Monday, November 28, 2011

Men’s Support for Breastfeeding

By James Achanyi-Fontem
CEO, Cameroon Link
WABA Men’s Working Group Coordinator
Why involve men in breastfeeding?
Breastfeeding is an important part of reproduction and health that biologically involves mothers and children. However, breastfeeding also concerns fathers as their attitudes towards breastfeeding strongly influence the mothers own point of view.
Fathers are generally an important source of support in a mother´s decision to breastfeed and in its implementation. There is also a positive connection between the degree of father support and the total duration of breastfeeding. A father´s involvement in the breastfeeding situation strengthens his relationship to both the child and partner, and helps him to develop his parental role in general. Highlighting the father’s role in more general terms such as parenting can broaden the argument for supporting breastfeeding.

Advantages of an active father role in parenting

Acclaimed researchers describe several advantages when both parents are active and engaged in taking care of children, compared to only one active parent. A few examples:
• Children’s psychological development and social skills are favoured in the communication with two committed parents.
• Fathers develop their empathic ability, considering that women are more trained at this.
• A more equal division of responsibilities increases the possibilities for both parents to fill many roles within the family complex, which tend to make them more satisfied with their lives.
• Cultures where fathers are more committed to childcare seem to produce less hostility and violence between men and women, compared to other cultures.

The role of the father is a gender issue

Gender that is considered to be masculinity versus femininity is a system of continually evolving social practices, which defines roles, assigns resources, and establishes power relations. According to this definition, gender roles are dynamic, constructed through social interaction, reinforced and reproduced by social institutions.
Gender researchers claim that as long as women are assumed to be more responsible than men for childcare, women´s role as mothers will continue to be a major obstacle to their achieving economic and social equality with men. Therefore, father’s involvement in childcare, including breastfeeding, is clearly a gender issue.
Gender equity and equality work towards a society where women and men have equal opportunities, rights and obligations in all aspects of life. From a gender perspective, how paid work and care giving are combined reflects assumptions and norms in the gendered situations of family and work.

Learning about gender issues – for all men

A father’s relation to breastfeeding relates to his and the environments perception of what his role should be. Traditionally, caring for children is not an important part of the concept of masculinity, as it is in the concept of femininity. This issue must be discussed and our ideas about masculinity must be challenged.
Just like the mothers, fathers need knowledge and incentives to be supportive. Attitudes concerning breastfeeding are influenced from all kinds of sources surrounding the family - relatives, friends, practitioners, legislators - and these attitudes can be linked to values of lifestyle and stereotype gender roles. In this perspective breastfeeding should be a concern, not only for fathers, but for all men.

Enabling men to be more supportive
Parental education
Many men need to be better prepared to assume a role as breastfeeding supporters. Studies have shown that breastfeeding education and promotion programs have effects on knowledge, attitudes and support for breastfeeding. Evidence suggests that even simple and inexpensive interventions can increase the level of breastfeeding knowledge of men.
In his supportive role it is also important that the father understands what it means for a woman, both physically and psychologically, to go through pregnancy, delivery and start breastfeeding. A well informed father knows the importance of being patient and sensitive as the mother recovers from the birth experience and gains confidence in breastfeeding. By importing the same knowledge and sharing the breastfeeding moments, the father is helping the new mother to gain breastfeeding skills. He can also protect her from misinformation about breastfeeding in the community, or even well-meant advice from friends and relatives. Sharing the care and responsibility of the new life will strengthen the parental relationship in this difficult period of transition and adjustment.
Today most preparatory courses for parents are organized by the maternity health care. The education is generally of a practical nature and focusing on medical factors of pregnancy, delivery and breastfeeding. This important forum should also involve issues of social and individual change, and create space for especially fathers to reflect on their situation and role. By focusing on and activating fathers, their role strengthens and they get a wider knowledge, more adjusted to their life situation and thus more useful to them.
There are, of course, many different ways to construct a support group for parents, where they get information and can discuss parenthood. The right way to do it depends on the interests and needs of the people you are aiming at. For instance, a group of men work differently a few months before delivery compared to some months after the child is born.
It is generally easier to reach fathers before delivery than after, which is the time when most decisions on infant feeding are made. The most crucial step is how you invite them to participate: what kind of information about the group is shared, who it is that deliver this information and through which channel. In reaching fathers, it might be better if the "speaker" is a man that the forum addresses complimentary issues that you would expect the target group to be interested in like economics of breastfeeding. This will help to avoid pictures and expressions that might come through as feminine in any printed material, etc

