Attitudes, Roles, and Community Perspectives Regarding Male Involvement in Breastfeeding in Juba, South Sudan
There is growing awareness that fathers’ infant-feeding preferences may influence mothers’ intentions to breastfeed and help promote optimal breastfeeding. Despite this understanding, fathers are not part of most breastfeeding promotion strategies such as ‘mother-to-mother’ support groups. This study examined male partners’ breastfeeding attitudes, roles, and community views on male involvement through quantitative and qualitative methods. We interviewed 275 fathers of children aged <2 years, 15 key informants, and five focus groups to learn from the community. The data were analyzed using SPSS version 28.0; and thematically to generate frequency tables, median, interquartile range, and repeating patterns. Above 70% of fathers agreed that breastfeeding did not harm marriage or reduce women’s attractiveness. Breastfeeding in public is also accepted, and responsibilities are shared. The study also found support for >80% of the critical roles, including housework, baby care, and holding and watching the mother breastfeed. Education level was significantly associated with breastfeeding attitudes (r=-0.207 p =0.001<0.05) and roles (r=0.308, p=0.001<0.05). Employment status was also significantly associated with attitudes (r=0.184, p=0.003<0.05) and roles in breastfeeding (r=-0.155, p=0.007<0.05). However, there was no significant association between hours of work and the attitudes/roles of male partners in breastfeeding (r=-0.074, p=0.125>0.05 and r=0.049, p=0.224>0.05, respectively). The key barriers that emerge included challenging patriarchy, gender role segregation; Sexism; false beliefs; and work-related, social, economic, and personal factors. The major cultural hurdles that emerged signify the need to develop context-specific strategies to dispel myths about male breastfeeding involvement and promote supporting practices.
Keywords: Attitudes, Breastfeeding, Community, Involvement, Male, Perspectives, Roles.
 UNSDGS. (2015). Goal
3: Ensure healthy lives and promote wellbeing for all ages. Retrieved from https://www.un.org/sustainabledevelopment/health/.
 UNICEF South Sudan. (2020). Key demographic indicators.
 WHO. (2017). Ten facts on breastfeeding. https://www.who.int/features/factfiles/breastfeeding/en/.
 UNICEF. (2019). Health Briefing Note. https://www.unicef.org/southsudan/reports/health-briefing-note.
 WHO &The Lancet. (2016).
LANCET BREASTFEEDING SERIES: Key Messages and Findings. https://www.who.int/pmnch/media/news/2016/breastfeeding_lancet.pdf.
 Yourkavitch, J. M., Alvey, J.
L., Prosnitz, D. M., & Thomas, J. C. (2017). Engaging men to promote and support
exclusive breastfeeding: a descriptive review of 28 projects in 20 low-and middle-income
countries from 2003 to 2013. Journal of Health, Population, and Nutrition,
36 (1), 1-10.
 Dinga, L. A., Kiage, B. N., &
Kyallo, F. M. (2018). Effect of paternal education about complementary feeding of
infants in Kisumu County, Kenya. African Journal of Food, Agriculture, Nutrition
and Development, 18(3), 13702-13716.
 Gebremariam, K. T., Zelenko,
O., Mulugeta, A., & Gallegos, D. (2021). A cross-sectional comparison of breastfeeding
knowledge, attitudes, and perceived partners’ support among expectant couples in
Mekelle, Ethiopia. International Breastfeeding Journal, 16(1), 1-8.
 Bulemela, J., Mapunda, H., Snelgrove-Clarke,
E., MacDonald, N., & Bortolussi, R. (2019). Supporting breastfeeding: Tanzanian
men’s knowledge and attitude towards exclusive breastfeeding. International breastfeeding
journal, 14(1), 1-7.
 Abera, M., Abdulahi, M., &
Wakayo, T. (2017). Fathers’ involvement in breastfeeding practices and associated
factors among households with fewer than six months in Southern Ethiopia: a cross-sectional
study. Pediatr Ther, 7 (1), 1000306.
 (Newhook et al., 2017)
 Tsai. (2014). Influence of Partner Support on an Employed
Mother’s Intention to Breastfeed After Returning to Work. Breastfeed med. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025622/.
 CARE South Sudan. (2014). Gender in brief. https://www.care.org/wp-content/uploads/2020/05/Gender20in20Brief20South20Sudan20.pdf.
 Dumbaugh, M., Tawiah-Agyemang, C., Manu, A., ten Asbroek,
G. H., Kirkwood, B., & Hill, Z. (2014). Perceptions of, attitudes towards and
barriers to male involvement in newborn care in rural Ghana, West Africa: a qualitative
analysis. BMC pregnancy and childbirth, 14, 269. https://doi.org/10.1186/1471-2393-14-269.
 Chisango, T., Mayekiso, T. and Thomae, M. (2015), The social
nature of benevolent Sexism and the antisocial personality of hostile Sexism: Is
benevolent Sexism more likely to manifest in public contexts and hostile Sexism
in private contexts?. Int J Psychol, 50: 363-371. https://doi.org/10.1002/ijop.12106.
 World Bank. (2018).9lLiteracy rate, adult male (% of males ages 15 and above)-South Sudan.
 Abu-Abbas, M.W., Kassab, M., & Shelash,
K.I. (2016). Fathers And Breastfeeding Process: Determining Their Role And Attitudes. European
Scientific Journal, ESJ, 12, 327-327.
 Papp L. M. (2012). The longitudinal role of breastfeeding
in mothers’ and fathers’ relationship
quality trajectories. Breastfeeding medicine: the official journal of the Academy of Breastfeeding Medicine, 7(4), 241–247. https://doi.org/10.1089/bfm.2011.0074.
 Komodiki, E., Kontogeorgou, A.,
Papastavrou, M., Volaki, P., & Genitsaridi, S. (2014). Breastfeeding in public:
a global review of different attitudes towards it. J Pediatr Neonatal Care,
1(6), 00040. DOI: 10.15406/jpnc.2014.01.00040.
 Dinga, L. A., Kiage, B. N., & Kyallo, F. M. (2018).
Effect of paternal education about complementary feeding of infants in Kisumu County,
Kenya. African Journal of Food, Agriculture, Nutrition and Development, 18(3),
 Tamiru, D., Belachew, T., Loha, E., & Mohammed, S.
(2012). Sub-optimal breastfeeding of infants during the first six months and associated
factors in rural communities of Jimma Arjo Woreda, Southwest Ethiopia. BMC public
health, 12, 363. https://doi.org/10.1186/1471-2458-12-363.
 Mat Nawi, N. I., & Abdul Hamid, S. B. (2021). Determinants
of fathers’ involvement in breastfeeding practices in Kuala Selangor. Malaysian
Journal of Nutrition, 27 (1). DOI: https://doi.org/10.31246/mjn-2020-0070.