Paternal Breastfeeding Involvement, Paternal-Infant Attachment, and Breastfeeding Outcomes: A Prospective Cohort Study.

RESEARCH AIM: To examine the relationship between paternal breastfeeding involvement and paternal-infant attachment with exclusive breastfeeding (EBF) and total breastfeeding duration. METHODS: This prospective observational cohort study included fathers of 1-month-old infants recruited through convenience sampling. Paternal breastfeeding involvement was assessed using the Partner Breastfeeding Influence Scale (PBIS). Paternal-infant attachment, paternal depressive symptoms, and marital adjustment were evaluated using validated instruments. Assessments were conducted at 1, 6, and 12 months postpartum. At 12 months postpartum, breastfeeding continuation, total duration, and reasons for cessation were obtained through follow-up interviews. RESULTS: The rate of EBF at 6 months was 86.1% (198/230), and continued breastfeeding at 12 months was 73.9% (170/230). Higher PBIS scores were significantly associated with both EBF at 6 months and longer total breastfeeding duration (p < 0.001). Higher paternal breastfeeding involvement and stronger paternal-infant attachment were independently associated with increased odds of EBF. Each 1-point increase in PBIS total score was associated with a 3.1% increase in the odds of EBF (aOR, 1.031; 95% CI [1.013, 1.048]). CONCLUSION: Paternal breastfeeding involvement and paternal-infant attachment were independent predictors of EBF and longer breastfeeding duration. These findings support the importance of father-inclusive breastfeeding interventions to improve breastfeeding outcomes.