JOURNAL ARTICLE
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Integrative Review of the Factors That Influence Fathers' Involvement in the Breastfeeding of Their Infants.

OBJECTIVE: To integrate research findings related to the factors that influence fathers' involvement in the breastfeeding of their infants.

DATA SOURCES: Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Web of Science) were searched with the keywords breastfeeding, factors, fathers, involvement, partner, and parent to identify studies that were published in English through July 2018.

STUDY SELECTION: The initial search produced 11,927 articles. After the removal of non-English articles and duplicates, a total of 7,533 articles remained. Application of the inclusion and exclusion criteria to titles and abstracts resulted in the elimination of 7,061 articles. In-depth reviews of the remaining 472 full-text articles according to quality appraisal resulted in 39 articles for inclusion in this review.

DATA EXTRACTION: We extracted specific information from each article's purpose, methods, setting, and key findings sections that explained factors that influenced fathers' involvement in the breastfeeding of their infants.

DATA SYNTHESIS: Thematic analysis was used to synthesize the findings into seven themes: Fathers' Knowledge Regarding Breastfeeding, Fathers' Attitudes Toward Breastfeeding, Fathers' Perceptions of Subjective Norms Surrounding Their Involvement in Breastfeeding, Fathers' Perceived Behavioral Control of Their Involvement, Committed Relationship, Sociodemographic Characteristics, and Fathers' Attendance at Antenatal Classes.

CONCLUSION: We identified nonmodifiable and modifiable factors that influenced fathers' involvement in the breastfeeding of their infants. Many of these are amenable to intervention, particularly educational interventions for fathers to improve their knowledge of and attitudes about breastfeeding. Nurses can educate fathers about the benefits of breastfeeding and the importance of their participation to encourage greater involvement.

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