Current Status and Influencing Factors of Fathers’ Early Support for Breastfeeding Self-Efficacy in China: A Cross-Sectional Survey

Current Status and Influencing Factors of Fathers’ Early Support for Breastfeeding Self-Efficacy in China: A Cross-Sectional Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current Status and Influencing Factors of Fathers’ Early Support for Breastfeeding Self-Efficacy in China: A Cross-Sectional Survey Rui Yu, YiFei Zhang, Can Zhu, ZhangDong ying This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8676744/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background: Breast milk is the optimal source of infant nutrition, yet breastfeeding rates in China remain below recommended targets. The father is a key source of social support for breastfeeding; fathers’ breastfeeding support self-efficacy may shape their involvement and, in turn, influence breastfeeding initiation and duration. However, evidence remains limited regarding factors associated with fathers’ breastfeeding support self-efficacy in the early postpartum period and its relationship with mothers’ breastfeeding self-efficacy. Methods: A two-wave survey was conducted among 216 families (newborns’ father and mother) recruited from a tertiary hospital in Beijing, China. Fathers’ breastfeeding support self-efficacy, breastfeeding-related knowledge, and relevant sociodemographic and family factors were assessed at 72 hours postpartum (T1) and 2 weeks postpartum (T2), alongside mothers’ breastfeeding self-efficacy at the same time points. Data were analysed using descriptive statistics, correlation analyses, and multiple linear regression to identify factors associated with fathers’ breastfeeding support self-efficacy Results: Fathers’ breastfeeding support self-efficacy was positively correlated with mothers’ breastfeeding self-efficacy at T1 (r=0.219, p<0.05), with a stronger association at T2 (r=0.462, p<0.05). In multivariable regression, fathers’ breastfeeding knowledge, participation in the breastfeeding process, paternity leave, and exposure to breast-milk substitute advertising were significantly associated with fathers’ breastfeeding support self-efficacy (all p<0.05). Conclusion : Fathers’ breastfeeding support self-efficacy was at a moderate level, and higher paternal breastfeeding support self-efficacy was associated with higher maternal breastfeeding self-efficacy. Paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, and breastfeeding-related knowledge were significant correlates of fathers’ breastfeeding support self-efficacy. Breastfeeding Paternal breastfeeding support self-efficacy Family support Figures Figure 1 Background The benefits of breastfeeding for both mothers and infants are well established [1,2]. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life, with continued breastfeeding alongside appropriate complementary foods up to 24 months of age or beyond [3]. Studies indicate that the rate of exclusive breastfeeding among infants younger than six months should exceed 50%[4]. However, current breastfeeding practices in China fall well short of this goal. A national survey conducted in 2019 reported an exclusive breastfeeding rate of only 29.2% among infants younger than 6 months in China [5]. Breastfeeding practices are influenced by a multitude of factors [6], with social support recognized as a crucial and modifiable component. Across different sources of support (e.g., healthcare providers, family members, and peers), paternal support is closely associated with breastfeeding decision-making, initiation, duration, and maternal confidence [7,8]. Previous studies suggest that when fathers feel unconfident or frustrated in providing breastfeeding support, mothers face a substantially higher risk of discontinuing breastfeeding [9,10]. Self-efficacy refers to an individual's belief in their ability to perform a specific behavior in a given context and plays a key role in behavioral regulation.Dennis proposed the concept of fathers’ breastfeeding support self-efficacy, positing that fathers’ confidence in supporting breastfeeding can influence their supportive behaviours and, in turn, affect maternal breastfeeding practices [11].The early postpartum period, particularly from hospitalization through the first few weeks after discharge, represents a critical window for establishing and sustaining breastfeeding. It is also a time when challenges most commonly emerge and behaviors remain most amenable to change [12]. Despite its importance, research remains limited on the characteristics, correlates, and longitudinal relationship between fathers’ breastfeeding support self-efficacy and mothers’ breastfeeding self-efficacy during this early postpartum phase. Therefore, we conducted surveys at 72 hours postpartum and again at 2 weeks postpartum to: (1) describe fathers’ breastfeeding support self-efficacy at both time points; (2) examine factors associated with fathers’ breastfeeding support self-efficacy; (3) test the association between spousal breastfeeding support self-efficacy and mothers’ breastfeeding self-efficacy at each time point; and (4) describe the distribution of infant feeding modes at 2 and 6 weeks postpartum. Methods Study design This study surveyed the same families (the newborn’s father and mother) at 72 hours postpartum (T1) and at 2 weeks postpartum (T2). Participants at T2 were restricted to those who provided valid responses at T1. Infant feeding method was additionally followed up at 6 weeks postpartum. Setting and participants The study was conducted between June and November 2022 in the obstetric ward of a tertiary hospital in Beijing, China. Using convenience sampling, we recruited postpartum mothers who delivered during their hospital stay and their spouses (fathers). Eligibility criteria were as follows: (a) Father: (1) living with the mother; (2) able to read and communicate in Chinese. (b) Mother: (1) aged ≥22 years; (2) gestational age ≥37 weeks; (3) singleton pregnancy; (4) rooming-in with the infant within 24 hours of birth; (5) intention to breastfeed. (c) Newborn: (1) birthweight ≥2500 g; (2) 1-minute Apgar score ≥8. The exclusion criteria were as follows:(a) refusal to participate after being approached; (b) diagnosed mental illness or cognitive impairment; (c) breastfeeding contraindications in the mother (e.g., severe heart disease), or breastfeeding contraindications or sucking difficulties in the newborn; and (d) inability or unwillingness to complete follow-up via telephone or text message. Sample size Based on a commonly used rule of thumb for multivariable analyses, the sample size is typically 5–10 times the number of independent variables. We anticipated 15 potential correlates; using a 5:1 ratio yielded a minimum of 75 participants. Allowing for approximately 30% attrition and invalid questionnaires, we planned to recruit at least 100 mother–father dyads per group. In total, 216 families were included. Data collection procedures and time points Data were collected using an electronic questionnaire administered via the Wenjuanxing platform. Eligible families were identified in the obstetric ward by the research team. After the study aims and procedures were explained, written informed consent was obtained. The information collected at each time point is summarised in Fig. 1. At T1, the father completed a demographic questionnaire, the Father Support Breastfeeding Self-Efficacy Scale–Short Form (FBSES-SF), and the Comprehensive Breastfeeding Knowledge Scale (CBKS). The mother completed a demographic questionnaire and the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF).At T2, the father completed the FBSES-SF and CBKS again and additionally answered items related to breastfeeding involvement (whether he had participated in the breastfeeding process and family members’ attitudes towards his involvement). The mother reported the infant feeding mode and completed the BSES-SF. At 6 weeks postpartum, the mother was contacted for follow-up to ascertain the infant feeding mode. At T1, mothers’ contact details (telephone/email/WeChat) were collected to facilitate follow-up. Because obtaining fathers’ contact details directly was sometimes difficult, fathers’ questionnaires were provided to mothers with instructions, and mothers forwarded the survey link to the father for completion. Measures 1.General information questionnaire A general information questionnaire was developed by the research team based on a review of the literature. It comprised sections for both the father and the mother. The father section collected demographic and background information, including age, educational attainment, ethnicity, religious affiliation, occupation, monthly per-capita household income, parity, paternity leave availability, exposure to breastfeeding-related situations, intended feeding method, whether he had accessed breastfeeding- and pregnancy-related health information, exposure to breast-milk substitute (infant formula) advertising, and whether he had been involved in the breastfeeding process. The mother section collected information on age, ethnicity, educational attainment, and occupation. 2. Father Breastfeeding Self-Efficacy Scale–Short Form (FBSES-SF) Fathers’ breastfeeding support self-efficacy was assessed using the short form of the Fathers’ Breastfeeding Support Self-Efficacy Scale (FBSES-SF) developed by Dennis and colleagues in 2018 [13]. The scale was translated and culturally adapted into Chinese by Zhou Yang and colleagues. The Chinese version comprises 14 items, with a total score ranging from 14 to 70. Each item is rated on a 5-point Likert scale from 1 (“not at all confident”) to 5 (“very confident”), with higher scores indicating greater breastfeeding support self-efficacy in the father. The Chinese version has demonstrated excellent internal consistency, with a Cronbach’s α of 0.935 [14]. 3. Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) The Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) is a self-report instrument used to assess mothers’ breastfeeding self-efficacy [15]. The scale was translated and culturally adapted into Chinese by Liu Yanjin and colleagues. The Chinese version comprises 14 items, each rated on a 5-point Likert scale ranging from 1 (“not at all confident”) to 5 (“very confident”), yielding a total score of 14–70. Higher scores indicate higher breastfeeding self-efficacy in mothers. The Chinese version has demonstrated good internal consistency, with a Cronbach’s α of 0.927 [16]. 4.Comprehensive Breastfeeding Knowledge Scale (CBKS) Breastfeeding knowledge was measured using the Comprehensive Breastfeeding Knowledge Scale (CBKS) developed by Jennifer Abbass-Dick and colleagues. The CBKS contains 28 items with a total score ranging from 28 to 84 and comprises three domains: Domain I, milk supply management (7 items; score range 7–21); Domain II, persisting through challenges (10 items; score range 10–30); and Domain III, correcting misconceptions (11 items; score range 11–33). The scale has shown good internal consistency, with a Cronbach’s α of 0.83 [17]. 5.Infant feeding method Infant feeding method was assessed using a 24-hour recall by asking how the infant had been fed during the 24 hours prior to the survey. Feeding method was categorized as exclusive breastfeeding, mixed feeding, or formula feeding. Statistical analysis Data were analyzed using SPSS version 25.0. Categorical variables were summarized as frequencies and percentages. Continuous variables with an approximately normal distribution were described as mean ± standard deviation (mean ± SD). Differences in fathers’ breastfeeding support self-efficacy across levels of categorical variables (e.g., ethnicity) and differences in fathers’ breastfeeding support self-efficacy across time points were examined using independent-samples t tests or one-way analysis of variance (ANOVA), as appropriate. Associations between fathers’ breastfeeding support self-efficacy and breastfeeding knowledge were assessed using Pearson’s or Spearman’s correlation coefficients, depending on data distribution. Multivariable analyses were performed using multiple linear regression. All statistical tests were two-sided, and a p value ≤ 0.05 was considered statistically significant. Results 1. Sample recruitment and follow-up A total of 216 family dyads were initially approached and provided with questionnaires.At T1, 180 valid maternal questionnaires were returned (83.3%), and 167 valid paternal questionnaires were returned (77.3%).At T2, questionnaires were re-administered to the previously valid sample (n = 180); 130 valid maternal questionnaires (72.2%) and 114 valid paternal questionnaires (63.3%) were returned.Infant feeding mode at 6 weeks postpartum was obtained for 130 mothers. 2. Participant characteristics Participants’ sociodemographic and study-related characteristics are presented in Tables 1–2.At T1, 180 mothers were included in the analysis,the mean maternal age was 33.00±3.81years, and 51.67% had a postgraduate degree or above.A total of 167 fathers were included in the analysis , with a mean age of 34.44±4.26 years.Among fathers, 96.41% reported no religious affiliation, 95.21% were of Han ethnicity, 71.86% had local household registration, and 84.43% were first-time fathers.In addition, 55.69% of fathers had a postgraduate degree or above , and 47.31% reported a per-capita monthly household income of≥RMB 20,000.Overall, educational attainment and income levels were relatively high in this sample, which may reflect the study setting in Beijing, China, where education levels are generally higher.(Table 1) Regarding fathers’ breastfeeding-related experiences and attitudes (Table 2), 82.0% had paternity leave, 79.6% reported exposure to breastfeeding-related situations, and 93.4% had discussed infant feeding methods with the mother.The most commonly reported feeding intention was mixed feeding (breast milk plus formula) (59.9%), followed by exclusive breastfeeding (40.1%).Over half of fathers (52.1%) reported exposure to breast-milk substitute advertising, and 90.4% believed that breastfeeding requires cooperation between partners.At 2 weeks postpartum, 86.0% of fathers reported having been involved in the breastfeeding process (n = 114). Table 1 Sociodemographic Characteristics of Mothers and Fathers Variable Category No. n(%) Mother (n=180) Age ( ) 33.00 3.81 educational attainment Postgraduate or above 93(51.67) Bachelor’s degree or below 87(48.33) profession company employee 106(58.89) civil servant 16(8.89) teacher 9(5.00) merchant 3(1.67) medical workers 10(5.56) professional 14(7.78) Other occupations or none 22(12.22) Father (n=167) Age ( ) 34.44 4.26 religion Yes 6(3.59) No 161(96.41) Ethnicity Han Chinese 159(95.21) Ethnic minorities 8(4.79) educational attainment Postgraduate or above 93(55.69) Bachelor’s degree 64(38.32) Below bachelor’s degree 10(5.99) Hukou status Local hukou 120(71.86) Non-local hukou 47(28.14) Monthly per capita household income (RMB, CNY) ≥ 20,000 79(47.31) 15,000–19,999 27(16.17) 10,000–14,999 49(29.34) <10,000 12(7.19) Parity Primiparous 141(84.43) Second parity 26(15.57) Table 2. General characteristics of fathers (n = 167) Variable Category No. n(%) Paternity leave Yes 137(82.04) No 30(17.96) Prior breastfeeding exposure Yes 133(79.64) No 34(20.36) Discussion on feeding methods Yes 156(93.41) No 11(6.59) Preferred feeding method Exclusive breastfeeding 67(40.12) Mixed feeding 100(59.88) Formula milk feeding 0 Intended breastfeeding duration Not planned or < 3 months 21(12.57) 3–6 months 40(23.95) 6–12 months 63(37.72) 12–18 months 27(16.17) ≥18 months 16(9.58) breast-milk substitute advertising Yes 87(52.10) No 80(47.90) Belief in collaborative breastfeeding Yes 151(90.42) Not sure 11(6.59) No 5(3.00) Involvement in the breastfeeding process (n = 114) Yes 98(85.96) No 16(14.04) Perceived social disapproval of father's involvement (n = 114) Yes 7(6.14) Not sure 9(7.90) No 82(71.93) Not involved 16(14.04) Note: Exposure to breastfeeding contexts refers to having personally experienced breastfeeding-related situations (e.g., having been breastfed oneself, witnessing others breastfeeding, etc.). 