Influence of paternal preconception health on pregnancy, intrapartum, postpartum and early childhood outcomes: protocol for a parallel scoping review.

INTRODUCTION: Preconception care is the provision of behavioural, social or biomedical interventions to women and couples prior to conception. To date, preconception research has primarily focused on maternal health, despite the male partner's contribution before birth to both short-term and long-term child outcomes. The objectives of the reviews are: (1) to identify, consolidate and analyse the literature on paternal preconception health on pregnancy and intrapartum outcomes, and (2) to identify, consolidate and analyse the literature on paternal preconception health on postpartum and early childhood outcomes. METHODS AND ANALYSIS: A scoping review will be conducted following the Joanna Briggs Institute methodology. MEDLINE, PsycINFO, Embase, Scopus and CINAHL databases will be searched for articles published in English. Two independent reviewers will screen titles and abstracts and then full text using Covidence, with conflicts resolved by a third reviewer. Data extraction will be performed using Covidence. ETHICS AND DISSEMINATION: Ethics approval is not required for this scoping review. Results will be published in peer-reviewed journals as well as presented at relevant national and international conferences and meetings.

Translation and validation of the Chinese version of the comprehensive breastfeeding knowledge scale (CBKS).

BACKGROUND: The level of breastfeeding knowledge of nursing students may influence their ability to support breastfeeding families. However, to date, it has not been possible to measure this accurately due to the lack of existence of a validated tool in Chinese. OBJECTIVES: To translate the Comprehensive Breastfeeding Knowledge Scale (CBKS) into Chinese, and then evaluate its psychometric properties among Chinese undergraduate nursing students in order to inform and evaluate a nursing breastfeeding education programme. METHODS: The Brislin translation model was followed, and a three-phase process (translation, back-translation and cultural adaptation) was used to sinicize the CBKS and evaluate its content validity. Construct validity was evaluated with exploratory factor analysis (EFA), and the reliability of internal consistency of the Chinese version of the CBKS was tested by calculating Cronbach's alpha coefficient and the half reliability coefficient. SETTINGS: Two nursing schools in Beijing and Nanjing, China. PARTICIPANTS: Four hundred and thirty-nine undergraduate nursing students (257 from Beijing and 182 from Nanjing). RESULTS: Five experts rated the content validity of the Chinese version of the CBKS as excellent. EFA showed that the Chinese version of the CBKS had three subscales and 23 items. Cronbach's alpha coefficient of the Chinese version of the CBKS and the half reliability coefficient were 0.70 and 0.73, respectively. Students who had completed an obstetrics or paediatric nursing course had significantly higher total scores and mean scores for most items compared with those who had not taken a course. Most of the indictors of EFA met the standards of construct validity, and some were very close to the cut-off. CONCLUSION: Overall, the 23-item Chinese version of the CBKS is an acceptable tool to measure the level of breastfeeding knowledge among undergraduate nursing students. This scale can be used to inform the design and evaluation of breastfeeding education materials for nursing students or other health profession students.

Maternal and co-parental experiences and satisfaction with a co-parenting breastfeeding eHealth intervention in Canada.

BACKGROUND: Suboptimal breastfeeding rates are a public health priority. Interventions that include both breastfeeding women and their co-parents can increase breastfeeding initiation, duration, and exclusivity. eHealth can be an effective means of designing such interventions, as parents increasingly use the internet to access health information. The objective of this study was to determine maternal and co-parent satisfaction with an eHealth intervention. METHODS: The study was part of a larger randomized controlled trial that took place in Canada between March 2018 and April 2020. Data was collected from mothers (n = 56) and co-parents (n = 47). INTERVENTION: The eHealth intervention group received: 1) continued access to an eHealth breastfeeding co-parenting resource from the prenatal period to 52 weeks postpartum; 2) a virtual meeting with a research assistant; and 3) 6 weekly emails reminders. Follow-up data were collected via online questionnaires completed at 2 weeks post enrollment and 4, 12, 26, and 52 weeks postpartum to determine use and satisfaction with the intervention components. FINDINGS: The majority of mothers and co-parents independently reviewed the eHealth resource (95% and 91%, respectively), with higher use in the prenatal period. Participants found the resource to be useful (92%), informative (93%), targeted both parents (90%), and easy to understand (97%). Participants indicated the resource was comprehensive, easily navigated, convenient, and engaging. APPLICATION TO PRACTICE: Providing mothers and their co-parents with breastfeeding co-parenting support via an eHealth intervention delivers accessible, comprehensive information which may assist them in meeting their breastfeeding goals.

