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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Breastfeeding.

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Strategy. Father/Partner Engagement

Approach. Support and offer social support to expecting and new fathers/partners seeking information and advice around providing breastfeeding support

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Overview. Social support for breastfeeding and in particular support of the babies’ fathers have been identified as crucial elements for successful breastfeeding. A mother’s partner can act as a strong enabler or barrier to breastfeeding. Educational interventions to engage fathers/partners can include father/partner-focused breastfeeding education classes and digital technologies such as mobile apps and social media platforms.[1] More research is needed for conclusive results.

Evidence. Expert Opinion. Strategies with this rating are recommended by credible, impartial experts, guidelines, or committee statements; these strategies are consistent with accepted theoretical frameworks and have good potential to work. Often there is literature-based evidence supporting these strategies in related topic areas that indicate this approach would prove effective for this issue. Further research is needed to confirm effects in this topic area.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of fathers/partners who receive education on breastfeeding support. (Measures the reach of father/partner-focused educational efforts.)
  • Number of father/partner-focused breastfeeding classes or workshops offered. (Quantifies opportunities for fathers/partners to learn breastfeeding support skills.)
  • Number of community organizations engaged to promote breastfeeding education for fathers/partners. (Tracks collaboration with trusted community entities.)

OUTCOME MEASURES:

  • Number of fathers/partners who report increased knowledge of how to support breastfeeding. (Assesses the educational impact of interventions for fathers/partners.)
  • Number of fathers/partners who attend breastfeeding support groups with their partner. (Measures active father/partner participation in breastfeeding support activities.)
  • Number of fathers/partners who access breastfeeding educational resources (e.g., handouts, videos, apps). (Tracks father/partner utilization of supportive tools and information.)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of breastfeeding education materials that are inclusive of diverse family structures and father/partner roles. (Assesses inclusivity of educational content.)
  • Percent of father/partner breastfeeding education that incorporates adult learning principles and interactivity. (Measures the use of effective educational strategies.)
  • Percent of breastfeeding support staff who receive training on engaging fathers/partners. (Tracks workforce development to enhance father/partner support skills.)

OUTCOME MEASURES:

  • Percent of fathers/partners who report increased confidence in their ability to support breastfeeding. (Measures the interventions' impact on father/partner self-efficacy.)
  • Percent of breastfeeding mothers who report active support and encouragement from their partner. (Assesses the mother's perception of partner support, a key enabler for breastfeeding.)
  • Percent of fathers/partners who can identify at least 3 specific ways they can support breastfeeding. (Captures fathers'/partners' knowledge of tangible support strategies.)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of healthcare providers who routinely engage fathers/partners in breastfeeding education during prenatal care. (Measures father/partner engagement in health care settings.)
  • Number of WIC clinics offering targeted breastfeeding education and resources for fathers/partners. (Tracks integration of father/partner support into existing programs.)
  • Number of employers providing breastfeeding education and support for fathers/partners in the workplace. (Assesses father/partner engagement in employment settings.)

OUTCOME MEASURES:

  • Number of breastfeeding challenges (e.g., latch issues, milk supply) resolved with father/partner support. (Captures the direct impact of partner assistance on breastfeeding issues.)
  • Number of mothers with supportive partners who breastfeed exclusively for 6 months. (Links partner support to achievement of a key breastfeeding duration goal.)
  • Number of father/partner testimonials and success stories shared to promote breastfeeding support. (Measures dissemination of father/partner champions and peer role models.)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • - Percent of father/partner breastfeeding education resources available in the languages spoken in the community. (Assesses linguistic accessibility of education.)
  • - Percent of breastfeeding support groups and services that welcome and accommodate fathers/partners from diverse cultural backgrounds. (Measures cultural inclusivity.)
  • - Percent of funding for breastfeeding education and support that is dedicated to father/partner engagement. (Tracks equitable resource allocation for this strategy.)

OUTCOME MEASURES:

  • - Percent of low-income fathers/partners who receive breastfeeding education and support services. (Assesses reach and impact of efforts among socioeconomically disadvantaged families.)
  • - Percent increase in breastfeeding initiation and duration among families where fathers/partners were actively engaged, compared to baseline. (Measures population-level impact.)
  • - Percent of mothers who report that partner support was a key factor in their decision to continue breastfeeding. (Captures mothers' voiced perceptions of partner influence.)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Evidence for this strategy includes:

Wolfberg AJ, Michels KB, Shields W, O’Campo P,Bronner Y, Bienstock J. Dads as breastfeeding advocates: results from a randomized controlled trial of an educational intervention. Am J Obstet Gynecol. 2004; 191:708-712.
Arora S, McJunkin C, Wehrer J, Kuhn P. Major factors influencing breastfeeding rates: mother’s perception of father’s attitude and milk supply. Pediatrics. 2000; 106:E67.
Libbus K, Bush TA, Hockman NM. Breastfeeding beliefs of low-income primigravidae. Int J Nurs Stud. 1997;34:144-150
Sihota, H., Oliffe,J., Kelly, M.T., & McCuaig, F. (2019). Fathers’ Experiences and Perspectives of Breastfeeding: A Scoping Review. American Journal of Men’s Health.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.