3.Infant feeding method The exclusive breastfeeding rates at 2 and 6 weeks postpartum were 38.5% and 43.8%.The remaining infants were fed with mixed feeding to varying degrees or formula feeding(Table 3). Table 3. Infant feeding practices(n = 130) Category n(%) T1 T2 No other liquids or solid foods were given to the infant besides breast milk, including water; however, vitamin or mineral supplements and medicinal drops or syrups were allowed. 38.5 43.8 In addition to breast milk, the infant was given water or fruit juice, but no more than 1–2 times per day and no more than 1–2 sips each time. 3.1 0.8 The infant consumed less than one bottle of formula per day, and breast milk accounted for ≥80% of the infant’s total intake. 19.2 31.5 The infant consumed at least one bottle of formula per day, and breast milk accounted for 20–79% of the infant’s total intake. 33.8 20.0 Breast milk accounted for <20% of the infant’s total intake. 3.8 3.1 Breastfeeding was used only for comfort and did not provide caloric intake. 0.8 0 No breast milk was given; the infant was fed formula only. 0.8 0.8 4. Analysis of fathers’ breastfeeding support self-efficacy scores Fathers’ total scores on the Father Breastfeeding Self-Efficacy Scale–Short Form (FBSES-SF) at T1 and T2 were 51.71 ± 8.88 and 52.50 ± 9.79, respectively.A one-way analysis of variance was used to compare FBSES-SF total scores between the two time points, and no statistically significant difference was observed ( p = 0.481).(Table 4) At T1, item 2 had the highest mean item score, whereas item 4 had the lowest.At T2, item 9 had the highest mean item score, whereas item 4 had the lowest.The item with the lowest mean score was consistent across both time points (item 4).(Table 5) Table 4. Comparison of fathers’ breastfeeding support self-efficacy scores between T1 and T2 Time point Minimum Maximum F P T1(n=167) 51.71±8.878 25 69 0.498 0.481 T2(n=114) 52.50±9.786 23 70 Table 5. Items with the highest and lowest mean FBSES-SF scores at T1 and T2 Time point Item T1(n=167) Three items with the highest mean scores 2.Successfully cope with breastfeeding like I have with other challenging tasks 3.96 ± 0.763 10.Deal with the fact that breastfeeding can be time-consuming 3.89 ± 0.784 1.Determine that our baby is getting enough milk 3.89 ± 0.846 Three items with the lowest mean scores 4.Help mom ensure that our baby is properly latched on for the whole feeding 3.44 ± 0.985 14.Tell when our baby is finished breastfeeding 3.46 ± 0.903 12.Help mom continue to breastfeed our baby for every feeding 3.48 ± 0.917 T2(n=114) Three items with the highest mean scores 9.Be satisfied with our breastfeeding experience 3.95 ± 0.818 2.Successfully cope with breastfeeding like I have with other challenging tasks 3.94 ± 0.823 7.Keep wanting mom to breastfeed our baby 3.90 ± 0.872 Three items with the lowest mean scores 4.Help mom ensure that our baby is properly latched on for the whole feeding 3.48 ± 0.961 6.Help mom manage to breastfeed even if our baby is crying 3.50 ± 0.943 3.Help mom breastfeed our baby without using formula as a supplement 3.56 ± 0.941 5. Analysis of mothers’ breastfeeding self-efficacy scores Mothers’ total scores on the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF) at T1 and T2 were 46.24 ± 10.32 and 47.68 ± 11.73, respectively.A one-way analysis of variance was used to compare BSES-SF total scores between the two time points, and no statistically significant difference was observed (p = 0.253).(Table 6) Table 6. Comparison of mothers’ breastfeeding self-efficacy scores across time points Time point Minimum Maximum F P T1(n=180) 46.24±10.323 14 70 1.309 0.253 T2(n=130) 47.68±11.732 17 70 6. Correlation between fathers’ breastfeeding support self-efficacy and mothers’ breastfeeding self-efficacy Correlation analyses showed that fathers’ breastfeeding support self-efficacy was positively correlated with mothers’ breastfeeding self-efficacy at both T1 and T2.Specifically, higher fathers’ breastfeeding support self-efficacy scores were associated with higher mothers’ breastfeeding self-efficacy scores (both p < 0.05).(Table 7) Table 7. Correlation between fathers’ breastfeeding support self-efficacy and mothers’ breastfeeding self-efficacy Category Time point FBSES-SF score(s) Pearson’s r P BSES-SF score(s) T1(n=167) 0.219 0.005 T2(n=114) 0.462 <0.001 7. Fathers’ CBKS total and domain scores Fathers’ total CBKS scores at T1 and T2 were 69.10 ± 5.56 and 72.05 ± 4.29, respectively.A one-way analysis of variance was used to compare CBKS total scores between the two time points, and the difference was statistically significant (p < 0.05).(Table 8) Table 8. Fathers’ CBKS total and domain scores Domain T1(n=167) T2(n=114) F* P Score Mean item score Score Mean item score Domain I 18.87±2.077 2.70±0.30 19.86±1.545 2.84±0.221 25.210 <0.001 Domain II 24.32±2.630 2.43±0.263 25.61±2.114 2.56±0.211 Domain III 25.90±3.043 2.36±0.277 26.58±2.975 2.42±0.270 Total score 69.10±5.564 2.47±0.199 72.05±4.290 2.57±0.153 Note: (1) Dimension I: Breast milk supply management; Dimension II: Perseverance in the face of challenges; Dimension III: Correcting misconceptions. (2) F*: Approximate F distribution; Welch’s test was used. (3) Comparisons of partners’ breastfeeding knowledge scale scores were based on the total score. 8. Univariate analysis of fathers’ breastfeeding-support self-efficacy The results of the univariate analyses of fathers’ breastfeeding-support self-efficacy are presented in Table 9.No statistically significant differences in fathers’ breastfeeding-support self-efficacy scores were observed by age, educational level, household income, exposure to breastfeeding-related situations, whether the couple had discussed the intended feeding method, planned duration of breastfeeding, agreement that breastfeeding requires joint cooperation, or prior access to breastfeeding-related health information (P>0.05).In contrast, parity, paternity leave entitlement, preferred feeding method, exposure to breast-milk substitute advertising, involvement in the breastfeeding process, and perceived discouragement from family members or others (i.e., the belief that fathers should not or are not suitable to be involved in breastfeeding) were significantly associated with fathers’ breastfeeding-support self-efficacy scores (P<0.05). Table 9 Univariate analysis of fathers’ breastfeeding-support self-efficacy by participant characteristics (n=167) Variable Category n t/F P Parity -2.000 0.047 Primiparous 141 51.02±8.488 Second parity 26 54.80±9.704 Paternity leave -2.711 0.007 no 30 47.80±8.495 yes 137 52.56±8.759 Preferred feeding method 4.376 <0.001 Exclusive breastfeeding 67 55.19±8.631 Mixed feeding 100 49.37±8.292 Table 9 Univariate analysis of fathers’ breastfeeding-support self-efficacy by participant characteristics (n=167) Variable Category n t/F P Exposure to breast-milk substitute advertising -2.860 0.005 yes 87 50.15±9.368 no 80 53.40±8.033 Involvement in the breastfeeding process (n = 114) 4.327 <0.001 yes 98 53.93±8.776 no 16 43.75±11.328 Perceived discouragement from family members or others regarding your involvement in breastfeeding (n = 98) 2.163 0.003 yes 7 50.00±9.883 Unsure 9 52.78±13.264 no 82 54.39±8.119 At both T1 and T2, breastfeeding knowledge was significantly positively correlated with fathers’ breastfeeding-support self-efficacy (P < 0.05). Higher breastfeeding knowledge scores were associated with higher levels of fathers’ breastfeeding-support self-efficacy.(Table 10) Table 10 Correlation analysis between breastfeeding knowledge and fathers’ breastfeeding-support self-efficacy Category Time point CBKS score(s) Pearson correlation coefficient P FBSES-SF score(s) T1(n=167) 0.327 <0.001 T2(n=114) 0.246 0.008 9. Multivariable analysis of fathers’ breastfeeding-support self-efficacy To further clarify the effects of various factors on fathers’ breastfeeding-support self-efficacy, a multiple linear regression analysis was planned. The FBSES-SF score was used as the dependent variable, and variables that were statistically significant in the univariable analyses were entered as independent variables in the multivariable model. Statistical significance was set at P < 0.05. In multiple linear regression, multicollinearity is considered potentially problematic when tolerance (Tol) is 5.In this study, fathers’ breastfeeding-support self-efficacy at 72 h postpartum was modeled as the outcome, with five candidate predictors entered into the regression model.Collinearity diagnostics showed VIF values ranging from 1.023 to 3.042 and Tol values ranging from 0.330 to 0.977.These results indicate no evidence of substantial multicollinearity among the independent variables.Breastfeeding knowledge was entered into the model as the raw score, and the coding of the remaining variables is presented in Table 11. Table 11 Coding of independent variables Category Coding scheme Parity Primiparous=0 Second parity=1 Paternity leave no=0 yes=1 Preferred feeding method Mixed feeding=0 Exclusive breastfeeding=1 Exposure to breast-milk substitute advertising yes=0 no=1 Involvement in the breastfeeding process no=0 yes=1 The multivariable linear regression analysis showed that paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, and breastfeeding knowledge were independently associated with fathers’ breastfeeding-support self-efficacy at 72 h postpartum.The corresponding regression coefficients (B) for these four variables were 3.327, 4.441, 3.842, and 0.296, respectively.Based on the magnitude of the regression coefficients, the strength of association (from largest to smallest) was as follows: preferred feeding method, exposure to breast-milk substitute advertising, paternity leave, and breastfeeding knowledge.The adjusted coefficient of determination (adjusted R²) was 0.203, indicating that the model explained 20.3% of the total variance in the outcome.Detailed results are presented in Table 12.Accordingly, the regression equation was: fathers’ breastfeeding-support self-efficacy (72 h postpartum) = 18.941+3.327 (paternity leave) + 4.441 (preferred feeding method) + 3.842 (exposure to breast-milk substitute advertising) + 0.296 (breastfeeding knowledge). Table 12 Multiple linear regression analysis of factors associated with fathers’ breastfeeding-support self-efficacy at 72 h postpartum (n = 167) Fathers’ breastfeeding-support self-efficacy at T1 Regression coefficient standard error standardized regression coefficient t P (Constant) 18.941 9.195 2.060 0.041 Parity 1.096 1.758 0.046 0.623 0.534 Paternity leave 3.327 1.618 0.147 2.056 0.041 Preferred feeding method 4.441 1.399 0.246 3.155 0.002 Exposure to breast-milk substitute advertising 3.842 1.255 0.218 3.061 0.003 Breastfeeding knowledge 0.296 0.125 0.185 2.363 0.019 Note: (1) Model R = 0.487, R² = 0.238, adjusted R² = 0.203, F = 6.855, P < 0.01. (2) “Ref” indicates the reference group. For the 2-week postpartum multiple linear regression model, three candidate predictors were initially entered: fathers’ involvement in the breastfeeding process, whether family members or others believed that fathers should not or were not suitable to be involved in breastfeeding, and breastfeeding knowledge level.Collinearity diagnostics showed VIF values ranging from 1.036 to 15.798 and Tol values ranging from 0.063 to 0.966, suggesting potential multicollinearity among the independent variables.Therefore, to improve model stability, the variable “whether family members or others believed that fathers should not or were not suitable to be involved in breastfeeding” was removed. After removing this variable, Tol was 0.986 and VIF was 1.014, indicating no evidence of substantial multicollinearity. In the final model, independent variables were entered using their original values.Table 13. The multivariable analysis showed that fathers’ involvement in the breastfeeding process and breastfeeding knowledge were associated with fathers’ breastfeeding-support self-efficacy at 2 weeks postpartum. The relative strength of association was higher for involvement in the breastfeeding process than for breastfeeding knowledge. The adjusted R² was 0.174, indicating that the model explained 17.4% of the total variance. Regression equation:Fathers’ breastfeeding-support self-efficacy (2 weeks postpartum) = 29.396 + 9.499 (involvement in the breastfeeding process) + 0.471 (breastfeeding knowledge). Table 13 Multiple linear regression analysis of factors associated with fathers’ breastfeeding-support self-efficacy at 2 weeks postpartum (n = 114) Fathers’ breastfeeding-support self-efficacy at T2 Regression coefficient standard error standardized regression coefficient t P (Constant) 29.396 14.887 1.975 0.051 Involvement in the breastfeeding process 9.499 2.437 -0.339 -3.898 <0.01 Breastfeeding knowledge 0.471 0.198 0.206 2.377 0.019 Note: (1) Model R = 0.417, R² = 0.174, adjusted R² = 0.159, F = 16.987, P < 0.01. Discussion 1. Fathers’ breastfeeding support self-efficacy: current status In this study, higher levels of fathers’ breastfeeding support self-efficacy were associated with better breastfeeding self-efficacy among mothers. This finding is consistent with a similar study conducted by Krikitrat P in Thailand [18], which also reported a positive correlation between fathers’ and mothers’ breastfeeding self-efficacy scores, further underscoring the importance of spousal support in the breastfeeding process. Overall, fathers’ breastfeeding support self-efficacy scores at 72 hours postpartum and at 2 weeks postpartum were at a moderate level. The mean scores in our sample were slightly lower than those reported by Jing Zeng [19]and colleagues in a survey of families at 6 months postpartum in southeastern China (53.52 ± 11.16), and were also somewhat lower than results from a Thai study at 6 months postpartum (54.65 ± 9.8). This discrepancy may be related to the earlier timing of data collection in the present study[18]. Fathers’ breastfeeding support self-efficacy did not differ significantly between the two time points (P > 0.05), which may reflect the selected measurement points and the relatively short interval between assessments. Notably, the first survey was administered at 72 hours postpartum. In China, mothers are typically still hospitalised during this period, leaving fathers with limited opportunities to participate in infant care. The second survey was conducted at 2 weeks postpartum. In the context of traditional postpartum practices in China, during the early postpartum period (particularly within the first 28 days), mothers commonly recuperate in postpartum care centres or rely on a maternity nanny and/or older family members for infant care. This may have reduced fathers’ involvement in caregiving during this window and limited their ability to provide breastfeeding support. 