Educating Homecare Nurses about Deprescribing of Medications to Manage Polypharmacy for Older Adults.

The purpose of this study is to evaluate the acceptability, appropriateness, and effectiveness of educational intervention with homecare nurses about deprescribing of medications among older adults. An evaluation research study was conducted using survey design to evaluate deprescribing education with a total sample of 45 homecare nurses from three homecare organizations. Post-training evaluation data were evaluated using Likert scale and open-ended questions were analyzed using descriptive statistical analyses and qualitative thematic analysis. Post-intervention questionnaire responses provided descriptions about homecare nurses' perspectives related to deprescribing education, as well as the effectiveness of training in addressing their knowledge gaps. The pilot-testing of deprescribing learning modules and educational training revealed acceptability and suitability for future scale-up to expand its future reach and adoption by other homecare organizations. This study provided important implications into the barriers that impact the effectiveness of deprescribing education, and facilitators that support the future refinement of learning modules.

Designing an eHealth Breastfeeding Resource With Young Mothers Using a Participatory Design.

INTRODUCTION: Breastfeeding rates among young mothers are low and do not meet recommendations from health authorities, putting the health of young mothers and their infants at risk. Young mothers require breastfeeding support that meets their learning needs and preferred mode for accessing information. The objective of this study was to work collaboratively with young mothers in order to cocreate an eHealth breastfeeding resource. METHODOLOGY: A three-phase exploratory study was conducted in Ontario, Canada. In Phases I and II, young mothers and health care providers (HCPs) were recruited and preferences for an eHealth breastfeeding resource were explored. In Phase III, feedback from young mothers and HCPs about the new resource was collected. RESULTS: Participants found the breastfeeding eHealth resource visually appealing, engaging, and informative. DISCUSSION: Cocreating a tailored breastfeeding eHealth resource with young mothers and HCPs using a participatory approach ensured that the resource design and content met the learning needs of young mothers.

The comparison of access to an eHealth resource to current practice on mother and co-parent teamwork and breastfeeding rates: A randomized controlled trial.

BACKGROUND: Breastfeeding rates are suboptimal, putting mothers and their infants' health at risk. One modifiable risk factor amenable to intervention is partner support. Having women work as a team with their co-parents to meet their breastfeeding goals has been found to improve breastfeeding outcomes. eHealth resources have been found to be accessible and feasible ways to provide breastfeeding education yet, the best way to design breastfeeding interventions for mothers and their co-parents is not known. OBJECTIVES: To compare two study conditions to determine: (1) which way is more effective to provide breastfeeding education to women and their co-parents on increasing breastfeeding rates and associated secondary outcomes, such as breastfeeding knowledge, attitude, self-efficacy and overcoming challenges; (2) the difference in co-parenting and partner support between the study groups; (3) how parents in both groups preferred to access breastfeeding information; and (4) the groups' satisfaction with the eHealth resource that was provided. DESIGN: This study used a randomized controlled trial design (Clinicaltrials.org #NCT03492411). Participants were randomly allocated to study groups with concealed opaque envelopes by a blinded research assistant. Participants in Study Condition #1 (SC1) accessed a previously created, online e-Health resource, in addition to other generally available resources they could access in the community; participants in Study Condition #2 (SC2) accessed only the generally available resources. SETTING: Participants were recruited in health care providers' offices and services for expectant parents in Ontario and via social media throughout Canada. PARTICIPANTS: Expectant women (n = 113) and their co-parents (n = 104) were enrolled. METHODS: After eligibility was determined, consents obtained and baseline surveys completed, group allocation was conducted. SC1 had a virtual meeting with a research assistant to review the eHealth resource. Weekly emails were sent to all participants for 6 weeks as reminders. Follow-up data were electronically collected from mothers and co-parents at 2 weeks post enrollment and 4, 12, 26 and 52-weeks postpartum. RESULTS: Breastfeeding rates were high in both groups (SC1 63% and SC2 57% 'exclusive' 6 months) and (SC1 71% and SC2 78% 'any' 12 months) and not statistically significantly different. High scores were found in both groups in secondary outcome measures. Generally available breastfeeding resources were used in both groups with websites being used often and rated as most helpful. SC1 rated the eHealth resource provided to them highly. CONCLUSION: The findings suggest both mothers and their co-parents should be targeted in breastfeeding education and web-based resources designed to meet their needs.

Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale.

AIM: To develop a breastfeeding knowledge scale that aligns with the Baby Friendly Hospital Initiative and psychometrically test it among expectant parents. BACKGROUND: Although breastfeeding is recommended by all leading health authorities, rates remain suboptimal with women often not achieving their breastfeeding goals. One factor found to positively influence infant feeding behaviours is increased maternal breastfeeding knowledge. However, little research has been conducted validating the dimensions of breastfeeding knowledge to guide interventions to promote positive breastfeeding outcomes. DESIGN: Following an extensive literature review, the 28-item Comprehensive Breastfeeding Knowledge Scale (CBKS) was developed and psychometrically tested. METHOD: A sample of 217 Canadian expectant parents (113 women and 104 coparents) was recruited and administered the CBKS with follow-up questionnaires at 4 and 12 weeks postpartum. Psychometric analyses included exploratory factor analysis, internal consistency, concurrent validity, and predictive validity. RESULTS: Exploratory factor analysis resulted in three dimensions: (1) managing milk supply; (2) persisting through challenges; and (3) correcting misconceptions. Coefficient alpha for the total scale was 0.83 and support for concurrent validity was demonstrated through significant positive correlations with the Iowa Infant Feeding Attitude scale. Further, higher total and subscale scores in pregnancy were associated with exclusive breastfeeding at 4 and 12 weeks postpartum, providing good evidence for predictive validity. CONCLUSION: Preliminary data suggest the CBKS is a valid and reliable measure of breastfeeding knowledge. Upon further testing, this self-report measure may be used to (1) identify women with low breastfeeding knowledge requiring targeted support, (2) individualize health professional care with breastfeeding women, and (3) evaluate the effectiveness of breastfeeding interventions and programs.

Exploration of home care nurse's experiences in deprescribing of medications: a qualitative descriptive study.

OBJECTIVES: The aim of this study is to explore the barriers and enablers of deprescribing from the perspectives of home care nurses, as well as to conduct a scalability assessment of an educational plan to address the learning needs of home care nurses about deprescribing. METHODS: This study employed an exploratory qualitative descriptive research design, using scalability assessment from two focus groups with a total of 11 home care nurses in Ontario, Canada. Thematic analysis was used to derive themes about home care nurse's perspectives about barriers and enablers of deprescribing, as well as learning needs in relation to deprescribing approaches. RESULTS: Home care nurse's identified challenges for managing polypharmacy in older adults in home care settings, including a lack of open communication and inconsistent medication reconciliation practices. Additionally, inadequate partnership and ineffective collaboration between interprofessional healthcare providers were identified as major barriers to safe deprescribing. Furthermore, home care nurses highlighted the importance of raising awareness about deprescribing in the community, and they emphasised the need for a consistent and standardised approach in educating healthcare providers, informal caregivers and older adults about the best practices of safe deprescribing. CONCLUSION: Targeted deprescribing approaches are important in home care for optimising medication management and reducing polypharmacy in older adults. Nurses in home care play a vital role in medication management and, therefore, educational programmes must be developed to support their awareness and understanding of deprescribing. Study findings highlighted the need for the future improvement of existing programmes about safer medication management through the development of a supportive and collaborative relationship among the home care team, frail older adults and their informal caregivers.

Perinatal breastfeeding interventions including fathers/partners: A systematic review of the literature.

OBJECTIVE: Support from fathers is consistently associated with improved breastfeeding duration and exclusivity rates. Additionally, there is growing evidence that fathers want to be included in breastfeeding interventions provided by health care professionals. The objective of this review was to determine the effect of partner-inclusive educational and psychosocial interventions on breastfeeding initiation, duration, and exclusivity. DESIGN: A systematic review was conducted using a search strategy developed with an expert health sciences librarian. Electronic databases MEDLINE, EMBASE, CINAHL, and PsycINFO were systematically searched for randomized controlled trials and quasi-experimental studies from inception to August 4, 2018. Independent data extraction and quality assessments were conducted by authors using Cochrane Collaboration tools. Due to significant heterogeneity in intervention content, outcome measures, and follow-up time points, data were synthesized qualitatively. FINDINGS: 3982 articles were identified, of which 12 studies in 15 publications met the inclusion criteria and were included. All of the studies improved at least one breastfeeding outcome, including duration (n = 5/9) and exclusivity (n = 8/10) up to 24 weeks postpartum. Six studies examined increasing paternal breastfeeding support and all found beneficial effects. Biases were identified in the studies with the most common bias relating to the randomization process and the blinding of outcome assessors. IMPLICATIONS FOR PRACTICE: The inclusion of fathers/partners in breastfeeding interventions improves breastfeeding initiation, duration, and exclusivity rates. Interventions that include face-to-face information delivery, are designed in a culturally appropriate manner, and provide information on how partners can support breastfeeding are more likely to have a beneficial effect. Research is warranted to examine the underlying intervention mechanisms.