Supporting fathers

Fathers need support to be supportive. During the period of pregnancy, the expectant mother attends counseling sessions at the clinic, but her partner is not counseled. A father that views himself to be subordinate as parent and does his part mostly out of expectation and duty is not likely to give support of a higher quality. It is important for the mother to trust her partner and to show that trust by inviting him to jointly take care of the little child. The father can also be motivated by understanding the advantages of him spending time with the baby, for example that it is likely to benefit the well-being of the whole family.
In becoming a parent, mothers are generally more in touch with examining this new step in life compared to fathers. The supportive role of the father is depending on the values of people around him. Often it is not expected of a father to engage himself in the care of the newborn baby.
A mother may need time and space for relaxation, especially when the child is anxious or ill. Those periods it is an advantage if the father and child have developed a contact that allows the mother to be alone for awhile, to rest and regain strength without having to worry about the other two. This procedure of course requires that the mother is willing to give this confidence and that the father wants to take it. Breastfeeding can sometimes inhibit fathers from developing close relationships to their children and also have a negative effect on the parent relationship. This is a concern that has to be dealt with. Fathers may feel excluded, jealous and resentful to the detriment of breastfeeding success and the adult couple relationship. Helping fathers to find other ways and situations where they can develop a close relationship with their child will be important.
Fathers sometimes feel neglected and made disassociated by relatives, friends and even the maternity services. Fathers can feel themselves as”parent number two” or, even worse, not to be reckoned with as child-care givers at all. Maternity services should develop methods that signal to fathers that they are important and offer them special information on papers or arranging special father groups or meetings.

Delivering right messages

Information can, if delivered in a right way, influence fathers and change their views and behaviour. Engaging with family professionals can impact positively on fathers’ negative behaviour and parenting styles; increase their knowledge and understanding of child development; increase their confidence in their parenting skills; and lead to more sensitive and positive parenting and to greater involvement in infant and child care, and in interaction with children.
In countries where it is accepted that fathers are present during delivery, fathers should be encouraged to do so as his presence during delivery seems to have positive effects on the well-being of both the mother and the baby. Having the father nearby during the first hours after labor seems to make it easier for mothers to successfully initiate breastfeeding and also seems to positively influence the duration of breastfeeding. This needs to be encouraged.

Father´s attitudes towards breastfeeding

Some fathers harbor misconceptions and negative attitudes toward breastfeeding. To overcome obstacles, issues of breastfeeding need to be discussed with both parents, during childbirth preparation classes and prenatal visits. Professionals must make sure that this information reaches the fathers.
The two most common ideas about reasons for the negative attitudes of fathers is concern that their partner's breasts may be exposed to others and that the breasts may change and get less attractive. Actually there is not much knowledge about why some fathers are negative about breastfeeding. If we knew more about this, better measures could be taken.
As described above, a mother's perception of her partner's attitudes toward breastfeeding influences her choice of infant feeding method. However, she is often wrong about this. Scientific research has shown that fathers may have more favorable attitudes toward breastfeeding than their partners think.

Postpartum Depression

Postpartum depression is a common affliction which severely can lower mothers’ incentive to breastfeed and in other ways cause difficulties to babies’ health. If rightly informed, fathers can be made watchers over the psychological health of their partner, as they are likely to know them rather well and notice if there is some serious trouble arising, and if necessary act so help can be requested through contact with the local maternity service or others.

Young fathers

Young fathers can be seen as a special risk group. Young fathers have a harder time identifying themselves as fathers and, surprisingly enough, professionals tend to neglect them. Also, concerning young couples, the quality of the relationship between the couple themselves seem to be the most important factor for high father involvement the months after birth. This is another argument for involving the importance of the parental relationship in the information offered by the maternity health care and other professionals

Actions for behavior change communication

•Breastfeeding education should be provided to all adult family members, including the father.
•Parenting interventions should always include fathers.
•Give professionals training and methods to reach and educate parents in a way that promotes breastfeeding. Methods may need to be developed to meet the requirements of today’s parents. Among other things a modern and thoroughly accomplished preparatory course would give parents tools for creating a family situation aiming at communication, support and satisfaction, which is favorable to everyone concerned, including the child.
•The World Health Organisation (WHO) recommends six months of exclusive breastfeeding and complementary feeding plus partial breastfeeding until the child is two years old. This step should be taken by authorities in all countries.
•Spread the knowledge that children are favored by much contact with both its parents.
•A father should be encouraged to let his partner frequently know that he approves of her breastfeeding, and let others know as well.
•Spread images that taking care of children is a masculine behavior.
•Influence politicians and governments to produce laws that give fathers the possibilities to engage more in the concerns of home and children, and mothers the possibilities to engage more in bread-winning labor.
•Start groups for fathers, especially those who live in a vulnerable life situation. Remember that a first time father usually has no knowledge about all the facts that could be important for him and his child, what his role could be, and that he has to battle against much of prejudice if he wants to become what he can become as a father.
•Find out why fathers have negative views towards breastfeeding and with that knowledge know what to do and how to meet those attitudes...
•Many representatives of society must embrace that they are working in organizational structures that are built long ago and as such carries old values, and that it is one of the duties of these professionals to acknowledge this and make efforts for change.
•Men (and boys) should encourage other men (and boys) to engage in taking greater responsibility in domestic work, caring for children, safe sex and family planning.