2.Factors influencing fathers’ breastfeeding support self-efficacy and implications for intervention In this study, the following factors were associated with fathers’ self-efficacy in supporting mothers to breastfeed: access to paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, involvement in the breastfeeding process, and breastfeeding-related knowledge. These findings highlight potential targets for intervention to strengthen fathers’ capacity to provide effective breastfeeding support. Participation in the breastfeeding process and access to paternity leave were associated with fathers’ breastfeeding support self-efficacy. One study [20] reported that fathers who were involved in breastfeeding were more likely to view breastfeeding as part of a “shared parenting task” and to take a more proactive role in providing support and engaging positively throughout the breastfeeding process. Paternity leave refers to the statutory leave granted to the father during the mother’s maternity leave to care for and support the mother and newborn. Its core purpose is to enable fathers’ involvement in early childcare through institutional protection, to share family responsibilities, and to promote gender equality. In our study, fathers with paternity leave had higher scores on the FBSES-SF. A large Swedish cohort study [21] found that, compared with fathers who did not take paternity leave or who postponed leave until after the infant’s first year, taking paternity leave at the time of birth was associated with higher levels of breastfeeding at 2, 4, and 6 months. Another study showed that, compared with fathers who took less than two weeks of leave, fathers who took more than two weeks had infants with higher breastfeeding rates [22]. However, evidence suggests that although around two-thirds of countries worldwide have paternity leave policies, these are often unpaid [23]. In China, paternity leave for newborn fathers varies from 7 to 30 days. Short leave duration and limited eligibility may constrain fathers’ early involvement in childcare. Greater attention to paternity leave is therefore warranted. Strengthening the legal and regulatory framework, improving enforcement, and ensuring effective implementation may further increase fathers’ participation in early parenting and, in turn, enhance their capacity to support mothers to breastfeed. Preferred feeding method and exposure to breast-milk substitute advertising were associated with fathers’ breastfeeding support self-efficacy. In this study, fathers’ preferred feeding method included exclusive breastfeeding, mixed feeding (breast milk plus formula), and formula feeding. However, no participant reported an intention to use formula feeding alone. Overall, 40.1% of fathers preferred exclusive breastfeeding and 59.9% preferred mixed feeding. This pattern is consistent with prior work on factors influencing fathers’ breastfeeding attitudes [24], suggesting a close link between feeding intention and feeding attitude. Fathers who intended exclusive breastfeeding tended to hold stronger beliefs in breastfeeding and greater confidence in supporting the mother to breastfeed. In our survey, 52.1% of fathers reported exposure to breast-milk substitute advertising. Although the benefits of breastfeeding are widely recognised, marketing of breast-milk substitutes may undermine mothers’ confidence in exclusive breastfeeding and shorten breastfeeding duration [25]. When mothers use a range of media platforms to seek infant-care information and share experiences, they may frequently encounter formula-related content embedded within these platforms, which can substantially shape feeding decisions. This underscores the need for more proactive, breastfeeding-supportive media actions to facilitate breastfeeding promotion and uptake. Breastfeeding-related knowledge was also an important factor associated with fathers’ breastfeeding support self-efficacy. Adequate knowledge is pivotal for enabling the father to provide effective support during breastfeeding; fathers’ knowledge may also reinforce mothers’ breastfeeding knowledge. Moreover, breastfeeding knowledge can strengthen fathers’ commitment to breastfeeding and enable them to provide more practical and emotional support to the mother [26]. Limitations Several limitations should be noted. First, this was a single-centre study using convenience sampling, and participants had relatively high levels of education and income, which may limit generalisability. Second, loss to follow-up occurred at both time points, which may have introduced selection bias. Third, outcomes were primarily assessed using self-report measures and may have been influenced by social desirability. Fourth, although the study used a prospective two–time point design, analyses were largely modelled separately at each time point; mixed-effects models or generalised estimating equations were not used to characterise within-person change trajectories and time effects. Fifth, some fathers completed questionnaires that were relayed via the mother, which may have affected fathers’ participation and data quality. Conclusion In this study, fathers’ breastfeeding support self-efficacy was assessed at two time points in the early postpartum period in Beijing, China. The main findings were: (1) fathers’ breastfeeding support self-efficacy was moderate overall, with no significant change in mean scores from 72 hours to 2 weeks postpartum (p > 0.05); (2) fathers’ breastfeeding support self-efficacy was positively correlated with mothers’ breastfeeding self-efficacy at both time points (p < 0.05); (3) fathers’ breastfeeding knowledge was positively correlated with fathers’ breastfeeding support self-efficacy at both time points; (4) paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, participation in the breastfeeding process, and breastfeeding knowledge were associated with fathers’ breastfeeding support self-efficacy; and (5) the exclusive breastfeeding rates at 2 and 6 weeks postpartum were 38.5% and 43.8%, respectively. Future research Future work should include multicentre studies with extended follow-up to 3–6 months postpartum. Longitudinal modelling is needed to test trajectories of fathers’ breastfeeding support self-efficacy and to examine its predictive value for breastfeeding outcomes. In addition, the effectiveness of skills-based interventions targeting fathers should be evaluated. Abbreviations WHO World Health Organization FBSES-SF Father Support Breastfeeding Self-Efficacy Scale-Short Form BSES-SF Support Breastfeeding Self-Efficacy Scale-Short Form CBKS Comprehensive Breastfeeding Knowledge Scale Declarations Ethics approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki. This study has been approved by the Institutional Review Board and Ethics Committee of Peking Union Medical College (approval no. PUMCSON-2021-25).All participants participated voluntarily, provided written informed consent, and could withdraw at any time.All collected data were anonymized to ensure that participants could not be identified. Consent for publication Not applicable. Availability of data and materials The data for this study will be available from the first and corresponding author upon reasonable request Declaration of Competing Interest The authors declare no competing interests. Funding declaration This study did not receive any specific grant support. Author Contributions Statement Yu Rui: study design, data collection, data analysis, manuscript writing, and other related aspects. ZhangYi Fei: performed data analysis,revised the manuscript writing Zhu Can: assisted in data collection and revised the manuscript content. ZhangDong ying: supervised the study and reviewed the data and manuscript content. Acknowledgement We would like to express our gratitude to the Obstetrics Department of Peking Union Medical College Hospital for providing the research platform and clinical data support. This support does not constitute financial funding for this study. References Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C., & Lancet Breastfeeding Series Group (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet (London, England), 387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7 Vartan S. (2025). Breastfeeding boosts immune cells that protect against breast cancer. Nature, 10.1038/d41586-025-03419-4. Advance online publication. https://doi.org/10.1038/d41586-025-03419-4 Geneva.Global strategy for infant and young child feeding[EB/OL]. https://www.who.int/nutrition/topics/global_strategy_iycf/en/ Hollis, J. L., Collins, C. E., DeClerck, F., Chai, L. K., McColl, K., & Demaio, A. R. (2020). Defining healthy and sustainable diets for infants, children and adolescents. Global Food Security, 27, 100401. https://doi.org/10.1016/j.gfs.2020.100401 Liu, K., Guo, J., Deng, W., & Su, Y. (2022). The Current Status of Breastfeeding Knowledge and Its Influencing Factors in Nursing Undergraduates: A Cross-Sectional Study in China. International journal of environmental research and public health, 20(1), 103. https://doi.org/10.3390/ijerph20010103 Isiguzo, C., Mendez, D. D., Demirci, J. R., Youk, A., Mendez, G., Davis, E. M., & Documet, P. (2023). Stress, social support, and racial differences: Dominant drivers of exclusive breastfeeding. Maternal & child nutrition, 19(2), e13459. https://doi.org/10.1111/mcn.13459 Gu, Y., Xiang, Y., Chen, X., Wang, L., Shan, C., & Ji, M. (2025). Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women's lactation: a longitudinal study. BMC pregnancy and childbirth, 25(1), 768. https://doi.org/10.1186/s12884-025-07851-2 Furman, L., Killpack, S., Matthews, L., Davis, V., & O'Riordan, M. A. (2016). Engaging Inner-City Fathers in Breastfeeding Support. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 11(1), 15–20. https://doi.org/10.1089/bfm.2015.0092 Brown, A., & Davies, R. (2014). Fathers' experiences of supporting breastfeeding: challenges for breastfeeding promotion and education. Maternal & child nutrition, 10(4), 510–526. https://doi.org/10.1111/mcn.12129 Atkinson, L., Silverio, S. A., Bick, D., & Fallon, V. (2021). Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: Mixed-methods findings from a global on-line survey of English-speaking fathers. Maternal & child nutrition, 17 Suppl 1(Suppl 1), e13147. https://doi.org/10.1111/mcn.13147 Dennis, C. L., Brennenstuhl, S., & Abbass-Dick, J. (2018). Measuring paternal breastfeeding self-efficacy: A psychometric evaluation of the Breastfeeding Self-Efficacy Scale-Short Form among fathers. Midwifery, 64, 17–22. https://doi.org/10.1016/j.midw.2018.05.005 Nieto, C., Lopez-Mases, P., Vila-Candel, R., & Lazaro, E. (2026). Experience of breastfeeding during hospitalization after birth: a qualitative study. European journal of obstetrics, gynecology, and reproductive biology, 316, 114786. https://doi.org/10.1016/j.ejogrb.2025.114786 Chipojola, R., Dennis, C. L., & Kuo, S. Y. (2022). Psychometric Assessment of the Paternal Breastfeeding Self-Efficacy Scale-Short Form: A Confirmatory Factor Analysis of Malawian Fathers. Journal of human lactation : official journal of International Lactation Consultant Association, 38(1), 28–36. https://doi.org/10.1177/08903344211065036 Zhou, Y., Xue, C., Jin, H. Y., Zhang, M., Shen, Z. C., Hu, Y. M., Zhang, W. N., & Luo, C. F. (2020). Reliability and validity of the Chinese version of the Father Support Breastfeeding Self-Efficacy Scale-Short Form (FBSES-SF) (in Chinese). Zhonghua Huli Zazhi (Chin J Nurs), 55(7), 1116-1120. https://doi.org/10.3761/j.issn.0254-1769.2020.07.031 Dennis C. L. (2003). The breastfeeding self-efficacy scale: psychometric assessment of the short form. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 32(6), 734–744. https://doi.org/10.1177/0884217503258459 Liu, Y. J., Wang, M., & Dong, X. F. (2016). Reliability and validity of the Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) (in Chinese). Zhongguo Shiyong Huli Zazhi (Chin J Prac Nurs), 32(18), 1361-1364. https://doi.org/10.3760/cma.j.issn.1672-7088.2016.18.001 Abbass-Dick, J., Newport, A., Pattison, D., Sun, W., Kenaszchuk, C., & Dennis, C. L. (2020). Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale. Midwifery, 83, 102642. https://doi.org/10.1016/j.midw.2020.102642 Krikitrat, Preeyakamon et al. “Relationships between Thai fathers' self-efficacy to support breastfeeding and exclusive breastfeeding duration.” Midwifery vol. 106 (2022): 103261. doi:10.1016/j.midw.2022.103261 Zeng, Jing et al. “Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study.” BMC public health vol. 24,1 2698. 3 Oct. 2024, doi:10.1186/s12889-024-20136-1 Jacobsen, Marie Honoré et al. “Understanding fathers' responses to breastfeeding as a "shared parental task": a realist evaluation of a Danish breastfeeding support intervention.” Archives of public health = Archives belges de sante publiquevol. 83,1 299. 