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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Many studies show that the most factor which influenced the mother&#39;s decision to start and maintain breastfeeding is the father&#39;s support&#46; The mother who receives support from their husbands feels ten times more comfortable and confident about breastfeeding their babies than those who are not receiving support from their husband&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> Postpartum mother will experience changes that will affect the coping mechanism and perceptive&#44; father&#39;s support make the coping mechanism and mother perspective become positive and will not cause any anxiety on the mother&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The problem is 83&#46;6&#37; of fathers still have low knowledge about lactation regulation&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Therefore&#44; we need an education model that can increase the father&#39;s support to the mother through breastfeeding&#46; This study will be summarized recent evidence about the breastfeeding father education model and its impact to improve breastfeeding frequency of mothers to prevent postpartum blues&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study uses literature review design&#44; articles collected using search engines such as PubMed&#44; Elsevier&#44; Scinapse&#44; Plos One&#44; and Google Scholar&#46; Keywords that are inputted include &#8220;breastfeeding father&#8221; &#8220;education model&#8221; &#8220;postpartum blues&#8221; &#8220;breastfeeding mother&#46;&#8221; The criteria for articles used are those published in 2015&#8211;2020&#46; The table of findings is compiled by the Review-Manager app&#46; We identified journals based on the PRISMA 2015 Guidelines with a total of <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5690 and obtained the number of journals reviewed <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#46; The region where the study was conducted mostly in Indonesia&#44; Ireland&#44; and Nepal&#46; Collected articles were reviewed and the result is summarized to form a novel study hypothesis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Result</span><p id="par0020" class="elsevierStylePara elsevierViewall">Six studies and twenty-seven additional articles &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41; that met the aforementioned inclusion criteria were summarized in this review&#46; The literature discussed the breastfeeding father education model&#44; maternal breastfeeding and postpartum blues separately and consistently show that breastfeeding activity affects the postpartum blues&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the relationship between breastfeeding in mother&#44; postpartum blues&#44; and breastfeeding father educational model in the included articles&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The literature consistently shows that breastfeeding provides many benefits for both children and mothers&#46; The relationship between breastfeeding and the incidence of postpartum blues has been proven in several studies&#44; the majority of studies stated that these two variables have a positive correlation&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4&#8211;6</span></a> The results of this study show empirical evidence that breastfeeding can be a protective factor against postpartum blues&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5&#44;6</span></a> The low coverage of breastfeeding in some region makes this problem as a challenge&#46; Some of the studies recommended to find out some risk factors and treat them as well as preventing postpartum blues occurrence&#46; From all the identified causes&#44; the father&#39;s support act as the most relatable&#44; and a modifiable risk factor also can be treated by giving much more education&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;7&#44;8</span></a> Other relevant studies have implemented a breastfeeding father method in which the father helps the mother to breastfeed in some ways that can influence the mother&#39;s decision to start and maintain breastfeeding&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#44;9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Some recent studies reveal that the role of father to do breastfeeding father is low and the possible cause is the low father&#39;s knowledge&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> So that some novel innovation is implemented by giving father&#39;s education about breastfeeding father&#46; Father education is proven to increase breastfeeding with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; In addition&#44; support from husbands is also classified as sufficient &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Postpartum blues</span><p id="par0035" class="elsevierStylePara elsevierViewall">Postpartum blues is likened to the iceberg phenomenon because it is difficult to detect and become underdiagnosed&#46; Most of the mothers do not know if they are experiencing the postpartum blues&#46; Also&#44; people still consider psychological disorders to be a natural thing as a mother&#39;s instinct and protective attitude towards her baby&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> Some studies show that in Indonesia&#44; one of ten mothers who had just delivered a baby has a tendency to postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Postpartum blues is a manifestation of psychological phenomena experienced by women related to the presence of the baby&#46; The cause of this postpartum blues is rapid hormonal changes&#44; a less supportive social environment as well as a result of doubt about the new role as a mother&#46; The postpartum blues will have an impact on the mother&#44; husband&#44; and baby&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Several previous studies examined the factors that influence the incidence of postpartum blues&#44; there are mother&#39;s readiness&#44; husband support&#44; type of labor&#44; maternal adjustment&#44; coping stress&#44; and social support&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Breastfeeding and postpartum