Volume 178, June 2026, 105383Author links open overlay panelFei Wan Ngai a, Yuk Yin Winsome Lam a, Chi Oi Christine Lam b, Pui Sze Chan aShow moreAbstractBackground

The World Health Organization recommends breastfeeding as the best source of food for optimal infant growth and development because it reduces the risk of infant mortality and morbidity. Most breastfeeding promotion interventions have targeted mothers, very few have involved family members in promoting breastfeeding.

Objective

The objective of this study was to examine the effect of a father-involvement breastfeeding telephone support intervention on the prevalence and duration of exclusive breastfeeding and any breastfeeding.

Methods

This was a multicentre randomised controlled trial. A sample of 649 postpartum parents were recruited from four regional public hospitals and randomly assigned to either the father-involvement breastfeeding telephone support intervention or the standard care group. Infant feeding data were collected during hospitalisation and at 1, 2, 4 and 6 months after birth.

Results

The results showed that relative to mothers receiving standard care, mothers receiving the father-involvement breastfeeding telephone support intervention were more likely to be exclusively breastfeeding at 1 month after birth (mean difference = 6.7%, 95% CI: 0.2%–13.3%, p < 0.05) and to be engaging in any breastfeeding at 1 month (mean difference = 9.1%, 95% CI: 4%–14.2%, p < 0.001), 2 months (mean difference = 9.3%, 95% CI: 2.8%–15.7%, p < 0.05), 4 months (mean difference = 8.2%, 95% CI: 0.5%–16.0%, p < 0.05) and 6 months (mean difference = 9.6%, 95% CI: 1.7%–17.5%, p < 0.05) postpartum. They also were less likely to stop any breastfeeding over the 6-month period than the control group (Hazard ratio of 0.54; 95% CI: 0.44–0.67).

Conclusions

The findings provide empirical evidence that father-involvement telephone support effectively promotes exclusive breastfeeding at 1 month after birth and any breastfeeding over the 6-month postpartum period. The study highlights the importance of including fathers in the design of flexible and accessible health promotion programmes for breastfeeding families.

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Access through your organizationSection snippetsWhat is already known•

Breastfeeding is recommended as the best source of food for optimal infant growth and development.

•

Family members play a significant role in a woman's decision to breastfeed.

What this paper adds•

Including fathers in telephone support for breastfeeding is a promising approach to improving breastfeeding duration and exclusivity during the early postpartum period.

•

The implementation of proactive telephone support for breastfeeding families is a feasible, accessible public health approach for promoting breastfeeding.

Trial design

This was a multisite randomised controlled trial that examined the effect of a father-involvement breastfeeding telephone support intervention on exclusive breastfeeding and any breastfeeding. Recruitment was conducted at the postnatal units of four public hospitals in Hong Kong from April 2022 to January 2025. There are eight public hospitals with maternity units in Hong Kong, and all of them are accredited as baby-friendly hospitals. The maternity practices in the four study hospitals are

Characteristics of participants

The study flow is presented in Fig. 1. Nine hundred and eighty parents were approached for enrolment in the study, 34 declined to participate and 297 did not meet the eligibility criteria. Of the 649 parents (95.0%) who agreed to participate, 325 were randomly assigned to the breastfeeding telephone support intervention and 324 were randomly assigned to the usual care group. All of the mothers completed the outcome assessments of exclusive breastfeeding and any breastfeeding during

Discussion

To the best of our knowledge, this is the first multicentre randomised controlled trial to evaluate a father-involvement telephone support intervention for breastfeeding among Chinese parents. The findings indicated that mothers who received the father-involvement breastfeeding telephone support intervention were more likely to breastfeed exclusively at 1 month and to continue any breastfeeding at 1, 2, 4 and 6 months after birth, and were less likely to stop breastfeeding completely over the

Conclusions

This study has demonstrated that the delivery of a father-involvement telephone support intervention during early postpartum is a promising approach to improving breastfeeding duration and exclusivity among Chinese mothers. The results may be used to further improve perinatal services to promote breastfeeding in Chinese society. Such interventions not only promote the quality of women's life but the healthy development of the children and the entire family.

CRediT authorship contribution statement

Fei Wan Ngai: Writing – review & editing, Writing – original draft, Validation, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Yuk Yin Winsome Lam: Writing – review & editing, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Chi Oi Christine Lam: Writing – review & editing, Methodology, Investigation, Data curation, Conceptualization. Pui Sze Chan: Writing – review & editing, Methodology,

Funding

This project was supported by the Health and Medical Research Fund, the Health Bureau, The Government of the Hong Kong Special Administrative Region (grant no. 18191141).

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fei Wan Ngai reports financial support was provided by The Health Bureau, The Government of the HKSAR. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgments

The authors would like to thank Ms. Wing Yan Wong and Ms. Hoi Ying Lai, who assisted with trial treatment and the research team in data collection and management.

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