27 Nov. 2025, doi:10.1186/s13690-025-01790-2 Flacking, Renée et al. “The influence of fathers' socioeconomic status and paternity leave on breastfeeding duration: a population-based cohort study.” Scandinavian journal of public health vol. 38,4 (2010): 337-43. doi:10.1177/1403494810362002 Parker, J. J., Simon, C. D., & Garfield, C. F. (2025). Fathers' work leave and infant breastfeeding in a state-representative sample of fathers in Georgia, United States. BMC public health, 25(1), 767. https://doi.org/10.1186/s12889-025-22013-x Nick, J. M., Sahin, S., Roberts, L. R., Hatton, A., & Cafferky, B. (2025). Effect of paternity leave or fathers' parental leave on infant health: a systematic review protocol. JBI evidence synthesis, 23(4), 792–800. https://doi.org/10.11124/JBIES-24-00046 Burris, J. C., Stroker, V., Fu, Z., & Woolf, K. (2025). Feeding attitudes of fathers in the United States are associated with breastfeeding success: A cross-sectional study. Nutrition and health, 31(4), 1747–1757. https://doi.org/10.1177/02601060251320722 Arslan, A. G. S., & Eksioglu, A. (2025). Perceptions of Media and Advertisements on Breastfeeding Decisions of Mothers in Turkey: A Qualitative Study. Journal of human lactation : official journal of International Lactation Consultant Association, 41(4), 620–633. https://doi.org/10.1177/08903344251363609 Ouyang, Y. Q., & Nasrin, L. (2021). Father's Knowledge, Attitude and Support to Mother's Exclusive Breastfeeding Practices in Bangladesh: A Multi-Group Structural Equations Model Analysis. Healthcare (Basel, Switzerland), 9(3), 276. https://doi.org/10.3390/healthcare9030276 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 27 Feb, 2026 Editor assigned by journal 23 Feb, 2026 Editor invited by journal 01 Feb, 2026 Submission checks completed at journal 28 Jan, 2026 First submitted to journal 28 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8676744","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":599301608,"identity":"a71d92f7-9ba1-404d-a45c-0ae948439131","order_by":0,"name":"Rui Yu","email":"","orcid":"","institution":"Peking Union Medical College Hospital","correspondingAuthor":false,"prefix":"","firstName":"Rui","middleName":"","lastName":"Yu","suffix":""},{"id":599301609,"identity":"b255e185-1a58-47c4-898e-80fb143ae3db","order_by":1,"name":"YiFei Zhang","email":"","orcid":"","institution":"Chinese PLA General Hospital","correspondingAuthor":false,"prefix":"","firstName":"YiFei","middleName":"","lastName":"Zhang","suffix":""},{"id":599301610,"identity":"ea0be5d4-bfed-46f5-842b-0cea802c2ce0","order_by":2,"name":"Can Zhu","email":"","orcid":"","institution":"Peking Union Medical College Hospital","correspondingAuthor":false,"prefix":"","firstName":"Can","middleName":"","lastName":"Zhu","suffix":""},{"id":599301611,"identity":"6a66f80a-f68d-436a-8492-e7f2de4a0e01","order_by":3,"name":"ZhangDong ying","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxUlEQVRIiWNgGAWjYFCCBDDJw8/e2PjwAyla5CR7DjcbS5CixdhgRnqbAA8xGuTbc8we8+bYJW6QfNjGIMFgJ6fbQEALY88bc2PebcmJ26UT2x4UMCQbmx0goIVZIsdMmnfbgcSdsxPbDSQYDiRuI6SFDaZlw82DbRI8xGjhgWoxNrjBSKQWCZ5n5YZztyUDAzkRGMgGRPhFvj1524O32+yAUXn84cMPFXZyBLUwMHCYIXEMCCoHAfZnRCkbBaNgFIyCEQwAYnZAWZ/BTO4AAAAASUVORK5CYII=","orcid":"","institution":"Peking Union Medical College Hospital","correspondingAuthor":true,"prefix":"","firstName":"ZhangDong","middleName":"","lastName":"ying","suffix":""}],"badges":[],"createdAt":"2026-01-23 08:24:46","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8676744/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8676744/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104175591,"identity":"61fee358-820d-4d2a-880f-a59fe2a285bf","added_by":"auto","created_at":"2026-03-08 16:30:59","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":182378,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eData collection procedures and time points\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8676744/v1/a0805881d15f5c39721a21de.png"},{"id":104404953,"identity":"aabb5109-3a37-412c-80dd-9516eefe01a8","added_by":"auto","created_at":"2026-03-11 12:21:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3604693,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8676744/v1/925352e0-ada3-4d40-9794-09843fb205e6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Current Status and Influencing Factors of Fathers’ Early Support for Breastfeeding Self-Efficacy in China: A Cross-Sectional Survey","fulltext":[{"header":"Background","content":"\u003cp\u003eThe benefits of breastfeeding for both mothers and infants are well established [1,2]. The World Health Organization (WHO) recommends exclusive breastfeeding for the first 6 months of life, with continued breastfeeding alongside appropriate complementary foods up to 24 months of age or beyond [3]. Studies indicate that the rate of exclusive breastfeeding among infants younger than six months should exceed 50%[4]. However, current breastfeeding practices in China fall well short of this goal. A national survey conducted in 2019 reported an exclusive breastfeeding rate of only 29.2% among infants younger than 6 months in China [5].\u003c/p\u003e\n\u003cp\u003eBreastfeeding practices are influenced by a multitude of factors\u003csup\u003e\u0026nbsp;\u003c/sup\u003e[6], with social support recognized as a crucial and modifiable component. Across different sources of support (e.g., healthcare providers, family members, and peers), paternal support is closely associated with breastfeeding decision-making, initiation, duration, and maternal confidence [7,8]. Previous studies suggest that when fathers feel unconfident or frustrated in providing breastfeeding support, mothers face a substantially higher risk of discontinuing breastfeeding [9,10]. Self-efficacy refers to an individual\u0026apos;s belief in their ability to perform a specific behavior in a given context and plays a key role in behavioral regulation.Dennis proposed the concept of fathers\u0026rsquo; breastfeeding support self-efficacy, positing that fathers\u0026rsquo; confidence in supporting breastfeeding can influence their supportive behaviours and, in turn, affect maternal breastfeeding practices [11].The early postpartum period, particularly from hospitalization through the first few weeks after discharge, represents a critical window for establishing and sustaining breastfeeding. It is also a time when challenges most commonly emerge and behaviors remain most amenable to change\u003csup\u003e\u0026nbsp;\u003c/sup\u003e[12]. Despite its importance, research remains limited on the characteristics, correlates, and longitudinal relationship between fathers\u0026rsquo; breastfeeding support self-efficacy and mothers\u0026rsquo; breastfeeding self-efficacy during this early postpartum phase.\u003c/p\u003e\n\u003cp\u003eTherefore, we conducted surveys at 72 hours postpartum and again at 2 weeks postpartum to: (1) describe fathers\u0026rsquo; breastfeeding support self-efficacy at both time points; (2) examine factors associated with fathers\u0026rsquo; breastfeeding support self-efficacy; (3) test the association between spousal breastfeeding support self-efficacy and mothers\u0026rsquo; breastfeeding self-efficacy at each time point; and (4) describe the distribution of infant feeding modes at 2 and 6 weeks postpartum.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy design\u003c/p\u003e\n\u003cp\u003eThis study surveyed the same families (the newborn\u0026rsquo;s father and mother) at 72 hours postpartum (T1) and at 2 weeks postpartum (T2). Participants at T2 were restricted to those who provided valid responses at T1. Infant feeding method was additionally followed up at 6 weeks postpartum.\u003c/p\u003e\n\u003cp\u003eSetting and participants\u003c/p\u003e\n\u003cp\u003eThe study was conducted between June and November 2022 in the obstetric ward of a tertiary hospital in Beijing, China. Using convenience sampling, we recruited postpartum mothers who delivered during their hospital stay and their spouses (fathers).\u003c/p\u003e\n\u003cp\u003eEligibility criteria were as follows: (a) Father: (1) living with the mother; (2) able to read and communicate in Chinese. (b) Mother: (1) aged \u0026ge;22 years; (2) gestational age \u0026ge;37 weeks; (3) singleton pregnancy; (4) rooming-in with the infant within 24 hours of birth; (5) intention to breastfeed. (c) Newborn: (1) birthweight \u0026ge;2500 g; (2) 1-minute Apgar score \u0026ge;8.\u003c/p\u003e\n\u003cp\u003eThe exclusion criteria were as follows:(a) refusal to participate after being approached; (b) diagnosed mental illness or cognitive impairment; (c) breastfeeding contraindications in the mother (e.g., severe heart disease), or breastfeeding contraindications or sucking difficulties in the newborn; and (d) inability or unwillingness to complete follow-up via telephone or text message.\u003c/p\u003e\n\u003cp\u003eSample size\u003c/p\u003e\n\u003cp\u003eBased on a commonly used rule of thumb for multivariable analyses, the sample size is typically 5\u0026ndash;10 times the number of independent variables. We anticipated 15 potential correlates; using a 5:1 ratio yielded a minimum of 75 participants. Allowing for approximately 30% attrition and invalid questionnaires, we planned to recruit at least 100 mother\u0026ndash;father dyads per group. In total, 216 families were included.\u003c/p\u003e\n\u003cp\u003eData collection procedures and time points\u003c/p\u003e\n\u003cp\u003eData were collected using an electronic questionnaire administered via the Wenjuanxing platform. Eligible families were identified in the obstetric ward by the research team. After the study aims and procedures were explained, written informed consent was obtained. The information collected at each time point is summarised in Fig. 1.\u003c/p\u003e\n\u003cp\u003eAt T1, the father completed a demographic questionnaire, the Father Support Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (FBSES-SF), and the Comprehensive Breastfeeding Knowledge Scale (CBKS). The mother completed a demographic questionnaire and the Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (BSES-SF).At T2, the father completed the FBSES-SF and CBKS again and additionally answered items related to breastfeeding involvement (whether he had participated in the breastfeeding process and family members\u0026rsquo; attitudes towards his involvement). The mother reported the infant feeding mode and completed the BSES-SF. At 6 weeks postpartum, the mother was contacted for follow-up to ascertain the infant feeding mode.\u003c/p\u003e\n\u003cp\u003eAt T1, mothers\u0026rsquo; contact details (telephone/email/WeChat) were collected to facilitate follow-up. Because obtaining fathers\u0026rsquo; contact details directly was sometimes difficult, fathers\u0026rsquo; questionnaires were provided to mothers with instructions, and mothers forwarded the survey link to the father for completion.\u003c/p\u003e\n\u003cp\u003eMeasures\u003c/p\u003e\n\u003cp\u003e1.General information questionnaire\u003c/p\u003e\n\u003cp\u003eA general information questionnaire was developed by the research team based on a review of the literature. It comprised sections for both the father and the mother. The father section collected demographic and background information, including age, educational attainment, ethnicity, religious affiliation, occupation, monthly per-capita household income, parity, paternity leave availability, exposure to breastfeeding-related situations, intended feeding method, whether he had accessed breastfeeding- and pregnancy-related health information, exposure to breast-milk substitute (infant formula) advertising, and whether he had been involved in the breastfeeding process. The mother section collected information on age, ethnicity, educational attainment, and occupation.\u003c/p\u003e\n\u003cp\u003e2. Father Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (FBSES-SF)\u003c/p\u003e\n\u003cp\u003eFathers\u0026rsquo; breastfeeding support self-efficacy was assessed using the short form of the Fathers\u0026rsquo; Breastfeeding Support Self-Efficacy Scale (FBSES-SF) developed by Dennis and colleagues in 2018 [13]. The scale was translated and culturally adapted into Chinese by Zhou Yang and colleagues. The Chinese version comprises 14 items, with a total score ranging from 14 to 70. Each item is rated on a 5-point Likert scale from 1 (\u0026ldquo;not at all confident\u0026rdquo;) to 5 (\u0026ldquo;very confident\u0026rdquo;), with higher scores indicating greater breastfeeding support self-efficacy in the father. The Chinese version has demonstrated excellent internal consistency, with a Cronbach\u0026rsquo;s \u0026alpha; of 0.935 [14].\u003c/p\u003e\n\u003cp\u003e3. Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (BSES-SF)\u0026nbsp;is a self-report instrument used to assess\u0026nbsp;mothers\u0026rsquo; breastfeeding self-efficacy\u0026nbsp;[15]. The scale was translated and culturally adapted into Chinese by Liu Yanjin and colleagues. The Chinese version comprises 14 items, each rated on a 5-point Likert scale ranging from 1 (\u0026ldquo;not at all confident\u0026rdquo;) to 5 (\u0026ldquo;very confident\u0026rdquo;), yielding a total score of 14\u0026ndash;70. Higher scores indicate higher breastfeeding self-efficacy in mothers. The Chinese version has demonstrated good internal consistency, with a Cronbach\u0026rsquo;s \u0026alpha; of 0.927 [16].\u003c/p\u003e\n\u003cp\u003e4.Comprehensive Breastfeeding Knowledge Scale (CBKS)\u003c/p\u003e\n\u003cp\u003eBreastfeeding knowledge was measured using the Comprehensive Breastfeeding Knowledge Scale (CBKS) developed by Jennifer Abbass-Dick and colleagues. The CBKS contains 28 items with a total score ranging from 28 to 84 and comprises three domains: Domain I, milk supply management (7 items; score range 7\u0026ndash;21); Domain II, persisting through challenges (10 items; score range 10\u0026ndash;30); and Domain III, correcting misconceptions (11 items; score range 11\u0026ndash;33). The scale has shown good internal consistency, with a Cronbach\u0026rsquo;s \u0026alpha; of 0.83 [17].\u003c/p\u003e\n\u003cp\u003e5.Infant feeding method\u003c/p\u003e\n\u003cp\u003eInfant feeding method was assessed using a 24-hour recall by asking how the infant had been fed during the 24 hours prior to the survey.\u0026nbsp;Feeding method was categorized as exclusive breastfeeding, mixed feeding, or formula feeding.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStatistical analysis\u003c/p\u003e\n\u003cp\u003eData were analyzed using SPSS version 25.0. Categorical variables were summarized as frequencies and percentages. Continuous variables with an approximately normal distribution were described as mean \u0026plusmn; standard deviation (mean \u0026plusmn; SD). Differences in fathers\u0026rsquo; breastfeeding support self-efficacy across levels of categorical variables (e.g., ethnicity) and differences in fathers\u0026rsquo; breastfeeding support self-efficacy across time points were examined using independent-samples t tests or one-way analysis of variance (ANOVA), as appropriate. Associations between fathers\u0026rsquo; breastfeeding support self-efficacy and breastfeeding knowledge were assessed using Pearson\u0026rsquo;s or Spearman\u0026rsquo;s correlation coefficients, depending on data distribution. Multivariable analyses were performed using multiple linear regression.\u003c/p\u003e\n\u003cp\u003eAll statistical tests were two-sided, and a p value \u0026le; 0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003ch3\u003e\u003cstrong\u003e1. Sample recruitment and follow-up\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eA total of 216 family dyads were initially approached and provided with questionnaires.At T1, 180 valid maternal questionnaires were returned (83.3%), and 167 valid paternal questionnaires were returned (77.3%).At T2, questionnaires were re-administered to the previously valid sample (n = 180); 130 valid maternal questionnaires (72.2%) and 114 valid paternal questionnaires (63.3%) were returned.Infant feeding mode at 6 weeks postpartum was obtained for 130 mothers.