blues</span><p id="par0050" class="elsevierStylePara elsevierViewall">Breastfeeding is an important activity to do by mother after delivery because breastmilk is the best nutrition for babies that contains white blood cells&#44; protein&#44; and immune substances that are suitable for babies&#46; Breastmilk promotes optimal growth and development and protects against disease&#46; The nutritional value of breastmilk is greater than formula milk&#46; Besides has a benefit for the baby&#44; breastfeeding also has a protective effect on the mother&#39;s psychological state&#46; Research shows that breastfeeding can improve the condition of the mother&#44; hormonal and psychological processes associated with the postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Breastfeeding is suggested to attenuate cortisol stress responses by decreasing stress hormone levels which respond to the occurrence of mood disorder or in this case&#44; is postpartum blues&#46; Also&#44; breastfeeding is suggested to attenuate neuroendocrine responses to stress and may act to enhance maternal mood&#46; Specifically&#44; oxytocin and prolactin&#44; hormones responsible for lactation&#44; are suggested to have mood-ameliorating effects thus can prevent the occurrence of postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Father&#39;s support and improvement in breastfeeding</span><p id="par0060" class="elsevierStylePara elsevierViewall">Several organizations such as the World Health Organization &#40;WHO&#41;&#44; the European Commission for Public Health &#40;ECPH&#41;&#44; and the American Academy of Pediatrics &#40;AAP&#41; mandate exclusive breastfeeding for the first six months of life&#46; Breastfeeding initiation rates are very high but there is a marked decrease in breastfeeding during the first few weeks after initiation&#44; and exclusive breastfeeding is rare&#46; Also&#44; a study in Indonesia shows the low coverage of breastfeeding of 54&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Studies show several obstacles in the continuing the breastfeeding such as a psychological factor including mother who feels embarrassed or not wanting to breastfeed in public&#44; children who are uncomfortable&#44; busy with work&#44; mother&#39;s knowledge factors&#44; lack of support for mother&#44; and also other psychological stressors&#46; Some evidence said that the husband&#39;s support is known to have the greatest role because the husband is the closest person to the postpartum mother who will support all the processes of the mother&#39;s psychological change in the proper direction&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">17&#8211;19</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Lack of father&#39;s support makes the breastfeeding activity of mother decreased&#44; as well as proven by a study that found out from twelve postpartum mothers who experienced postpartum blues there is only a mother who has good father&#39;s support&#46; Furthermore&#44; a mother who considered that those who supported to breastfeed were eleven times more likely to do breastfeeding starting from the hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> The father&#39;s support is believed to have influenced the mother&#39;s decision to start and maintain breastfeeding&#46; This phenomenon can be explained by adaptation theory that said there are three aspect mechanism in adaptation those are coping&#44; <span class="elsevierStyleItalic">kognator</span>&#44; and regulators mechanism&#44; if there was a good role of father then the control process that covers these aspects will be adaptive so that the mother&#39;s anxiety will be decreased&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Support from the father will make the adaptation mechanism of the postpartum mother become positive&#46; This positive adaptation mechanism will cause inhibition of stress hormone release&#44; especially cortisol&#46; Also&#44; with a positive postpartum adaptation factor&#44; it can remove the inhibitor of oxytocin release which in turn will release the mother&#39;s milk smoothly&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Breastfeeding father educational model in increasing breastfeeding frequency</span><p id="par0080" class="elsevierStylePara elsevierViewall">Breastfeeding fathers refer to the way fathers coordinate parenting responsibilities with mothers to achieve their breastfeeding goals&#46; Fathers can take the responsibility of supporting breastfeeding by assisting mothers in building a willingness to breastfeed and overcoming common obstacles&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Low of father&#39;s knowledge causes fathers to tend to ask mothers to provide formula milk as a companion to breastfeeding because they are worried about insufficient milk production&#46; Also&#44; the fathers will not give the mother support because they think breastfeeding is only for the mother&#46; This problem makes an educational model is needed for the breastfeeding father implementation&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">A well-educated father can be obtained through the breastfeeding father&#39;s educational model that will give fathers information about how to give support to the mother including his role in helping mothers to breastfeed&#46; Father education is proven to increase breastfeeding activity&#44; with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Education for father is important because the information that given to father can change father&#39;s understanding&#44; and further can change father&#39;s attitude and behavior&#46; The attitude is in a form of support and behavior is how the father will help the mother in breastfeeding activity&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> Fathers who have high school educational background is said to have played a role in supporting mothers with sufficient categories &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The real implementation of the breastfeeding father educational model is by making a framework that consists of 5 components&#44; there are&#58; &#40;1&#41; setting goals for joint breastfeeding&#59; &#40;2&#41; responsibility for joint breastfeeding&#59; &#40;3&#41; proactive