BACKGROUND: Further research gaps exist in relation to the promotion of breastfeeding. Robust scientific evidence obtained by a meta-analysis would provide objectively summarized data while enabling the assessment of consistency of findings. This review includes the first documented meta-analysis done on the effectiveness of targeting fathers for promoting breastfeeding (BF). Assessments have been done for a primary outcome and for six more secondary outcomes.
METHODS: PubMed, EMBASE, Google Scholar, CENTRAL databases and unpublished researches were searched. Selections of randomized-controlled trials and quasi-experimental studies were done in three rounds. Heterogeneity and potential publication bias were assessed. Eight studies were included in meta-analysis and others in narrative synthesis of the outcomes. Pooling was done with the Mental- Haenszel method using risk ratio (RR). Summary-of-Findings table was composed by Review-Manager (version 5.3) and GRADEproGDT applications. Subsequent sensitivity analysis was done.
RESULTS: Selected eight interventional studies included 1852 families. Exclusive BF at six months was significantly higher (RR=2.04, CI=1.58-2.65) in the intervention groups. The RR at 4 months was 1.52 (CI=1.14 to 2.03). Risk of full-formula-feeding (RR=0.69, CI=0.52-0.93) and the occurrence of lactation-related problems were lower in the intervention groups (RR=0.24, CI=0.10-0.57). More likelihood of rendering support in BF-related issues was seen in intervention groups (RR=1.43, CI=1.22-1.68). Increase of maternal knowledge and favorable attitudes on BF were higher in the intervention groups (P <=; 0.001). The quality of evidence according to GRADE was "low" (for one outcome), "moderate" (for four outcomes), and "high" (for two outcomes).
CONCLUSIONS: Targeting fathers in promotion of BF has provided favorable results for all seven outcomes with satisfactory quality of evidence.