The development, implementation and evaluation of a father inclusive perinatal support intervention to increase breastfeeding duration : a randomised controlled trial

Breastfeeding is the biological norm for infant feeding and the most efficient and cost-effective method of giving the required nutrition to infants. The World Health Organization, the American Academy of Paediatrics and the National Health and Medical Research Council recommend exclusive breastfeeding for six months and the continuation of complementary foods for up to two years. Although most developed countries maintain high initiation rates, the duration rates fail to meet these recommendations. The promotion of breast milk substitutes, changing societal values, urbanization, and the erosion of traditional support systems pose threats to breastfeeding. In Australia the breastfeeding initiation rates are between 85%-95% but fall to 20%-45% by six months. There is some evidence that fathers, the primary support to their partners, influence the initiation and maintenance of breastfeeding by their partners. There has been little research in this area, however, with little known about the nature of a father’s support required by the mother and few interventions have specifically targeted fathers.The present thesis describes the development, implementation and evaluation of a father inclusive perinatal support intervention at six weeks postnatal. The project was conducted over three years as a randomised controlled trial (RCT) across eight public maternity hospitals in Perth, Western Australia

Can father inclusive practice reduce paternal postnatal anxiety? A repeated measures cohort study using the hospital anxiety and depression scale

Background: Perinatal research on anxiety and depression has primarily focused on mothers. We have limited knowledge of fathers’ anxiety during the perinatal period yet there is evidence that the parenting capacity of a person can be compromised by anxiety and depression. The purpose of this paper is to identify the impact of a father inclusive intervention on perinatal anxiety and depression. The prime focus of the intervention was to provide education and support to fathers of breastfeeding partners with the aim of increasing both initiation and duration of breastfeeding. Methods: A repeated measures cohort study was conducted during a RCT that was implemented across eight public maternity hospitals in Perth, Western Australia between May 2008 and June 2009. A baseline questionnaire which included the Hospital Anxiety and Depression Scale (HADS) was administered to all participants on the first night of their hospital based antenatal education program and was repeated at six weeks postnatal. SPSS version 17was used for reporting descriptive results.Results: The mean anxiety levels at baseline for the fathers in the intervention group (n=289) and control group (n=244) were 4.58 and 4.22 respectively. At 6 weeks postnatal (only matched pairs), intervention and control group were 3.93 and 3.79. More intervention group fathers self-rated less anxiety compared to the fathers in the control group from baseline to post test (p=0.048). Depression scores for intervention fathers at baseline (mean =1.09) and at six weeks (mean=1.09) were very similar to fathers in the control group at baseline (mean=1.11) and at six weeks (mean =1.07) with no significant changes. Conclusions: Both intervention and control group fathers experienced some anxiety prior to the birth of their baby, but this was rapidly reduced at six weeks. Paternal anxiety is common to new fathers and providing them with information and strategies for problem-solving can increase their knowledge and potentially lower the risk of postnatal anxiety

Exploring the scope of consumer participation in mental health nursing education: Perspectives from nurses and consumers

Purpose: Exploration of the views and experiences of nurse academics and consumer academics and educators regarding the scope of consumer participation in mental health nursing education. Design and Methods: A qualitative, exploratory inquiry into the description and views of mental health nurse academics and consumer educators about these roles. Findings: A significant variation in roles from guest speaker to substantive academic positions was evident, with most involvement brief and specifically teaching focused. Consumer participation in education was generally valued but noted to be limited in breadth and scope. Some concern was raised about the relevance of consumer academic roles, with a clear conceptualization of the consumer academic role necessary to facilitate their contribution to the education of health professionals. Practice Implications: Mental health consumer involvement in the education of nurses has been shown to impact positively on the attitudes of health professionals to people with mental illness. Advocacy for increased, meaningful input from consumers into nursing education is therefore necessary to improve practice

Education and Support for Fathers Improves Breastfeeding Rates: A Randomised Controlled Trial

Background: Studies have identified numerous factors affecting breastfeeding initiation and duration, including maternal education, mode of delivery, birth weight, socioeconomic status, and support of the infant’s father. Objective: The objective was to investigate the effects of an antenatal education session and postnatal support targeted to fathers. Methods: The Fathers Infant Feeding Initiative (FIFI Study) is a randomized controlled trial to increase the initiation and duration of breastfeeding that was conducted in 8 public maternity hospitals in Perth, Western Australia. A total of 699couples were randomized within hospitals to either intervention or control groups. The intervention consisted of a 2-hourantenatal education session and postnatal support provided to fathers. Results: The any breastfeeding rate for the intervention group was significantly greater at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group, odds ratio 1.46 (95% CI, 1.01-2.13). After adjustment for age and hospital, the odds ratio for any breastfeeding in the intervention group was 1.58 (1.06-2.35) and for socioeconomic status (SES), 1.56(1.06-2.30). The infants of older fathers were more likely to be breastfed at 6 weeks compared to infants of younger fathers(P < .01), and infants of fathers with high SES more likely than infants of fathers with low SES (P = .013).Conclusion: Even a small increase in breastfeeding rates brings public health benefits. In this study, a minimal intervention was found to significantly increase any breastfeeding at 6 weeks: 81.6% in the intervention group compared to 75.2% in the control group

Heading into fatherhood-nervously: support for fathering from online dads

Men are becoming increasingly aware of and keen about the promises of involved fathering, and there is growing recognition of the need to support fathers, especially in the postnatal period. However, there is limited evidence of how best to offer this support. In this article, we investigate a new avenue of support that is gaining popularity in the public health sector: the Internet. Using qualitative methods, we examine messages in an asynchronous online chat room for new fathers to reveal how fathers themselves requested, offered, and received social support. Features of their communication style included humor and self-disclosure. An emergent, overarching purpose of their communications was to make fathering more “visible,” and to encourage each other to engage confidently and wholeheartedly in fathering