breastfeeding support&#59; &#40;4&#41; parental interactions -children from father&#47;spouse&#59; &#40;5&#41; productive and problem solving&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The first component explains the setting for the duration and exclusivity of breastfeeding that should be mutually determined&#46; Bringing the baby to the mother when the baby shows signs of hunger&#44; checks the baby&#39;s drinking while feeding&#44; assesses the mother&#39;s comfort&#44; and helps to get professional breastfeeding assistance if needed&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The third component can be done by starting to give support&#44; there are three types of support those are providing information&#44; assessment&#44; and emotional support&#46; The fourth component can be done by improving the interaction of father and baby by ensuring that the father has the time and opportunity to be close to the baby&#46; The last component is to improve productivity and solve some problems related to breastfeeding father&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> summarizes the role of breastfeeding father educational model to increase the frequency of breastfeeding and prevent the occurrence of postpartum blues&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Providing an education model of breastfeeding father can increase the exclusive breastfeeding by the mother to prevent the occurrence of postpartum blues&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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          "titulo" => "Discussion"
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              "identificador" => "sec0025"
              "titulo" => "Postpartum blues"
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            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Breastfeeding and postpartum blues"
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            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Father&#39;s support and improvement in breastfeeding"
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            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Breastfeeding father educational model in increasing breastfeeding frequency"
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          "identificador" => "sec0045"
          "titulo" => "Conclusion"
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        7 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of interest"
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        8 => array:1 [
          "titulo" => "References"
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    "fechaRecibido" => "2021-06-28"
    "fechaAceptado" => "2021-09-20"
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            1 => "Education model"
            2 => "Postpartum blues"
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    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To find out if the breastfeeding father education model can increase exclusive breastfeeding in mothers to prevent the occurrence of postpartum blues&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study uses literature review design&#44; articles collected using search engines such as PubMed&#44; Elsevier&#44; Scinapse&#44; Plos One&#44; and Google Scholar&#46; We identified journals based on the PRISMA 2015 Guidelines with a total of <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5690 and obtained the number of journals reviewed <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The father&#39;s support is believed to have influenced the mother&#39;s decision to start and maintain breastfeeding&#46; Father education is proven to increase breastfeeding with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; In addition&#44; support from husbands is also classified as sufficient &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Providing an education model of breastfeeding father can increase the exclusive breastfeeding by the mother to prevent the occurrence of postpartum blues&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd International Nursing&#44; Health Science Students &#38; Health Care Professionals Conference&#46; Full-text and the content of it is under responsibility of authors of the article&#46;</p>"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author&#44; publication year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Title&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Methods&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anita R&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a> 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Optimizing the role of breastfeeding father through the provision of prenatal father education&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Posttest only control group design and simple random sampling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The role of breastfeeding father in prenatal education is an alternative solution in increasing the Success of exclusive breastfeeding program&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nepali S&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nepal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Husband&#39;s Support for Breastfeeding and Breastfeeding Self-Efficacy of Nepalese Mothers from Bungmati&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional design with a sample of 110 mother who visited the Vungmati Health Post for immunization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mothers who received support from their husbands were 10 times more comfortable and confident about breastfeeding than those who did not receive support from his husband&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Annemarie E&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> et al&#46;&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ireland&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Views of fathers in Ireland on the experience and challenges of having a breast- feeding partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with questionnaire on 1398 fathers with infants aged 4&#8211;7 