Thai Fathers’ Self-Efficacy to Support Exclusive Breastfeeding

Introduction: Breastfeeding is an optimal feeding approach for children and is critical to public health. Fathers’ support plays an important role in successful exclusive breastfeeding, as it influences mothers’ breastfeeding practices, including breastfeeding initiation and duration. Moreover, fathers’ self-efficacy to support breastfeeding is known to be an important influence on infant feeding practices. This study aimed to determine whether Thai fathers’ self-efficacy to support exclusive breastfeeding was related to exclusive breastfeeding duration and to explore Thai fathers’ confidence to provide exclusive breastfeeding support. Methods: Using a mixed-methods design, data collection was conducted in Chiang Mai, Thailand, among couples whose infants had exclusively breastfed for up to 6 months. In the quantitative phase, 205 father-mother couples completed a sociodemographic questionnaire and the Breastfeeding Self-Efficacy Scale (Short-Form). Father participants also completed the Father’s Attitude toward Exclusive Breastfeeding questionnaire. In the qualitative phase, semi-structured interviews were conducted with 30 couples using an interview guide based on the breastfeeding self-efficacy theory to gain deeper insight into fathers’ confidence to support exclusive breastfeeding. Survey data were analyzed using descriptive statistics, bivariate correlation, and Tobit regression, and interview transcripts were subjected to content analysis. Results: Survey data showed that paternal and maternal breastfeeding self-efficacy was positively associated with longer duration of exclusive breastfeeding (ρ=0.19 and ρ=0.54, respectively). Paternal self-efficacy was also positively correlated with maternal self-efficacy (ρ=0.30, p=.01). However, the results of Tobit regression analyses indicated that paternal self-efficacy did not moderate the relationship between maternal self-efficacy and exclusive breastfeeding duration. Only maternal self-efficacy was significantly associated with duration of exclusive breastfeeding (B=.16, p<.01). During content analysis of the interview data, five major themes emerged: my partner told me that she would like to breastfeed, so I totally agreed with her; breastfeeding is women’s business; confidence is dynamic; seeking knowledge and support; and institutional support and obstacles for breastfeeding. Conclusion: Paternal self-efficacy was positively related to maternal self-efficacy and exclusive breastfeeding duration. Inclusion of fathers in breastfeeding education interventions in both antenatal care clinics and postpartum units should be considered to enhance their confidence to support exclusive breastfeeding and to increase Thailand’s overall exclusive breastfeeding rate.