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Father with infant

Study: Fathers impact infant breastfeeding, fall short on safe sleep practices

June 16, 2023

Fathers are influential in encouraging breastfeeding for their infants, but few are following AAP’s safe sleep guidelines, according to a new study.

“As pediatricians, we focus on how to ensure the best health outcomes for children, with successful breastfeeding and safe sleep practices being two key behaviors that impact children’s health,” senior author Craig Garfield, M.D., FAAP, said in a press release. “Our study highlights the fact that fathers play a big role in both these behaviors, but there is more to be done to support fathers.”

Garfield and his colleagues at Northwestern University Feinberg School of Medicine and the Anne & Robert H. Lurie Children’s Hospital of Chicago joined with researchers from the Centers for Disease Control and Prevention and Georgia Department of Health to study new fathers in Georgia. They analyzed survey data on 250 Georgia fathers two to six months after their infant’s birth and reported their findings today in “Fathers, Breastfeeding, and Infant Sleep Practices: Findings from a State-Representative Survey,” (Parker JJ, et al. Pediatrics. June 16, 2023).

The AAP’s safe sleep guidance calls for placing infants on their back on a firm, flat surface without soft objects. Infants should sleep in their parents’ room but on a separate surface designed for infants for at least the first six months.

Researchers found about 81% of the Georgia dads put their infants on their back to sleep, 44% avoided soft bedding and 32% used an approved sleep surface. Just 16% followed all three. Rates of putting infants on their back and avoiding soft bedding were lower for Black fathers compared to White fathers. About two-thirds of fathers said a health care provider counseled them on all three practices.

"Fathers need to receive counseling on all the safe sleep practices for their infants,” lead author John James Parker, M.D., said in a press release. “To reduce racial disparities in sudden unexpected infant death, we need tailored strategies to increase safe infant sleep practices in the Black community, including public campaigns to increase awareness and home visiting programs. These interventions must involve both parents to be most effective.”

The AAP recommends exclusive breastfeeding for six months and supports continued breastfeeding until two years or beyond. The survey data showed 86% of infants were breastfed and 63% were breastfeeding at eight weeks. A father’s support of breastfeeding appeared to have an impact. Among those who wanted the infant’s mother to breastfeed, 95% did so compared to 69% when fathers had no opinion or preferred no breastfeeding. At eight weeks, 78% were still breastfeeding when a father encouraged it compared to 33% when a father did not encourage it.  

Breastfeeding rates were higher when the infant’s father had a college degree. In addition, infants of Hispanic fathers had higher breastfeeding rates than infants of White fathers.

“Many families do not gain the health benefits from breastfeeding because they are not provided the support to breastfeed successfully,” Dr. Parker said. “Fathers need to be directly engaged in breastfeeding discussions, and providers need to describe the important role fathers play in breastfeeding success.”




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