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Father with good education and social experience are very supportive of breastfeeding&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fitrah A&#46;K&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The relationship of husband&#39;s support to the incidence of postpartum blues&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with the population was all multiparous postpartum mothers who were in the Primar Clinic Puskesmas Payung Sekaki&#44; Pekanbaru City&#46; Consecutive sampling with total 45 postpartum mothers done by home visit&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">There is a relationship between husband&#39;s support for the incidence of postpartum blues&#46; Based on the result of the study&#44; it was found that from 12 postpartum mothers who experiences postpartum blues&#44; there only a mother who had good husband support&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jennifer A&#46;D&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Breast-feeding Coparenting Framework&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Survey and journals review&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Breastfeeding education and support programs are needed to increase the breastfeeding rates&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Suparwati&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> et al&#46;&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The relationship between breastmilk production and the incidence of postpartum blues in Trucuk II Klaten Health Center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with purposive sampling of 48 normal postpartum mothers at 3rd&#8211;10th days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">There is a relationship between breastmilk production with the incidence of postpartum blues&#46; All of the respondent whose breastfeeding was not smooth&#44; experienced severe postpartum blues&nbsp;\t\t\t\t\t\t\n
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Prevent postpartum blues with the implementation of breastfeeding father education model to increase the frequency of breastfeeding in mothers: A systematic review
Gusti Ayu Martha Winingsiha,b,
Autor para correspondencia
, Ummu Salmaha, Masnia, Rahayu Indriasaria, Ridwan Amiruddina, Agus Bintara Birawidaa
a Doctoral Program of Public Health, Hasanuddin University, Makassar, Indonesia
b Politeknik Kesehatan Kartini Bali, Denpasar, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Many studies show that the most factor which influenced the mother&#39;s decision to start and maintain breastfeeding is the father&#39;s support&#46; The mother who receives support from their husbands feels ten times more comfortable and confident about breastfeeding their babies than those who are not receiving support from their husband&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> Postpartum mother will experience changes that will affect the coping mechanism and perceptive&#44; father&#39;s support make the coping mechanism and mother perspective become positive and will not cause any anxiety on the mother&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The problem is 83&#46;6&#37; of fathers still have low knowledge about lactation regulation&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Therefore&#44; we need an education model that can increase the father&#39;s support to the mother through breastfeeding&#46; This study will be summarized recent evidence about the breastfeeding father education model and its impact to improve breastfeeding frequency of mothers to prevent postpartum blues&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study uses literature review design&#44; articles collected using search engines such as PubMed&#44; Elsevier&#44; Scinapse&#44; Plos One&#44; and Google Scholar&#46; Keywords that are inputted include &#8220;breastfeeding father&#8221; &#8220;education model&#8221; &#8220;postpartum blues&#8221; &#8220;breastfeeding mother&#46;&#8221; The criteria for articles used are those published in 2015&#8211;2020&#46; The table of findings is compiled by the Review-Manager app&#46; We identified journals based on the PRISMA 2015 Guidelines with a total of <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5690 and obtained the number of journals reviewed <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#46; The region where the study was conducted mostly in Indonesia&#44; Ireland&#44; and Nepal&#46; Collected articles were reviewed and the result is summarized to form a novel study hypothesis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Result</span><p id="par0020" class="elsevierStylePara elsevierViewall">Six studies and twenty-seven additional articles &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41; that met the aforementioned inclusion criteria were summarized in this review&#46; The literature discussed the breastfeeding father education model&#44; maternal breastfeeding and postpartum blues separately and consistently show that breastfeeding activity affects the postpartum blues&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the relationship between breastfeeding in mother&#44; postpartum blues&#44; and breastfeeding father educational model in the included articles&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The literature consistently shows that breastfeeding provides many benefits for both children and mothers&#46; The relationship between breastfeeding and the incidence of postpartum blues has been proven in several studies&#44; the majority of studies stated that these two variables have a positive correlation&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4&#8211;6</span></a> The results of this study show empirical evidence that breastfeeding can be a protective factor against postpartum blues&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5&#44;6</span></a> The low coverage of breastfeeding in some region makes this problem as a challenge&#46; Some of the studies recommended to find out some risk factors and treat them as well as preventing postpartum blues occurrence&#46; From all the identified causes&#44; the father&#39;s support act as the most relatable&#44; and