Prevalence and predictors of exclusive breastfeeding among immigrant and Canadian-born Chinese women.

Breastfeeding is the optimal method for infant feeding, yet migrant women may be at risk for suboptimal exclusivity rates. In a cohort of immigrant and Canadian-born Chinese women, our objectives were to (a) describe patterns and prevalence of exclusive breastfeeding at 1, 3, and 6 months postpartum; (b) identify risk and protective factors associated with exclusivity; and (c) examine potentially differential importance of these factors across this 6-month period. This was a prospective study of 565 immigrants and Canadian-born Chinese women (Toronto, Canada). Exclusive breastfeeding was measured at 1, 3, and 6 months postpartum. Predictors comprised fixed (demographics, history of depression, immigrant status, prenatal breastfeeding classes, in-hospital formula supplementation, baseline social support, and baseline acculturative stress) and time-dependent (depression, anxiety, fatigue, and breastfeeding problems) variables. Descriptive statistics, logistic regression, and generalized linear mixed models, respectively, were undertaken to address the objectives. Patterns of breastfeeding practices included exclusive breastfeeding in all time points (26.8%) or none (32.9%) and moving from exclusive to nonexclusive (20.3%) or nonexclusive to exclusive breastfeeding (15.2%). Women less likely to breastfeed exclusively at 1, 3, or 6 months were those whose infants received in-hospital formula supplementation. Exclusivity attrition was higher between 3 and 6 months than 1-3 months. Immigrant status and in-hospital formula supplementation had a significant impact on exclusivity earlier in the postpartum period while breastfeeding problems were associated with decreased exclusivity across time. Proactive preventive efforts are need to maintain breastfeeding exclusivity especially between 3 and 6 months if women are to meet international breastfeeding recommendations.

Investigating the effectiveness of school-based breastfeeding education on breastfeeding knowledge, attitudes and intentions of adolescent females.

Breastfeeding intentions are usually shaped prior to conception, often as early as adolescence. Secondary school reproductive curriculum may be an appropriate setting to provide breastfeeding information on a population level. The purpose of this pilot study was to investigate the impact of a school-based breastfeeding educational intervention on the breastfeeding knowledge, attitudes and future infant feeding intentions of secondary school adolescent females; as well as assess the acceptability and feasibility of the intervention among the target population. Participants consisted of a convenience sample of 77 adolescent female students from an Ontario secondary school. Participants received one 70 min breastfeeding educational session in health education class. Data were collected using self-administered questionnaire at baseline and one day after the intervention. A modified version of the Iowa Infant Feeding Attitude Scale (IIFAS) and a modified breastfeeding knowledge scale were used to measure breastfeeding attitudes and knowledge. Additional outcomes measured included future breastfeeding intentions and participants' perceptions of the educational session. Breastfeeding knowledge (p < 0.001), attitudes (p < 0.001), and future intentions of participants to exclusively breastfeed increased significantly (p < 0.05) at post-test. The participant feedback indicated that they found the content useful, interesting and the information was presented in an engaging manner. These findings suggest that adolescent females are receptive to learning about breastfeeding in school and a single school-based breastfeeding educational intervention can positively impact breastfeeding knowledge, attitudes and future intentions of adolescent females. The secondary school setting may be an ideal setting for the inclusion of educational breastfeeding content to enable future informed decision making.

Measuring paternal breastfeeding self-efficacy: A psychometric evaluation of the Breastfeeding Self-Efficacy Scale-Short Form among fathers.

