Examination Date

6-2022

Degree

Dissertation

Degree Program

Nursing (PhD)

Examination Committee

Gloria, Giarratano, Susan Orlando, Marie Adorno, Alessandra N. Bezzano, Shakira Henderson

Abstract

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Despite medical recommendations and health benefits associated with breastfeeding, there are racial disparities among breastfeeding outcomes. Nationally, breastfeeding initiation of Black infants (69.4%), continued breastfeeding at three months (58%) and six months (44.7%), lags behind that of White infants, respectively (85.9%; 72.7%; 62%) (Beauregard et al., 2019). Breastfeeding rates among African American (AA) women are disproportionately worse in the deep southern portion of the United States than the rest of the country, with breastfeeding initiation rates of AA women in Louisiana (48.9%) well below the Healthy People 2020 target of 81.9% (Louisiana Department of Health - Bureau of Family Health, 2014).

Studies indicate that fathers/partners have a pivotal role in a mother’s decision to breastfeed, as well as providing support for breastfeeding (Banks et al., 2013). Insufficient and inadequate social support by fathers/partners is a modifiable barrier that can be addressed to increase initiation and continuation of AA breastfeeding and improve women’s breastfeeding experiences. Fathers’/Partners’ attitudes, beliefs, and knowledge about breastfeeding and their

paternal role perception can impact their ability to be supportive. Few studies have explored AA fathers’/partners’ perceptions of infant breastfeeding, the barriers and facilitators to supporting breastfeeding partners, and ways to improve the paternal social support role in breastfeeding.

The purpose of this study was to describe AA fathers’/partners’ attitudes, beliefs, and knowledge about breastfeeding; their role perception in supporting their breastfeeding partner; and strategies to improve their role. Husserl’s descriptive phenomenological approach was employed utilizing semi-structured interviews. Purposive sampling was used to recruit 12 AA fathers/partners of women who were currently or had previously exclusively breastfed their infant/toddler for at least two weeks or longer within the last 24 months. Participants were

interviewed via a Zoom platform using open-ended guided questions. Interviews were recorded and transcribed into text and uploaded into NVivo software to organize and analyze the data. Colaizzi’s (1978) analytic method guided the thematic analysis, and Lincoln and Guba’s (1985) evaluation criteria ensured study rigor.

Study results included the following: Theme 1: It’s a Breastfeeding Journey, Sub-theme A: Learning on the Fly, Sub-theme B: Time and Space for Intimacy; Theme 2: Like an Assistant; Theme 3: Male Mindset Towards Breastfeeding, and Sub-theme A: Sensitivity Towards Public Breastfeeding. The participants were overall positive about breastfeeding and supported their respective partner’s decisions. The participants described their breastfeeding journey and how they lived through the experience with their partners, helping to overcome challenges faced through the journey, including varied lactation problems and lack of time and space for couple intimacy. The fathers described their perceived role as that of an assistant, who provided both physical and emotional support, characteristic of all forms of social support.

Participants were recommended strategies more sensitive to men/fathers to better prepare them for their role supporting partners, including men-to-men education or mentoring and male-focused videos and educational resources. Male perspectives and cultural biases were also described as concerns and fears about public breastfeeding.

Findings from this study can be used by nurses in practice and research to target future interventions aimed at strengthening the father's/partner's role in providing social support and improving breastfeeding outcomes for AA families.

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