a modifiable risk factor also can be treated by giving much more education&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;7&#44;8</span></a> Other relevant studies have implemented a breastfeeding father method in which the father helps the mother to breastfeed in some ways that can influence the mother&#39;s decision to start and maintain breastfeeding&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#44;9</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Some recent studies reveal that the role of father to do breastfeeding father is low and the possible cause is the low father&#39;s knowledge&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> So that some novel innovation is implemented by giving father&#39;s education about breastfeeding father&#46; Father education is proven to increase breastfeeding with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; In addition&#44; support from husbands is also classified as sufficient &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Postpartum blues</span><p id="par0035" class="elsevierStylePara elsevierViewall">Postpartum blues is likened to the iceberg phenomenon because it is difficult to detect and become underdiagnosed&#46; Most of the mothers do not know if they are experiencing the postpartum blues&#46; Also&#44; people still consider psychological disorders to be a natural thing as a mother&#39;s instinct and protective attitude towards her baby&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> Some studies show that in Indonesia&#44; one of ten mothers who had just delivered a baby has a tendency to postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Postpartum blues is a manifestation of psychological phenomena experienced by women related to the presence of the baby&#46; The cause of this postpartum blues is rapid hormonal changes&#44; a less supportive social environment as well as a result of doubt about the new role as a mother&#46; The postpartum blues will have an impact on the mother&#44; husband&#44; and baby&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Several previous studies examined the factors that influence the incidence of postpartum blues&#44; there are mother&#39;s readiness&#44; husband support&#44; type of labor&#44; maternal adjustment&#44; coping stress&#44; and social support&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Breastfeeding and postpartum blues</span><p id="par0050" class="elsevierStylePara elsevierViewall">Breastfeeding is an important activity to do by mother after delivery because breastmilk is the best nutrition for babies that contains white blood cells&#44; protein&#44; and immune substances that are suitable for babies&#46; Breastmilk promotes optimal growth and development and protects against disease&#46; The nutritional value of breastmilk is greater than formula milk&#46; Besides has a benefit for the baby&#44; breastfeeding also has a protective effect on the mother&#39;s psychological state&#46; Research shows that breastfeeding can improve the condition of the mother&#44; hormonal and psychological processes associated with the postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Breastfeeding is suggested to attenuate cortisol stress responses by decreasing stress hormone levels which respond to the occurrence of mood disorder or in this case&#44; is postpartum blues&#46; Also&#44; breastfeeding is suggested to attenuate neuroendocrine responses to stress and may act to enhance maternal mood&#46; Specifically&#44; oxytocin and prolactin&#44; hormones responsible for lactation&#44; are suggested to have mood-ameliorating effects thus can prevent the occurrence of postpartum blues&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Father&#39;s support and improvement in breastfeeding</span><p id="par0060" class="elsevierStylePara elsevierViewall">Several organizations such as the World Health Organization &#40;WHO&#41;&#44; the European Commission for Public Health &#40;ECPH&#41;&#44; and the American Academy of Pediatrics &#40;AAP&#41; mandate exclusive breastfeeding for the first six months of life&#46; Breastfeeding initiation rates are very high but there is a marked decrease in breastfeeding during the first few weeks after initiation&#44; and exclusive breastfeeding is rare&#46; Also&#44; a study in Indonesia shows the low coverage of breastfeeding of 54&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Studies show several obstacles in the continuing the breastfeeding such as a psychological factor including mother who feels embarrassed or not wanting to breastfeed in public&#44; children who are uncomfortable&#44; busy with work&#44; mother&#39;s knowledge factors&#44; lack of support for mother&#44; and also other psychological stressors&#46; Some evidence said that the husband&#39;s support is known to have the greatest role because the husband is the closest person to the postpartum mother who will support all the processes of the mother&#39;s psychological change in the proper direction&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">17&#8211;19</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Lack of father&#39;s support makes the breastfeeding activity of mother decreased&#44; as well as proven by a study that found out from twelve postpartum mothers who experienced postpartum blues there is only a mother who has good father&#39;s support&#46; Furthermore&#44; a mother who considered that those who supported to breastfeed were eleven times more likely to do breastfeeding starting from the hospital&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> The father&#39;s support is believed to have influenced the mother&#39;s decision to start and maintain breastfeeding&#46; This phenomenon can be explained by adaptation theory that said there are three aspect mechanism in adaptation those are coping&#44; <span class="elsevierStyleItalic">kognator</span>&#44; and regulators mechanism&#44; if there was a good role of father then the control process that covers these aspects will be adaptive so that the mother&#39;s anxiety will be decreased&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Support from the father will make the adaptation mechanism of the postpartum mother become