The majority of women discontinue breastfeeding before the recommended 6 months postpartum. If health professionals are to improve breastfeeding outcomes, predisposing factors amenable to intervention need to be identified. One possible risk factor to target is breastfeeding self-efficacy, which has been shown to significantly influence breastfeeding outcomes. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was originally designed to assess a mother's confidence in her ability to breastfeed. Fathers play an important role in supporting their breastfeeding partner and their self-efficacy may also influence breastfeeding outcomes. However, it is unknown if the BSES-SF is a valid and reliable measure for measuring self-efficacy among fathers. The goal of this study is to assess the psychometric properties of the BSES-SF among fathers. Fathers (n=214) whose partners were breastfeeding were recruited from a large hospital in Toronto, Canada. Fathers completed the modified BSES-SF in-hospital and at 6 weeks postpartum. The unidimensional structure of the BSES-SF was confirmed, with the best model fit found at 6 weeks. Cronbach's alpha coefficient was 0.91 at baseline and 0.92 at 6 weeks. Paternal BSES-SF scores were significantly correlated with maternal BSES-SF scores, fathers' breastfeeding attitude, importance fathers place on breastfeeding, breastfeeding level and exclusivity, and perception of breastfeeding progress. While paternal in-hospital BSES-SF scores did not predict breastfeeding at 6 and 12 weeks, 6 week BSES-SF scores predicted exclusivity at 12 weeks. This study provides initial evidence that the modified BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among fathers, especially when used following hospital discharge.

Designing an eHealth Breastfeeding Resource With Indigenous Families Using a Participatory Design.

INTRODUCTION: The traditional practice of breastfeeding has been negatively affected by the historical trauma experienced by the Canadian Indigenous community. Culturally relevant information and support should be created to enable the communities to reclaim this traditionally revered infant feeding method. The objective of this participatory design study was to work in partnership with Indigenous communities to create an eHealth breastfeeding resource for Indigenous families. METHODOLOGY: In partnership with Indigenous mothers and care providers in Ontario, Canada, an eHealth breastfeeding resource was designed based on their recommendations. Once the new resource was created, it was evaluated by additional Indigenous mothers. RESULTS: The participants indicated the resource was culturally relevant and that they liked the content and design. DISCUSSION: Using a participatory design when creating services and programs in partnership with Indigenous communities ensures the creation of resources that meet their needs, are culturally relevant, and align with cultural beliefs.

Maternal and paternal experiences and satisfaction with a co-parenting breastfeeding support intervention in Canada.

OBJECTIVE: Long-standing suboptimal breastfeeding rates suggest the design of interventions to assist parents in meeting international recommendations is warranted. Targeting both parents is necessary given research that indicates partner support for breastfeeding increases initiation, duration and exclusivity. The objective of this study was to determine maternal and paternal satisfaction with the intervention they received while participating in a co-parenting breastfeeding support trial. DESIGN: This study was part of a larger randomized controlled trial, which took place in Toronto, Canada between March and July 2012. The co-parenting breastfeeding support intervention was delivered to 107 mothers and 107 fathers in the intervention group. INTERVENTION: Intervention group participants were exposed to (1) an in-hospital discussion with a lactation consultant, (2) a breastfeeding booklet entitled Breastfeeding Matters, (3) an evidence-based co-parenting workbook, (4) a website with co-parenting and breastfeeding information, (5) a co-parenting DVD, (6) supportive emails to parents at week 1 and 3 postpartum, and (7) a proactive telephone call at two weeks postpartum. MEASUREMENTS: Mothers and fathers in the intervention group completed a survey with questions regarding their experience with the intervention components and satisfaction with the content on involving fathers, co-parenting, and breastfeeding, and the diverse modes of information delivery. FINDINGS: All mothers (n=107, 100%) and the majority of fathers (n =105, 98%) received at least one component of the intervention. The most highly utilized component was the Breastfeeding Matters booklet (mothers n=90, 90%; fathers n=67, 72%). The in-hospital discussion was the component the most fathers (n=77, 82.8%) and mothers (n=82, 82%) agreed was helpful. All intervention components were utilized and reported as helpful by mothers and fathers. IMPLICATIONS FOR PRACTICE: Providing information to parents on breastfeeding, including fathers, and co-parenting was well received by parents. Information should target both parents and be delivered in a variety of modes.

The Development and piloting of an eHealth breastfeeding resource targeting fathers and partners as co-parents.