\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003e2. Participant characteristics\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003eParticipants\u0026rsquo; sociodemographic and study-related characteristics are presented in Tables 1\u0026ndash;2.At T1, 180 mothers were included in the analysis,the mean maternal age was 33.00\u0026plusmn;3.81years, and 51.67% had a postgraduate degree or above.A total of 167 fathers were included in the analysis , with a mean age of 34.44\u0026plusmn;4.26 years.Among fathers, 96.41% reported no religious affiliation, 95.21% were of Han ethnicity, 71.86% had local household registration, and 84.43% were first-time fathers.In addition, 55.69% of fathers had a postgraduate degree or above , and 47.31% reported a per-capita monthly household income of\u0026ge;RMB 20,000.Overall, educational attainment and income levels were relatively high in this sample, which may reflect the study setting in Beijing, China, where education levels are generally higher.(Table 1)\u003c/p\u003e\n\u003cp\u003eRegarding fathers\u0026rsquo; breastfeeding-related experiences and attitudes (Table 2), 82.0% had paternity leave, 79.6% reported exposure to breastfeeding-related situations, and 93.4% had discussed infant feeding methods with the mother.The most commonly reported feeding intention was mixed feeding (breast milk plus formula) (59.9%), followed by exclusive breastfeeding (40.1%).Over half of fathers (52.1%) reported exposure to breast-milk substitute advertising, and 90.4% believed that breastfeeding requires cooperation between partners.At 2 weeks postpartum, 86.0% of fathers reported having been involved in the breastfeeding process (n = 114).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 Sociodemographic Characteristics of Mothers and Fathers\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo. n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"10\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=180)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (\u003c/strong\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 398px;\"\u003e\n \u003cp\u003e33.00 \u003cimg width=\"11\" height=\"17\" src=\"data:image/png;base64,R0lGODlhEAAZAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEABgAOAA8AggAAAAAAAAAAOjqQ25A6AJDb/9uQOv//2wMkCKpHsxC2F+Os1mGpN+uQEYxkGQhFRnmXB7QsuMGz7FaiaaIJADs=\" alt=\"image\"\u003e3.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eeducational attainment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostgraduate or above\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e93(51.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBachelor\u0026rsquo;s degree or below\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e87(48.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"7\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eprofession\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecompany employee\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e106(58.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecivil servant\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e16(8.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eteacher\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e9(5.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003emerchant\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e3(1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003emedical workers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e10(5.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eprofessional\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e14(7.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther occupations or none\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e22(12.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (\u003c/strong\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 398px;\"\u003e\n \u003cp\u003e34.44\u003cimg width=\"11\" height=\"17\" src=\"data:image/png;base64,R0lGODlhEAAZAHcAMSH+GlNvZnR3YXJlOiBNaWNyb3NvZnQgT2ZmaWNlACH5BAEAAAAALAEABgAOAA8AggAAAAAAAAAAOjqQ25A6AJDb/9uQOv//2wMkCKpHsxC2F+Os1mGpN+uQEYxkGQhFRnmXB7QsuMGz7FaiaaIJADs=\" alt=\"image\"\u003e4.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ereligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6(3.59)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e161(96.41)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"13\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnicity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHan Chinese\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e159(95.21)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEthnic minorities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e8(4.79)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eeducational attainment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostgraduate or above\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e93(55.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBachelor\u0026rsquo;s degree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e64(38.32)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBelow bachelor\u0026rsquo;s degree\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10(5.99)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHukou status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLocal hukou\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e120(71.86)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-local hukou\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e47(28.14)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMonthly per capita household income (RMB, CNY)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge; 20,000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e79(47.31)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e15,000\u0026ndash;19,999\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e27(16.17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;10,000\u0026ndash;14,999\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e49(29.34)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;10,000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12(7.19)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 103px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimiparous\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e141(84.43)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 268px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecond parity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e26(15.57)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. General characteristics of fathers (n = 167)\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo. n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternity leave\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e137(82.04)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e30(17.96)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Prior breastfeeding exposure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e133(79.64)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e34(20.36)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Discussion on feeding methods\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e156(93.41)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e11(6.59)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Preferred feeding method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e67(40.12)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMixed feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e100(59.88)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFormula milk feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Intended breastfeeding duration\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot planned or \u0026lt; 3 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e21(12.57)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u0026ndash;6 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e40(23.95)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6\u0026ndash;12 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e63(37.72)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12\u0026ndash;18 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e27(16.17)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge;18 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16(9.58)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ebreast-milk substitute advertising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e87(52.10)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e80(47.90)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBelief in collaborative breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e151(90.42)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot sure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e11(6.59)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5(3.00)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement in the breastfeeding process\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(n = 114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e98(85.96)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16(14.04)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 256px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived social disapproval of father\u0026apos;s involvement (n = 114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7(6.14)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot sure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9(7.90)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e82(71.93)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 158px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot involved\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16(14.04)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNote: Exposure to breastfeeding contexts refers to having personally experienced breastfeeding-related situations (e.g., having been breastfed oneself, witnessing others breastfeeding, etc.).\u003c/p\u003e\n\u003cp\u003e3.Infant feeding method\u003c/p\u003e\n\u003cp\u003eThe exclusive breastfeeding rates at 2 and 6 weeks postpartum were 38.5% and 43.8%.The remaining infants were fed with mixed feeding to varying degrees or formula feeding(Table 3).\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eInfant feeding practices(n = 130)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 146px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo other liquids or solid foods were given to the infant besides breast milk, including water; however, vitamin or mineral supplements and medicinal drops or syrups were allowed.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e38.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e43.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn addition to breast milk, the infant was given water or fruit juice, but no more than 1\u0026ndash;2 times per day and no more than 1\u0026ndash;2 sips each time.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe infant consumed less than one bottle of formula per day, and breast milk accounted for \u0026ge;80% of the infant\u0026rsquo;s total intake.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e31.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe infant consumed at least one bottle of formula per day, and breast milk accounted for 20\u0026ndash;79% of the infant\u0026rsquo;s total intake.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreast milk accounted for \u0026lt;20% of the infant\u0026rsquo;s total intake.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e3.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreastfeeding was used only for comfort and did not provide caloric intake.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 422px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo breast milk was given; the infant was fed formula only.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 72px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 74px;\"\u003e\n \u003cp\u003e0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4. Analysis of fathers\u0026rsquo; breastfeeding support self-efficacy scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFathers\u0026rsquo; total scores on the Father Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (FBSES-SF) at T1 and T2 were 51.71 \u0026plusmn; 8.88 and 52.50 \u0026plusmn; 9.79, respectively.A one-way analysis of variance was used to compare FBSES-SF total scores between the two time points, and no statistically significant difference was observed (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= 0.481).(Table 4)\u003c/p\u003e\n\u003cp\u003eAt T1, item 2 had the highest mean item score, whereas item 4 had the lowest.At T2, item 9 had the highest mean item score, whereas item 4 had the lowest.The item with the lowest mean score was consistent across both time points (item 4).