positive&#46; This positive adaptation mechanism will cause inhibition of stress hormone release&#44; especially cortisol&#46; Also&#44; with a positive postpartum adaptation factor&#44; it can remove the inhibitor of oxytocin release which in turn will release the mother&#39;s milk smoothly&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Breastfeeding father educational model in increasing breastfeeding frequency</span><p id="par0080" class="elsevierStylePara elsevierViewall">Breastfeeding fathers refer to the way fathers coordinate parenting responsibilities with mothers to achieve their breastfeeding goals&#46; Fathers can take the responsibility of supporting breastfeeding by assisting mothers in building a willingness to breastfeed and overcoming common obstacles&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Low of father&#39;s knowledge causes fathers to tend to ask mothers to provide formula milk as a companion to breastfeeding because they are worried about insufficient milk production&#46; Also&#44; the fathers will not give the mother support because they think breastfeeding is only for the mother&#46; This problem makes an educational model is needed for the breastfeeding father implementation&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">A well-educated father can be obtained through the breastfeeding father&#39;s educational model that will give fathers information about how to give support to the mother including his role in helping mothers to breastfeed&#46; Father education is proven to increase breastfeeding activity&#44; with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Education for father is important because the information that given to father can change father&#39;s understanding&#44; and further can change father&#39;s attitude and behavior&#46; The attitude is in a form of support and behavior is how the father will help the mother in breastfeeding activity&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a> Fathers who have high school educational background is said to have played a role in supporting mothers with sufficient categories &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The real implementation of the breastfeeding father educational model is by making a framework that consists of 5 components&#44; there are&#58; &#40;1&#41; setting goals for joint breastfeeding&#59; &#40;2&#41; responsibility for joint breastfeeding&#59; &#40;3&#41; proactive breastfeeding support&#59; &#40;4&#41; parental interactions -children from father&#47;spouse&#59; &#40;5&#41; productive and problem solving&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The first component explains the setting for the duration and exclusivity of breastfeeding that should be mutually determined&#46; Bringing the baby to the mother when the baby shows signs of hunger&#44; checks the baby&#39;s drinking while feeding&#44; assesses the mother&#39;s comfort&#44; and helps to get professional breastfeeding assistance if needed&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The third component can be done by starting to give support&#44; there are three types of support those are providing information&#44; assessment&#44; and emotional support&#46; The fourth component can be done by improving the interaction of father and baby by ensuring that the father has the time and opportunity to be close to the baby&#46; The last component is to improve productivity and solve some problems related to breastfeeding father&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> summarizes the role of breastfeeding father educational model to increase the frequency of breastfeeding and prevent the occurrence of postpartum blues&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Providing an education model of breastfeeding father can increase the exclusive breastfeeding by the mother to prevent the occurrence of postpartum blues&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflicts of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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              "titulo" => "Breastfeeding and postpartum blues"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Father&#39;s support and improvement in breastfeeding"
            ]
            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Breastfeeding father educational model in increasing breastfeeding frequency"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conclusion"
        ]
        7 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of interest"
        ]
        8 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
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    "tienePdf" => true
    "fechaRecibido" => "2021-06-28"
    "fechaAceptado" => "2021-09-20"
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
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          "palabras" => array:3 [
            0 => "Breastfeeding father"
            1 => "Education model"
            2 => "Postpartum blues"
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    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To find out if the breastfeeding father education model can increase exclusive breastfeeding in mothers to prevent the occurrence of postpartum blues&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This study uses literature review design&#44; articles collected using search engines such as PubMed&#44; Elsevier&#44; Scinapse&#44; Plos One&#44; and Google Scholar&#46; We identified journals based on the PRISMA 2015 Guidelines with a total of <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5690 and obtained the number of journals reviewed <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The father&#39;s support is believed to have influenced the mother&#39;s decision to start and maintain breastfeeding&#46; Father education is proven to increase breastfeeding with a value of <span class="elsevierStyleItalic">p</span> &#40;0&#46;001&#41;<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; In addition&#44; support from husbands is also classified as sufficient &#40;54&#37;&#41; in lowering anxiety levels in mothers with spearman&#39;s test results <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;48 