Partner behaviours improving breastfeeding outcomes: An integrative review

Problem: The impact of specific supportive behaviours of a woman's partner on breastfeeding outcomes is unclear. Background: Breastfeeding is beneficial for the infant, mother, and society. Partner support plays a significant role in promoting breastfeeding. Strategies to improve breastfeeding rates have had limited success with rates worldwide remaining well below World Health Organization recommendations, contributing to significant morbidity, mortality, and economic burden globally. Aim: To determine what specific supportive behaviours of a breastfeeding woman's partner increase breastfeeding initiation, exclusivity, and duration rates in Western-culture settings. Methods: A Population-Interest-Context framework-based search strategy was applied to the Cumulative Index to Nursing Allied Health Literature Plus with full-text, Web of Science, Scopus, and PubMed databases, limited to primary research published January 2008-December 2018 in English conducted in Western-culture settings. Findings: From 652 articles, after critical appraisal seven articles (eight studies) satisfied the requirements of this integrative review. Supportive behaviours were categorised as knowledge, help, encouragement, and responsiveness. Help and encouragement behaviours were associated with increased initiation. Results were mixed regarding behaviours affecting exclusivity and duration; however, responsiveness was found to ameliorate otherwise generally negative effects of knowledge, help, and encouragement on these outcomes. Discussion: Consistent with wider social support research, awareness of receiving support is associated with negative health consequences. However, where partner support is provided in a responsive manner as part of a 'breastfeeding team', thereby promoting the woman's sense of autonomy and self-efficacy, breastfeeding outcomes improve. Conclusion: Responsive partner behaviours improved breastfeeding outcomes in Western-culture settings. Further primary research is needed. (C) 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.