(Table 5)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Comparison of fathers\u0026rsquo; breastfeeding support self-efficacy scores between T1 and T2\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinimum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaximum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1(n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e51.71\u0026plusmn;8.878\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e25\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e69\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.498\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.481\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2(n=114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e52.50\u0026plusmn;9.786\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e23\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Items with the highest and lowest mean FBSES-SF scores at T1 and T2\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eItem\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1(n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThree items with the highest mean scores\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 135px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.Successfully cope with breastfeeding like I have with other challenging tasks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.96 \u0026plusmn; 0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10.Deal with the fact that breastfeeding can be time-consuming\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.89 \u0026plusmn; 0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.Determine that our baby is getting enough milk\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.89 \u0026plusmn; 0.846\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eThree items with the lowest mean scores\u003c/strong\u003e\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.Help mom ensure that our baby is properly latched on for the whole feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.44 \u0026plusmn; 0.985\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14.Tell when our baby is finished breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.46 \u0026plusmn; 0.903\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e12.Help mom continue to breastfeed our baby for every feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.48 \u0026plusmn; 0.917\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"8\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2(n=114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThree items with the highest mean scores\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9.Be satisfied with our breastfeeding experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.95 \u0026plusmn; 0.818\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.Successfully cope with breastfeeding like I have with other challenging tasks\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.94 \u0026plusmn; 0.823\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.Keep wanting mom to breastfeed our baby\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.90 \u0026plusmn; 0.872\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThree items with the lowest mean scores\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.Help mom ensure that our baby is properly latched on for the whole feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.48 \u0026plusmn; 0.961\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e6.Help mom manage to breastfeed even if our baby is crying\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.50 \u0026plusmn; 0.943\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 348px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.Help mom breastfeed our baby without using formula as a supplement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 135px;\"\u003e\n \u003cp\u003e3.56 \u0026plusmn; 0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5. Analysis of mothers\u0026rsquo; breastfeeding self-efficacy scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMothers\u0026rsquo; total scores on the Breastfeeding Self-Efficacy Scale\u0026ndash;Short Form (BSES-SF) at T1 and T2 were 46.24 \u0026plusmn; 10.32 and 47.68 \u0026plusmn; 11.73, respectively.A one-way analysis of variance was used to compare BSES-SF total scores between the two time points, and no statistically significant difference was observed (p = 0.253).(Table 6)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6. Comparison of mothers\u0026rsquo; breastfeeding self-efficacy scores across time points\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMinimum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMaximum\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1(n=180)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e46.24\u0026plusmn;10.323\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.309\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.253\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2(n=130)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.68\u0026plusmn;11.732\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e17\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e70\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e6. Correlation between fathers\u0026rsquo; breastfeeding support self-efficacy and mothers\u0026rsquo; breastfeeding self-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrelation analyses showed that fathers\u0026rsquo; breastfeeding support self-efficacy was positively correlated with mothers\u0026rsquo; breastfeeding self-efficacy at both T1 and T2.Specifically, higher fathers\u0026rsquo; breastfeeding support self-efficacy scores were associated with higher mothers\u0026rsquo; breastfeeding self-efficacy scores (both p \u0026lt; 0.05).(Table 7)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 7. Correlation between fathers\u0026rsquo; breastfeeding support self-efficacy and mothers\u0026rsquo; breastfeeding self-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 306px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFBSES-SF score(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePearson\u0026rsquo;s r\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBSES-SF score(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1(n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.219\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.005\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2(n=114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 176px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.462\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e7. Fathers\u0026rsquo; CBKS total and domain scores\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFathers\u0026rsquo; total CBKS scores at T1 and T2 were 69.10 \u0026plusmn; 5.56 and 72.05 \u0026plusmn; 4.29, respectively.A one-way analysis of variance was used to compare CBKS total scores between the two time points, and the difference was statistically significant (p \u0026lt; 0.05).(Table 8)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 8. Fathers\u0026rsquo; CBKS total and domain scores\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"589\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT1(n=167)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT2(n=114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 59px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScore\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean item score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScore\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean item score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomain I\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e18.87\u0026plusmn;2.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.70\u0026plusmn;0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e19.86\u0026plusmn;1.545\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e2.84\u0026plusmn;0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e25.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomain II\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24.32\u0026plusmn;2.630\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.43\u0026plusmn;0.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e25.61\u0026plusmn;2.114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e2.56\u0026plusmn;0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDomain III\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e25.90\u0026plusmn;3.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.36\u0026plusmn;0.277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e26.58\u0026plusmn;2.975\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e2.42\u0026plusmn;0.270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e69.10\u0026plusmn;5.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e2.47\u0026plusmn;0.199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e72.05\u0026plusmn;4.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e2.57\u0026plusmn;0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 62px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: (1) Dimension I: Breast milk supply management; Dimension II: Perseverance in the face of challenges; Dimension III: Correcting misconceptions.\u003cbr\u003e\u0026nbsp;(2) F*: Approximate F distribution; Welch\u0026rsquo;s test was used.\u003cbr\u003e\u0026nbsp;(3) Comparisons of partners\u0026rsquo; breastfeeding knowledge scale scores were based on the total score.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e8. Univariate analysis of fathers\u0026rsquo; breastfeeding-support self-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of the univariate analyses of fathers\u0026rsquo; breastfeeding-support self-efficacy are presented in Table 9.No statistically significant differences in fathers\u0026rsquo; breastfeeding-support self-efficacy scores were observed by age, educational level, household income, exposure to breastfeeding-related situations, whether the couple had discussed the intended feeding method, planned duration of breastfeeding, agreement that breastfeeding requires joint cooperation, or prior access to breastfeeding-related health information (P\u0026gt;0.05).In contrast, parity, paternity leave entitlement, preferred feeding method, exposure to breast-milk substitute advertising, involvement in the breastfeeding process, and perceived discouragement from family members or others (i.e., the belief that fathers should not or are not suitable to be involved in breastfeeding) were significantly associated with fathers\u0026rsquo; breastfeeding-support self-efficacy scores (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 9 Univariate analysis of fathers\u0026rsquo; breastfeeding-support self-efficacy by participant characteristics (n=167)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et/F\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-2.000\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.047\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimiparous\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e141\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e51.02\u0026plusmn;8.488\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecond parity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e26\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e54.80\u0026plusmn;9.704\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternity leave\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e-2.711\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.007\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e30\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.80\u0026plusmn;8.495\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e137\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e52.56\u0026plusmn;8.759\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred feeding method\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e4.376\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e67\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e55.19\u0026plusmn;8.631\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMixed feeding\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e100\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e49.37\u0026plusmn;8.292\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 9 Univariate analysis of fathers\u0026rsquo; breastfeeding-support self-efficacy by participant characteristics (n=167)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cimg width=\"32\" height=\"17\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et/F\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExposure to breast-milk substitute advertising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e-2.860\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e50.15\u0026plusmn;9.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e53.40\u0026plusmn;8.033\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement in the breastfeeding process (n = 114)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4.327\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e98\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e53.93\u0026plusmn;8.776\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e43.75\u0026plusmn;11.328\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePerceived discouragement from family members or others regarding your involvement in breastfeeding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n = 98)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.163\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e50.00\u0026plusmn;9.883\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnsure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e52.78\u0026plusmn;13.264\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e82\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e54.39\u0026plusmn;8.119\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e At both T1 and T2, breastfeeding knowledge was significantly positively correlated with fathers\u0026rsquo; breastfeeding-support self-efficacy (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eHigher breastfeeding knowledge scores were associated with higher levels of fathers\u0026rsquo; breastfeeding-support self-efficacy.(Table 10) \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 10 Correlation analysis between breastfeeding knowledge and fathers\u0026rsquo; breastfeeding-support self-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime point\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCBKS score(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePearson correlation coefficient\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFBSES-SF score(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eT1(n=167)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eT2(n=114)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e9. Multivariable analysis of fathers\u0026rsquo; breastfeeding-support self-efficacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo further clarify the effects of various factors on fathers\u0026rsquo; breastfeeding-support self-efficacy, a multiple linear regression analysis was planned. The FBSES-SF score was used as the dependent variable, and variables that were statistically significant in the univariable analyses were entered as independent variables in the multivariable model. Statistical significance was set at P \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eIn multiple linear regression, multicollinearity is considered potentially problematic when tolerance (Tol) is \u0026lt; 0.10 or the variance inflation factor (VIF) is \u0026gt; 5.In this study, fathers\u0026rsquo; breastfeeding-support self-efficacy at 72 h postpartum was modeled as the outcome, with five candidate predictors entered into the regression model.Collinearity diagnostics showed VIF values ranging from 1.023 to 3.042 and Tol values ranging from 0.330 to 0.977.These results indicate no evidence of substantial multicollinearity among the independent variables.Breastfeeding knowledge was entered into the model as the raw score, and the coding of the remaining variables is presented in Table 11.