OBJECTIVE: Traditionally breastfeeding education programs target mothers solely. The objective of this study was to design and pilot test an interactive eHealth breastfeeding co-parenting resource developed to target both mothers and fathers. eHealth resources provide an accessible and engaging format on which to educate parents and assist them in meeting their breastfeeding goals. Best practices to design such resources are not currently known. DESIGN: A three phase pilot study was conducted. The three phases included conducting a needs assessment, creating the resource and pilot testing the resource with mother, father and health care professionals to determine their perspectives regarding the usability and design of the prototype resource. The interactive prototype resource was designed to provide information to parents on breastfeeding and co-parenting, which included suggestions on how fathers can be involved and support breastfeeding and how the couples can work as a team to meet their breastfeeding goals. Setting: Recruitment took place in a health region in Southern Ontario, Canada between June 2014 and March 2015. Online questionnaires were completed by participants in all phases of the study. PARTICIPANTS: Participants (n=149) were pregnant or new mothers and their partners in the health region who read and speak English and had access to the internet and health care professionals who work with breastfeeding families in Ontario, Canada. INTERVENTION: A prototype eHealth breastfeeding co-parenting resource was developed based on maternal and paternal feedback from Phase I and utilized an interactive interface which included games and multimodal information delivery. The prototype eHealth resource was provided to the parents in Phase II and health care professionals in Phase III. The final resource was created based on feedback from these participants. MEASUREMENTS AND FINDINGS: The resource was pilot tested with new and expectant parents using pre- and post-test questionnaires which included measures for breastfeeding self-efficacy (Breastfeeding Self-Efficacy Short Form), infant feeding attitude (Iowa Infant Feeding Attitude Scale), breastfeeding knowledge (Breastfeeding Knowledge Questionnaire) and co-parenting relationship (Co-parenting Relationship Scale). Maternal and paternal breastfeeding self-efficacy and knowledge and infant feeding attitude scores all increased from pre-test to post-test. However, there was no difference in the co-parenting relationship scores from pretest to post-test. KEY CONCLUSIONS: This study has used feedback from parents and health professionals to develop a prototype resource which appears to be effective in increasing parents' breastfeeding knowledge, attitude and self-efficacy. The prototype resource was rated positively by parents and health care providers. IMPLICATIONS FOR PRACTICE: An eHealth breastfeeding co-parenting resource designed with input from the target population is an effective way of providing information to mothers and fathers. Further research with a randomized controlled design and more diverse populations is needed to determine effectiveness of the resource on breastfeeding duration and exclusivity.

Breast-feeding Coparenting Framework: A New Framework to Improve Breast-feeding Duration and Exclusivity.

Targeting mothers and fathers in breast-feeding promotion programs is recommended as research has found that father's support positively impacts breast-feeding duration and exclusivity. Breast-feeding coparenting refers to the manner in which parents work together to achieve their breast-feeding goals. The Breast-feeding Coparenting Framework was developed on the basis of diverse coparenting models and research related to father's involvement with breast-feeding. This framework consists of 5 components: joint breast-feeding goal setting, shared breast-feeding responsibility, proactive breast-feeding support, father's/partner's parental-child interactions, and productive communication and problem solving. This framework may be of value to policy makers and program providers working to improve breast-feeding outcomes.

Coparenting breastfeeding support and exclusive breastfeeding: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a coparenting intervention on exclusive breastfeeding among primiparous mothers and fathers. METHODS: A randomized controlled trial was conducted in a large teaching hospital in Toronto, Canada. Couples were randomized to receive either usual care (n = 107) or a coparenting breastfeeding support intervention (n = 107). Follow-up of exclusive breastfeeding and diverse secondary outcomes was conducted at 6 and 12 weeks postpartum. RESULTS: Significantly more mothers in the intervention group than in the control group continued to breastfeed at 12 weeks postpartum (96.2% vs 87.6%, P = .02). Although proportionately more mothers in the intervention group were exclusively breastfeeding at 6 and 12 weeks, these differences were not significant. Fathers in the intervention group had a significantly greater increase in breastfeeding self-efficacy scores from baseline to 6 weeks postpartum compared with fathers in the control group (P = .03). In addition, significantly more mothers in the intervention group than in the control group reported that their partners provided them with breastfeeding help in the first 6 weeks (71% vs 52%, P = .02) and that they were satisfied with their partners' involvement with breastfeeding (89% vs 78.1%, P = .04). Mothers in the intervention group were also more satisfied with the breastfeeding information they received (81% vs 62.5%, P < .001). CONCLUSIONS: The significant improvements in breastfeeding duration, paternal breastfeeding self-efficacy, and maternal perceptions of paternal involvement and assistance with breastfeeding suggest that a coparenting intervention involving fathers warrants additional investigation.