed data from 12 studies on breast-feeding that took place in the United States between 1990 and 1995, and found that mothers consistently reported that their partners' opinions strongly encouraged or discouraged them to breast-feed.
The studies also revealed fathers' attitudes about breast-feeding, and many of the negative attitudes stemmed from medical misconceptions or feelings that they were being left out.
"When men are more knowledgeable, particularly about the health benefits of breast-feeding for the child, they tend to be more supportive," said Petosa. "But they tend to discourage breast-feeding for a variety of complex reasons."
Petosa and Manoj Sharma, now assistant professor of health education at the University of Nebraska, Omaha, published their findings in a recent issue of the Journal of the American Dietetic Association. At the time of the study, Sharma was health promotion supervisor at the Columbus Health Department.
Breast-feeding rates across the country have increased slightly since 1990, according to the American Academy of Pediatrics (AAP), although the numbers are still lower than they were in the mid-80s. In 1995, 59.5 percent of new mothers in the United States were breast-feeding when they were discharged from the hospital, but only 21 percent continued to nurse for the AAP-recommended minimum of 6 months. In a policy statement released in December 1997, the AAP urged all mothers to consider breast-feeding for the infant's first 12 months. In the statement, the AAP acknowledged physicians must better educate expectant mothers about breast-feeding, but Petosa said the AAP didn't place enough emphasis on the father's role.
Across the 12 studies Petosa examined, the proportion of women who reported that their mate's opinion affected their decision to breast-feed varied from 64 percent to 87 percent, with an average of about 75 percent.
Four of the studies specifically addressed fathers' attitudes about breast feeding. By far, the most common reasons that men gave for not supporting breast-feeding included their fear of separation from the mother, envy of the special bonding between the mother and child and general feelings of inadequacy because only the mother can breast-feed the child.
Petosa and Sharma cited one study in particular in which fathers feared that if they supported breast-feeding, they wouldn't bond with their child until weaning. "Fathers have many emotional reactions to breast-feeding," said Petosa. "The most obvious is the feeling of being an outsider during the first few days when the mother and child are bonding. Consciously or subconsciously, some men will try to undermine bonding between mother and child -- they'll encourage bottle feeding."
Petosa said men don't need to feel left out. For instance, many women who breast-feed use breast pumps to store milk in bottles, and men can feed the baby with a bottle while the mother is working, or while she catches a much-needed nap. Another solution is to set aside specific times for father-child bonding.
The studies revealed misconceptions among men, including the idea that infant formula is better for a baby than breast milk. This runs counter to the AAP's opinion that breast milk is the best source of nutrition for infants because it aids growth and development and bolsters the infant's immune system.
In its policy statement, the AAP also cited studies that show breast-feeding may help prevent sudden infant death syndrome, and may even enhance an infant's mental development.
The Ohio State study also revealed some of men's other misconceptions, such as the fear that breast-feeding is somehow bad for breasts and will make their wife's breasts appear ugly or less attractive. "There is no medical evidence that breast-feeding alters women's breasts permanently, yet these beliefs are real barriers that need to be directly addressed in a caring and supportive environment," said Petosa. "Individual attitudes about breast-feeding get confounded by our society's views of breast-feeding and sexuality."
He added that health educators can help change men's attitudes by dispelling misconceptions and giving them positive information, such as the fact that breast-feeding is not only good for babies, but helps mothers lose weight postpartum.
These recommendations may be hard for physicians to follow, since men do not always accompany women to prenatal care visits. Historically, researchers have documented very little of the role men play in this process, and neither the AAP nor the American College of Obstetricians and Gynecologists track men's participation in prenatal care.
Petosa disagreed with the AAP?s position that physicians are the ones who should educate patients about breast-feeding. He said that physicians cannot properly educate patients, because doctors have only a small amount of time to talk to patients during office visits. Rather, he said physicians should act as gatekeepers who direct women and their partners to educational services like classes on childbirth and breast-feeding.
Contact: Rick Petosa, (614) 292-8345; Petosa.1@osu.edu
Written by Pam Frost, (614) 292-9475; Frost.18@osu.edu
Journal
Journal of the American Dietetic Association