Supporting breastfeeding together: the role of fathers’ attitude and self-efficacy in enhancing mothers’ breastfeeding empowerment

Breastfeeding empowerment among mothers plays a critical role in improving neonatal health outcomes and ensuring sustained breastfeeding practices. Increasing attention has been given to the role of fathers in this process, particularly their attitudes and self-efficacy in supporting breastfeeding. This study aimed to assess paternal attitudes and self-efficacy regarding breastfeeding support and to investigate their associations with maternal breastfeeding empowerment. A cross-sectional study was conducted in 2024 involving 242 couples attending urban health centers in Tabriz, Iran. Data were collected using standardized questionnaires assessing paternal attitudes, paternal self-efficacy in supporting breastfeeding, and maternal breastfeeding empowerment. Descriptive statistics were used to summarize sample characteristics. Pearson correlation was employed to examine bivariate associations, and a general linear model (GLM) was applied to identify predictors of breastfeeding empowerment. The mean (± SD) breastfeeding empowerment score among mothers was 98.42 ± 15.37, while the mean paternal self-efficacy score was 52.64 ± 7.89. Most fathers (64.9%) exhibited neutral attitudes toward breastfeeding. The GLM analysis revealed that paternal self-efficacy was a significant positive predictor of maternal breastfeeding empowerment (B = 0.251, 95% CI: 0.050 to 0.452, p = 0.015). Other significant predictors included attending breastfeeding education classes (B = - 3.956, 95% CI: -7.504 to - 0.409, p = 0.029), maternal education at the elementary level (B = - 7.796, 95% CI: -15.352 to - 0.240, p = 0.043), maternal occupation as a housewife (B = 7.141, 95% CI: 0.670 to 13.612, p = 0.031), and history of abortion (B = 3.340, 95% CI: 0.332 to 6.347, p = 0.030). Paternal attitudes were not significantly associated with maternal breastfeeding empowerment (p = 0.703). Paternal self-efficacy in breastfeeding support is a significant determinant of maternal breastfeeding empowerment. Targeted interventions that enhance paternal self-efficacy during prenatal and postpartum care may contribute to improving breastfeeding outcomes. Involving fathers in breastfeeding promotion programs is essential for fostering supportive family environments.