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 11 Coding of independent variables\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCoding scheme\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimiparous=0 \u0026nbsp;Second parity=1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternity leave\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno=0 \u0026nbsp; \u0026nbsp;yes=1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred feeding method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMixed feeding=0 \u0026nbsp;Exclusive breastfeeding=1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExposure to breast-milk substitute advertising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eyes=0 \u0026nbsp; \u0026nbsp;no=1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 189px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement in the breastfeeding process\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 339px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eno=0 \u0026nbsp; \u0026nbsp;yes=1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe multivariable linear regression analysis showed that paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, and breastfeeding knowledge were independently associated with fathers\u0026rsquo; breastfeeding-support self-efficacy at 72 h postpartum.The corresponding regression coefficients (B) for these four variables were 3.327, 4.441, 3.842, and 0.296, respectively.Based on the magnitude of the regression coefficients, the strength of association (from largest to smallest) was as follows: preferred feeding method, exposure to breast-milk substitute advertising, paternity leave, and breastfeeding knowledge.The adjusted coefficient of determination (adjusted R\u0026sup2;) was 0.203, indicating that the model explained 20.3% of the total variance in the outcome.Detailed results are presented in Table 12.Accordingly, the regression equation was: fathers\u0026rsquo; breastfeeding-support self-efficacy (72 h postpartum) = 18.941+3.327 (paternity leave) + 4.441 (preferred feeding method) + 3.842 (exposure to breast-milk substitute advertising) + 0.296 (breastfeeding knowledge).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 12 Multiple linear regression analysis of factors associated with fathers\u0026rsquo; breastfeeding-support self-efficacy at 72 h postpartum (n = 167)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFathers\u0026rsquo; breastfeeding-support self-efficacy at T1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eRegression coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003estandard error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003estandardized regression coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(Constant)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e18.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e9.195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2.060\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.758\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.623\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternity leave\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e3.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.618\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.041\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreferred feeding method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e4.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.399\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e3.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExposure to breast-milk substitute advertising\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e3.842\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e3.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eBreastfeeding knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.125\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: (1) Model R = 0.487, R\u0026sup2; = 0.238, adjusted R\u0026sup2; = 0.203, F = 6.855, P \u0026lt; 0.01. (2) \u0026ldquo;Ref\u0026rdquo; indicates the reference group.\u003c/p\u003e\n\u003cp\u003eFor the 2-week postpartum multiple linear regression model, three candidate predictors were initially entered: fathers\u0026rsquo; involvement in the breastfeeding process, whether family members or others believed that fathers should not or were not suitable to be involved in breastfeeding, and breastfeeding knowledge level.Collinearity diagnostics showed VIF values ranging from 1.036 to 15.798 and Tol values ranging from 0.063 to 0.966, suggesting potential multicollinearity among the independent variables.Therefore, to improve model stability, the variable \u0026ldquo;whether family members or others believed that fathers should not or were not suitable to be involved in breastfeeding\u0026rdquo; was removed.\u003c/p\u003e\n\u003cp\u003eAfter removing this variable, Tol was 0.986 and VIF was 1.014, indicating no evidence of substantial multicollinearity.\u003c/p\u003e\n\u003cp\u003eIn the final model, independent variables were entered using their original values.Table 13.\u003c/p\u003e\n\u003cp\u003eThe multivariable analysis showed that fathers\u0026rsquo; involvement in the breastfeeding process and breastfeeding knowledge were associated with fathers\u0026rsquo; breastfeeding-support self-efficacy at 2 weeks postpartum. The relative strength of association was higher for involvement in the breastfeeding process than for breastfeeding knowledge. The adjusted R\u0026sup2; was 0.174, indicating that the model explained 17.4% of the total variance.\u003c/p\u003e\n\u003cp\u003eRegression equation:Fathers\u0026rsquo; breastfeeding-support self-efficacy (2 weeks postpartum) = 29.396 + 9.499 (involvement in the breastfeeding process) + 0.471 (breastfeeding knowledge).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 13 Multiple linear regression analysis of factors associated with fathers\u0026rsquo; breastfeeding-support self-efficacy at 2 weeks postpartum (n = 114)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFathers\u0026rsquo; breastfeeding-support self-efficacy at T2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eRegression coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003estandard error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003estandardized regression coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(Constant)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e29.396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e14.887\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1.975\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolvement in the breastfeeding process\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e9.499\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2.437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-0.339\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e-3.898\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreastfeeding knowledge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e2.377\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNote: (1) Model R = 0.417, R\u0026sup2; = 0.174, adjusted R\u0026sup2; = 0.159, F = 16.987, P \u0026lt; 0.01.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e1. Fathers\u0026rsquo; breastfeeding support self-efficacy: current status\u003c/p\u003e\n\u003cp\u003eIn this study, higher levels of fathers\u0026rsquo; breastfeeding support self-efficacy were associated with better breastfeeding self-efficacy among mothers. This finding is consistent with a similar study conducted by Krikitrat P in Thailand [18], which also reported a positive correlation between fathers\u0026rsquo; and mothers\u0026rsquo; breastfeeding self-efficacy scores, further underscoring the importance of spousal support in the breastfeeding process.\u003c/p\u003e\n\u003cp\u003eOverall, fathers\u0026rsquo; breastfeeding support self-efficacy scores at 72 hours postpartum and at 2 weeks postpartum were at a moderate level. The mean scores in our sample were slightly lower than those reported by Jing Zeng [19]and colleagues in a survey of families at 6 months postpartum in southeastern China (53.52 \u0026plusmn; 11.16), and were also somewhat lower than results from a Thai study at 6 months postpartum (54.65 \u0026plusmn; 9.8). This discrepancy may be related to the earlier timing of data collection in the present study[18]. Fathers\u0026rsquo; breastfeeding support self-efficacy did not differ significantly between the two time points (P \u0026gt; 0.05), which may reflect the selected measurement points and the relatively short interval between assessments.\u003c/p\u003e\n\u003cp\u003eNotably, the first survey was administered at 72 hours postpartum. In China, mothers are typically still hospitalised during this period, leaving fathers with limited opportunities to participate in infant care. The second survey was conducted at 2 weeks postpartum. In the context of traditional postpartum practices in China, during the early postpartum period (particularly within the first 28 days), mothers commonly recuperate in postpartum care centres or rely on a maternity nanny and/or older family members for infant care. This may have reduced fathers\u0026rsquo; involvement in caregiving during this window and limited their ability to provide breastfeeding support.\u003c/p\u003e\n\u003cp\u003e2.Factors influencing fathers\u0026rsquo; breastfeeding support self-efficacy and implications for intervention\u003c/p\u003e\n\u003cp\u003eIn this study, the following factors were associated with fathers\u0026rsquo; self-efficacy in supporting mothers to breastfeed: access to paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, involvement in the breastfeeding process, and breastfeeding-related knowledge. These findings highlight potential targets for intervention to strengthen fathers\u0026rsquo; capacity to provide effective breastfeeding support.\u003c/p\u003e\n\u003cp\u003eParticipation in the breastfeeding process and access to paternity leave were associated with fathers\u0026rsquo; breastfeeding support self-efficacy. One study [20] reported that fathers who were involved in breastfeeding were more likely to view breastfeeding as part of a \u0026ldquo;shared parenting task\u0026rdquo; and to take a more proactive role in providing support and engaging positively throughout the breastfeeding process.\u003c/p\u003e\n\u003cp\u003ePaternity leave refers to the statutory leave granted to the father during the mother\u0026rsquo;s maternity leave to care for and support the mother and newborn. Its core purpose is to enable fathers\u0026rsquo; involvement in early childcare through institutional protection, to share family responsibilities, and to promote gender equality. In our study, fathers with paternity leave had higher scores on the FBSES-SF. A large Swedish cohort study [21] found that, compared with fathers who did not take paternity leave or who postponed leave until after the infant\u0026rsquo;s first year, taking paternity leave at the time of birth was associated with higher levels of breastfeeding at 2, 4, and 6 months. Another study showed that, compared with fathers who took less than two weeks of leave, fathers who took more than two weeks had infants with higher breastfeeding rates [22]. However, evidence suggests that although around two-thirds of countries worldwide have paternity leave policies, these are often unpaid [23]. In China, paternity leave for newborn fathers varies from 7 to 30 days. Short leave duration and limited eligibility may constrain fathers\u0026rsquo; early involvement in childcare.\u003c/p\u003e\n\u003cp\u003eGreater attention to paternity leave is therefore warranted. Strengthening the legal and regulatory framework, improving enforcement, and ensuring effective implementation may further increase fathers\u0026rsquo; participation in early parenting and, in turn, enhance their capacity to support mothers to breastfeed.\u003c/p\u003e\n\u003cp\u003ePreferred feeding method and exposure to breast-milk substitute advertising were associated with fathers\u0026rsquo; breastfeeding support self-efficacy. In this study, fathers\u0026rsquo; preferred feeding method included exclusive breastfeeding, mixed feeding (breast milk plus formula), and formula feeding. However, no participant reported an intention to use formula feeding alone. Overall, 40.1% of fathers preferred exclusive breastfeeding and 59.9% preferred mixed feeding. This pattern is consistent with prior work on factors influencing fathers\u0026rsquo; breastfeeding attitudes [24], suggesting a close link between feeding intention and feeding attitude. Fathers who intended exclusive breastfeeding tended to hold stronger beliefs in breastfeeding and greater confidence in supporting the mother to breastfeed.\u003c/p\u003e\n\u003cp\u003eIn our survey, 52.1% of fathers reported exposure to breast-milk substitute advertising. Although the benefits of breastfeeding are widely recognised, marketing of breast-milk substitutes may undermine mothers\u0026rsquo; confidence in exclusive breastfeeding and shorten breastfeeding duration [25]. When mothers use a range of media platforms to seek infant-care information and share experiences, they may frequently encounter formula-related content embedded within these platforms, which can substantially shape feeding decisions. This underscores the need for more proactive, breastfeeding-supportive media actions to facilitate breastfeeding promotion and uptake.\u003c/p\u003e\n\u003cp\u003eBreastfeeding-related knowledge was also an important factor associated with fathers\u0026rsquo; breastfeeding support self-efficacy. Adequate knowledge is pivotal for enabling the father to provide effective support during breastfeeding; fathers\u0026rsquo; knowledge may also reinforce mothers\u0026rsquo; breastfeeding knowledge. Moreover, breastfeeding knowledge can strengthen fathers\u0026rsquo; commitment to breastfeeding and enable them to provide more practical and emotional support to the mother [26].\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eSeveral limitations should be noted. First, this was a single-centre study using convenience sampling, and participants had relatively high levels of education and income, which may limit generalisability. Second, loss to follow-up occurred at both time points, which may have introduced selection bias. Third, outcomes were primarily assessed using self-report measures and may have been influenced by social desirability. Fourth, although the study used a prospective two\u0026ndash;time point design, analyses were largely modelled separately at each time point; mixed-effects models or generalised estimating equations were not used to characterise within-person change trajectories and time effects. Fifth, some fathers completed questionnaires that were relayed via the mother, which may have affected fathers\u0026rsquo; participation and data quality.