or &#60;0&#46;05&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Providing an education model of breastfeeding father can increase the exclusive breastfeeding by the mother to prevent the occurrence of postpartum blues&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd International Nursing&#44; Health Science Students &#38; Health Care Professionals Conference&#46; Full-text and the content of it is under responsibility of authors of the article&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author&#44; publication year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Region&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Title&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Methods&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anita R&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a> 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Optimizing the role of breastfeeding father through the provision of prenatal father education&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Posttest only control group design and simple random sampling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The role of breastfeeding father in prenatal education is an alternative solution in increasing the Success of exclusive breastfeeding program&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nepali S&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nepal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Husband&#39;s Support for Breastfeeding and Breastfeeding Self-Efficacy of Nepalese Mothers from Bungmati&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional design with a sample of 110 mother who visited the Vungmati Health Post for immunization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mothers who received support from their husbands were 10 times more comfortable and confident about breastfeeding than those who did not receive support from his husband&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Annemarie E&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> et al&#46;&#44; 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ireland&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Views of fathers in Ireland on the experience and challenges of having a breast- feeding partner&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with questionnaire on 1398 fathers with infants aged 4&#8211;7 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Father with good education and social experience are very supportive of breastfeeding&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fitrah A&#46;K&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The relationship of husband&#39;s support to the incidence of postpartum blues&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with the population was all multiparous postpartum mothers who were in the Primar Clinic Puskesmas Payung Sekaki&#44; Pekanbaru City&#46; Consecutive sampling with total 45 postpartum mothers done by home visit&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">There is a relationship between husband&#39;s support for the incidence of postpartum blues&#46; Based on the result of the study&#44; it was found that from 12 postpartum mothers who experiences postpartum blues&#44; there only a mother who had good husband support&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jennifer A&#46;D&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> et al&#46;&#44; 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Breast-feeding Coparenting Framework&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Survey and journals review&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Breastfeeding education and support programs are needed to increase the breastfeeding rates&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Suparwati&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> et al&#46;&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Indonesia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The relationship between breastmilk production and the incidence of postpartum blues in Trucuk II Klaten Health Center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional study with purposive sampling of 48 normal postpartum mothers at 3rd&#8211;10th days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">There is a relationship between breastmilk production with the incidence of postpartum blues&#46; All of the respondent whose breastfeeding was not smooth&#44; experienced severe postpartum blues&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                      "titulo" => "Husbands&#8217; support for breastfeeding and breastfeeding self-efficacy of Nepalese mothers from Bungmati"
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                        0 => array:2 [
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                          "autores" => array:2 [
                            0 => "S&#46; Nepali"
                            1 => "M&#46; Shakya"
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                      "titulo" => "Hubungan Peran Ayah Asi &#40;Breastfeeding Father&#41; dengan Kecemasan Ibu Postpartum Berdasarkan Pendekatan Teori Model Adaptasi Roy"
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                        "editorial" => "Publ Stikes Patria Husada Blitar"
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              "identificador" => "bib0115"
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                      "titulo" => "Sikap Ayah dan Jumlah Anak serta Praktik Air Susu Ibu Eksklusif"
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                          "etal" => false
                          "autores" => array:2 [
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                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Kesehat Masy Nas"
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                      "titulo" => "Hubungan Antara Kelancaran Pengeluaran ASI dengan Kejadian Postpartum Blues di Wilayah Puskesmas Trucuk II Klaten"
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                        0 => array:2 [
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