Exclusive breastfeeding in rural Western China: does father\u2019s co-residence matter?

Lifang Zhang,Yaojiang Shi,Weiqi Nie,Shuyi Song,Ying Li,Nan Wang,Jie Yang,Andrew John Hartnett,Zhuo Liu,Jingchun Nie

doi:10.1186/s12889-021-12025-8

Abstract

BackgroundChina suffers from a low exclusive breastfeeding rate. Though it has been proofed that paternal support benefits breastfeeding a lot, the correlation between father’s co-residence and exclusive breastfeeding in China remain undiscovered. This study is to provide population-based evidence for the association of paternal co-residence on exclusive breastfeeding in rural western China. We also attempt to detect how the process works by examining the correlation between the father’s co-residence and breastfeeding family support as well as maternal decision-making power.MethodsA cross-sectional study was conducted in 13 nationally-designated poverty-stricken counties in the Qinba Mountains area in 2019. Data on breastfeeding practices, the status of fathers co-residence, breastfeeding family support, and maternal decision-making power were collected via structured questionnaires from 452 caregivers-infant pairs. Multivariate regressions were conducted to explore the correlation between paternal co-residence and exclusive breastfeeding.ResultsThe exclusive breastfeeding (0–6 months) rate was 16% in rural western China. Fathers’ co-residence was associated with a lower exclusive breastfeeding rate (OR = 0.413, 95% CI = 0.227–0.750, P = 0.004) and the rate did not improve when the father was the secondary caregiver. Even ruling out support from grandmothers, the association was still negative. Paternal co-residence did not improve maternal perceived breastfeeding family support, neither practically nor emotionally (β =0.109, P = 0.105; β =0.011,P = 0.791, respectively) and it reduced maternal decision-making power (β = − 0.196, P = 0.007).ConclusionsFathers’ co-residence is negatively associated with the exclusive breastfeeding rates in rural western China. More skill-based practical and emotional strategies should be considered on father’s education to help them better involvement and show more respect to mothers’ decisions.

Highlights

China suffers from a low exclusive breastfeeding rate
There were more than half of the fathers (53.5%) co-residing with their families
This study found that co-residence with fathers was associated with a significantly lower rate of exclusive breastfeeding in rural western China

Summary

Introduction

China suffers from a low exclusive breastfeeding rate. Though it has been proofed that paternal support benefits breastfeeding a lot, the correlation between father’s co-residence and exclusive breastfeeding in China remain undiscovered. This study is to provide population-based evidence for the association of paternal coresidence on exclusive breastfeeding in rural western China. We attempt to detect how the process works by examining the correlation between the father’s co-residence and breastfeeding family support as well as maternal decision-making power. China still suffers from a low exclusive breastfeeding rate for the first 6 month ranging from 20 to 30% in both urban and rural areas [3, 4]. With a growing number of women being employed, inadequate paid maternity leave and unsupportive work environments are major contributors to the low exclusive breastfeeding rate worldwide [5, 6]. Understanding the exclusive breastfeeding practice in rural China are essential for those children to get adequate nutrition, and for Chinese government to achieve the exclusive breastfeeding rate target of 50% by 2020 [8]

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