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this study, fathers\u0026rsquo; breastfeeding support self-efficacy was assessed at two time points in the early postpartum period in Beijing, China. The main findings were: (1) fathers\u0026rsquo; breastfeeding support self-efficacy was moderate overall, with no significant change in mean scores from 72 hours to 2 weeks postpartum (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05); (2) fathers\u0026rsquo; breastfeeding support self-efficacy was positively correlated with mothers\u0026rsquo; breastfeeding self-efficacy at both time points (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05); (3) fathers\u0026rsquo; breastfeeding knowledge was positively correlated with fathers\u0026rsquo; breastfeeding support self-efficacy at both time points; (4) paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, participation in the breastfeeding process, and breastfeeding knowledge were associated with fathers\u0026rsquo; breastfeeding support self-efficacy; and (5) the exclusive breastfeeding rates at 2 and 6 weeks postpartum were 38.5% and 43.8%, respectively.\u003c/p\u003e \u003cp\u003e \u003cb\u003eFuture research\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFuture work should include multicentre studies with extended follow-up to 3\u0026ndash;6 months postpartum. Longitudinal modelling is needed to test trajectories of fathers\u0026rsquo; breastfeeding support self-efficacy and to examine its predictive value for breastfeeding outcomes. In addition, the effectiveness of skills-based interventions targeting fathers should be evaluated.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eWHO \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; World Health Organization\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFBSES-SF \u0026nbsp; \u0026nbsp; Father Support Breastfeeding Self-Efficacy Scale-Short Form\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBSES-SF \u0026nbsp; \u0026nbsp; \u0026nbsp;Support Breastfeeding Self-Efficacy Scale-Short Form\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCBKS \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Comprehensive Breastfeeding Knowledge Scale\u003c/strong\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of\u003c/p\u003e\n\u003cp\u003eHelsinki.\u003c/p\u003e\n\u003cp\u003eThis study has been approved by the Institutional Review Board and Ethics Committee of Peking Union Medical College (approval no. PUMCSON-2021-25).All participants participated voluntarily, provided written informed consent, and could withdraw at any time.All collected data were anonymized to ensure that participants could not be identified.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data for this study will be available from the first and corresponding author upon\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ereasonable request\u003c/p\u003e\n\u003cp\u003eDeclaration of Competing Interest\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding declaration\u003c/p\u003e\n\u003cp\u003eThis study did not receive any specific grant support.\u003c/p\u003e\n\u003cp\u003eAuthor Contributions Statement\u003c/p\u003e\n\u003cp\u003eYu Rui: study design, data collection, data analysis, manuscript writing, and other related aspects. ZhangYi Fei: performed data analysis,revised the manuscript writing\u003c/p\u003e\n\u003cp\u003eZhu Can: assisted in data collection and revised the manuscript content. ZhangDong ying: supervised the study and reviewed the data and manuscript content.\u003c/p\u003e\n\u003cp\u003eAcknowledgement\u003c/p\u003e\n\u003cp\u003eWe would like to express our gratitude to the Obstetrics Department of Peking Union Medical College Hospital for providing the research platform and clinical data support. This support does not constitute financial funding for this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eVictora, C. G., Bahl, R., Barros, A. J., Fran\u0026ccedil;a, G. V., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C., \u0026amp; Lancet Breastfeeding Series Group (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet (London, England), 387(10017), 475\u0026ndash;490. https://doi.org/10.1016/S0140-6736(15)01024-7\u003c/li\u003e\n \u003cli\u003eVartan S. (2025). Breastfeeding boosts immune cells that protect against breast cancer. Nature, 10.1038/d41586-025-03419-4. Advance online publication. https://doi.org/10.1038/d41586-025-03419-4\u003c/li\u003e\n \u003cli\u003eGeneva.Global strategy for infant and young child feeding[EB/OL]. https://www.who.int/nutrition/topics/global_strategy_iycf/en/\u003c/li\u003e\n \u003cli\u003eHollis, J. L., Collins, C. E., DeClerck, F., Chai, L. K., McColl, K., \u0026amp; Demaio, A. R. (2020). Defining healthy and sustainable diets for infants, children and adolescents. Global Food Security, 27, 100401. https://doi.org/10.1016/j.gfs.2020.100401\u003c/li\u003e\n \u003cli\u003eLiu, K., Guo, J., Deng, W., \u0026amp; Su, Y. (2022). The Current Status of Breastfeeding Knowledge and Its Influencing Factors in Nursing Undergraduates: A Cross-Sectional Study in China. International journal of environmental research and public health, 20(1), 103. https://doi.org/10.3390/ijerph20010103\u003c/li\u003e\n \u003cli\u003eIsiguzo, C., Mendez, D. D., Demirci, J. R., Youk, A., Mendez, G., Davis, E. M., \u0026amp; Documet, P. (2023). Stress, social support, and racial differences: Dominant drivers of exclusive breastfeeding. Maternal \u0026amp; child nutrition, 19(2), e13459. https://doi.org/10.1111/mcn.13459\u003c/li\u003e\n \u003cli\u003eGu, Y., Xiang, Y., Chen, X., Wang, L., Shan, C., \u0026amp; Ji, M. (2025). Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women\u0026apos;s lactation: a longitudinal study. BMC pregnancy and childbirth, 25(1), 768. https://doi.org/10.1186/s12884-025-07851-2\u003c/li\u003e\n \u003cli\u003eFurman, L., Killpack, S., Matthews, L., Davis, V., \u0026amp; O\u0026apos;Riordan, M. A. (2016). Engaging Inner-City Fathers in Breastfeeding Support. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 11(1), 15\u0026ndash;20. https://doi.org/10.1089/bfm.2015.0092\u003c/li\u003e\n \u003cli\u003eBrown, A., \u0026amp; Davies, R. (2014). Fathers\u0026apos; experiences of supporting breastfeeding: challenges for breastfeeding promotion and education. Maternal \u0026amp; child nutrition, 10(4), 510\u0026ndash;526. https://doi.org/10.1111/mcn.12129\u003c/li\u003e\n \u003cli\u003eAtkinson, L., Silverio, S. A., Bick, D., \u0026amp; Fallon, V. (2021). Relationships between paternal attitudes, paternal involvement, and infant-feeding outcomes: Mixed-methods findings from a global on-line survey of English-speaking fathers. Maternal \u0026amp; child nutrition, 17 Suppl 1(Suppl 1), e13147. https://doi.org/10.1111/mcn.13147\u003c/li\u003e\n \u003cli\u003eDennis, C. L., Brennenstuhl, S., \u0026amp; Abbass-Dick, J. (2018). Measuring paternal breastfeeding self-efficacy: A psychometric evaluation of the Breastfeeding Self-Efficacy Scale-Short Form among fathers. Midwifery, 64, 17\u0026ndash;22. https://doi.org/10.1016/j.midw.2018.05.005\u003c/li\u003e\n \u003cli\u003eNieto, C., Lopez-Mases, P., Vila-Candel, R., \u0026amp; Lazaro, E. (2026). Experience of breastfeeding during hospitalization after birth: a qualitative study. European journal of obstetrics, gynecology, and reproductive biology, 316, 114786. https://doi.org/10.1016/j.ejogrb.2025.114786\u003c/li\u003e\n \u003cli\u003eChipojola, R., Dennis, C. L., \u0026amp; Kuo, S. Y. (2022). Psychometric Assessment of the Paternal Breastfeeding Self-Efficacy Scale-Short Form: A Confirmatory Factor Analysis of Malawian Fathers. Journal of human lactation : official journal of International Lactation Consultant Association, 38(1), 28\u0026ndash;36. https://doi.org/10.1177/08903344211065036\u003c/li\u003e\n \u003cli\u003eZhou, Y., Xue, C., Jin, H. Y., Zhang, M., Shen, Z. C., Hu, Y. M., Zhang, W. N., \u0026amp; Luo, C. F. (2020). Reliability and validity of the Chinese version of the Father Support Breastfeeding Self-Efficacy Scale-Short Form (FBSES-SF) (in Chinese). Zhonghua Huli Zazhi (Chin J Nurs), 55(7), 1116-1120. https://doi.org/10.3761/j.issn.0254-1769.2020.07.031\u003c/li\u003e\n \u003cli\u003eDennis C. L. (2003). The breastfeeding self-efficacy scale: psychometric assessment of the short form. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 32(6), 734\u0026ndash;744. https://doi.org/10.1177/0884217503258459\u003c/li\u003e\n \u003cli\u003eLiu, Y. J., Wang, M., \u0026amp; Dong, X. F. (2016). Reliability and validity of the Chinese version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) (in Chinese). Zhongguo Shiyong Huli Zazhi (Chin J Prac Nurs), 32(18), 1361-1364. https://doi.org/10.3760/cma.j.issn.1672-7088.2016.18.001\u003c/li\u003e\n \u003cli\u003eAbbass-Dick, J., Newport, A., Pattison, D., Sun, W., Kenaszchuk, C., \u0026amp; Dennis, C. L. (2020). Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale. Midwifery, 83, 102642. https://doi.org/10.1016/j.midw.2020.102642\u003c/li\u003e\n \u003cli\u003eKrikitrat, Preeyakamon et al. \u0026ldquo;Relationships between Thai fathers\u0026apos; self-efficacy to support breastfeeding and exclusive breastfeeding duration.\u0026rdquo; Midwifery vol. 106 (2022): 103261. doi:10.1016/j.midw.2022.103261\u003c/li\u003e\n \u003cli\u003eZeng, Jing et al. \u0026ldquo;Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study.\u0026rdquo; BMC public health vol. 24,1 2698. 3 Oct. 2024, doi:10.1186/s12889-024-20136-1\u003c/li\u003e\n \u003cli\u003eJacobsen, Marie Honor\u0026eacute; et al. \u0026ldquo;Understanding fathers\u0026apos; responses to breastfeeding as a \u0026quot;shared parental task\u0026quot;: a realist evaluation of a Danish breastfeeding support intervention.\u0026rdquo; Archives of public health = Archives belges de sante publiquevol. 83,1 299. 27 Nov. 2025, doi:10.1186/s13690-025-01790-2\u003c/li\u003e\n \u003cli\u003eFlacking, Ren\u0026eacute;e et al. \u0026ldquo;The influence of fathers\u0026apos; socioeconomic status and paternity leave on breastfeeding duration: a population-based cohort study.\u0026rdquo; Scandinavian journal of public health vol. 38,4 (2010): 337-43. doi:10.1177/1403494810362002\u003c/li\u003e\n \u003cli\u003eParker, J. J., Simon, C. D., \u0026amp; Garfield, C. F. (2025). Fathers\u0026apos; work leave and infant breastfeeding in a state-representative sample of fathers in Georgia, United States. BMC public health, 25(1), 767. https://doi.org/10.1186/s12889-025-22013-x\u003c/li\u003e\n \u003cli\u003eNick, J. M., Sahin, S., Roberts, L. R., Hatton, A., \u0026amp; Cafferky, B. (2025). Effect of paternity leave or fathers\u0026apos; parental leave on infant health: a systematic review protocol. JBI evidence synthesis, 23(4), 792\u0026ndash;800. https://doi.org/10.11124/JBIES-24-00046\u003c/li\u003e\n \u003cli\u003eBurris, J. C., Stroker, V., Fu, Z., \u0026amp; Woolf, K. (2025). Feeding attitudes of fathers in the United States are associated with breastfeeding success: A cross-sectional study. Nutrition and health, 31(4), 1747\u0026ndash;1757. https://doi.org/10.1177/02601060251320722\u003c/li\u003e\n \u003cli\u003eArslan, A. G. S., \u0026amp; Eksioglu, A. (2025). Perceptions of Media and Advertisements on Breastfeeding Decisions of Mothers in Turkey: A Qualitative Study. Journal of human lactation : official journal of International Lactation Consultant Association, 41(4), 620\u0026ndash;633. https://doi.org/10.1177/08903344251363609\u003c/li\u003e\n \u003cli\u003eOuyang, Y. Q., \u0026amp; Nasrin, L. (2021). Father\u0026apos;s Knowledge, Attitude and Support to Mother\u0026apos;s Exclusive Breastfeeding Practices in Bangladesh: A Multi-Group Structural Equations Model Analysis. Healthcare (Basel, Switzerland), 9(3), 276. https://doi.org/10.3390/healthcare9030276\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Breastfeeding, Paternal breastfeeding support self-efficacy, Family support","lastPublishedDoi":"10.21203/rs.3.rs-8676744/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8676744/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eBreast milk is the optimal source of infant nutrition, yet breastfeeding rates in China remain below recommended targets. The father is a key source of social support for breastfeeding; fathers’ breastfeeding support self-efficacy may shape their involvement and, in turn, influence breastfeeding initiation and duration. However, evidence remains limited regarding factors associated with fathers’ breastfeeding support self-efficacy in the early postpartum period and its relationship with mothers’ breastfeeding self-efficacy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A two-wave survey was conducted among 216 families (newborns’ father and mother) recruited from a tertiary hospital in Beijing, China. Fathers’ breastfeeding support self-efficacy, breastfeeding-related knowledge, and relevant sociodemographic and family factors were assessed at 72 hours postpartum (T1) and 2 weeks postpartum (T2), alongside mothers’ breastfeeding self-efficacy at the same time points. Data were analysed using descriptive statistics, correlation analyses, and multiple linear regression to identify factors associated with fathers’ breastfeeding support self-efficacy\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Fathers’ breastfeeding support self-efficacy was positively correlated with mothers’ breastfeeding self-efficacy at T1 (r=0.219, p\u0026lt;0.05), with a stronger association at T2 (r=0.462, p\u0026lt;0.05). In multivariable regression, fathers’ breastfeeding knowledge, participation in the breastfeeding process, paternity leave, and exposure to breast-milk substitute advertising were significantly associated with fathers’ breastfeeding support self-efficacy (all p\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Fathers’ breastfeeding support self-efficacy was at a moderate level, and higher paternal breastfeeding support self-efficacy was associated with higher maternal breastfeeding self-efficacy. Paternity leave, preferred feeding method, exposure to breast-milk substitute advertising, and breastfeeding-related knowledge were significant correlates of fathers’ breastfeeding support self-efficacy.\u003c/p\u003e","manuscriptTitle":"Current Status and Influencing Factors of Fathers’ Early Support for Breastfeeding Self-Efficacy in China: A Cross-Sectional Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-08 16:30:50","doi":"10.21203/rs.3.rs-8676744/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-02-27T08:28:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-23T12:36:54+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-01T18:25:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-29T02:34:40+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2026-01-29T02:25:06+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ad1c8c90-417d-4051-81e5-804c4eb17545","owner":[],"postedDate":"March 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-08T16:30:51+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-08 16:30:50","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8676744","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8676744","identity":"rs-8676744","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}