Abstract
Aim:
The objective of this study is to analyse the academic literature on paternal support during breastfeeding using bibliometric methods and to identify research trends, influential institutions, countries, and journals in this field.
Methods:
The Web of Science database was used to collect articles published between 1989 and June 30, 2025, concerning paternal support during breastfeeding. All titles were screened to ensure they met the inclusion criteria, and English titles were considered a primary requirement. A total of 517 articles met the inclusion criteria. The study data were analysed using the open-source R Studio software and the “biblioshiny for bibliometrix” package, an R software tool.
Results:
The study’s data consists of 458 articles, including 47 reviews, six conference abstracts, three presentations, one correction, and one piece of editorial material. The most notable increase in scientific publications on breastfeeding and father support occurred between 2016 and 2021. The journals with the most publications in this field were the International Breastfeeding Journal, Journal of Human Lactation, Maternal and Child Nutrition, and Midwifery. The most productive countries were the United States, Australia, the United Kingdom, and Canada. The article titled “Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice” tops the list with the highest total number of citations, receiving 379 citations.
Conclusion:
This study highlights recent trends and key institutions in paternal support during breastfeeding through bibliometric analysis, contributing to existing knowledge and guiding future research and practice.
Introduction
The short- and long-term benefits of breastfeeding for both parental and child health are scientifically proven and widely accepted. It is recommended that infants be exclusively breastfed for the first 6 months after birth and that breastfeeding be continued for at least 2 years, alongside appropriate complementary foods (World Health Organi-zation, 2010). The proportion of women exclusively breastfeeding in the first month after birth is 65%, but this drops to 44% by the sixth month (UNICEF, 2025). However, with appropriate support, breastfeeding rates can double (https://www.unicef.cn/en/press-releases/world-breastfeeding-week-unicef-and-who-call-equal-access-breastfeeding-support).
Although the lack of support for women during breastfeeding has been demonstrated by breastfeeding outcomes, the theme of World Breastfeeding Week 2024, “Closing the Gap: Breastfeeding Support for All,” emphasises this commitment. Both UNICEF and the World Health Organization have emphasised that increasing breastfeeding support is a responsibility that involves families, communities, health professionals, and other key decision-makers. One such form of support is paternal support. While every family’s dynamics are different, it is noted that fathers should be involved in the breastfeeding process. Furthermore, in some societies, social and economic factors influence fathers’ decisions regarding breastfeeding (Daniele et al., 2018). Father support has been shown to be important in influencing mothers’ breastfeeding decisions, duration of breastfeeding, motivation, and self-efficacy (Awaliyah et al., 2019; Edelblute & Altman, 2021; Erdoğan & Özerdoğan, 2025; Zhou et al., 2024). Furthermore, paternal support not only facilitates the initiation of breastfeeding but also its continuation (Abbass-Dick et al., 2015; Rempel et al., 2017).
They found that paternal support during breastfeeding included fathers taking care of household chores, offering emotional support and advice, and supporting breastfeeding within the community. They also supported breastfeeding by bathing their babies, changing nappies, and doing some household chores (Rempel et al., 2017). However, fathers who wanted to learn how to support their breastfeeding partners stated that they were unable to take full advantage of these support services due to their busy work schedules (Brown & Davies, 2014). It is recommended that fathers participate in training programmes to provide support. However, it is suggested that digital training would be more effective, as it is difficult for fathers to attend these training sessions during the prenatal period (Fletcher et al., 2016; White et al., 2018).
It is evident that insufficient research has been conducted on paternal support, which is an effective form of support during the breastfeeding process. In this regard, this study aims to analyse the academic literature on paternal support during breastfeeding using bibliometric methods; to identify research trends in this field, prominent authors, coauthorship networks, influential institutions, countries, and journals in which publications appear.
Methods
Bibliometric analysis is a systematic research method that enables the quantitative analysis of scientific publications based on metadata criteria such as publication count, citation relationships, author collaborations, and keyword patterns. Unlike a systematic review that synthesises clinical evidence (e.g., the effectiveness of a specific intervention), bibliometrics aims to map the knowledge structure, evolution, and impactful trends of a research field using objective data (Donthu et al., 2021; Ninkov et al., 2022). For the topic of breastfeeding and father support, this method is particularly appropriate to identify global research hotspots, collaborative networks, and gaps that need future attention. While this study identifies influential studies and thematic clusters (Ozen Cinar, 2025; Sabancı Baransel et al., 2023), it is important to clarify the method’s boundaries. Bibliometric analysis inherently relies on quantitative indicators of scientific literature (Belter, 2015; Greener, 2022). Therefore, this study does not evaluate the methodological quality, sample sizes, or causality of findings in the included articles (e.g., the direct effectiveness levels of paternal support types) (Cabezas-Clavijo et al., 2023; Cheng et al., 2024). Accordingly, the results reflect the publication and citation density in the literature rather than synthesising clinical outcomes (Ninkov et al., 2022).
To conduct this analysis, Web of Science (WoS) was chosen as the data source due to its comprehensive content, robust infrastructure, and high-quality bibliometric data suitable for large-scale analysis (Birkle et al., 2020). The collected data were then analysed using RStudio and the “biblioshiny for bibliometrix” package (Aria & Cuccurullo, 2017), which enables visualization of the field’s social and intellectual structure.
Key Messages
Research on breastfeeding and father support has grown steadily over the past three decades, with a 10.2% annual increase in publications from 1989 to 2025.
The United States, Australia, Canada, and the United Kingdom are the leading contributors to this field, while developing countries such as Indonesia and Turkey have recently increased their involvement.
The main research themes focus on fathers’ roles, social support, breastfeeding duration, and psychosocial aspects such as self-efficacy and parental attitudes.
Curtin University, McGill University, and Universitas Indonesia are among the most productive institutions, reflecting a global but regionally concentrated research network.
Highly cited studies emphasise the positive influence of paternal involvement on breastfeeding outcomes, indicating that engaging fathers can enhance breastfeeding success and maternal well-being.
Data Sources and Search Strategy
Data were retrieved from the Web of Science (WoS) Core Collection (including SCI-expanded, SSCI, AHCI, and ESCI indices) to ensure adherence to high-quality bibliometric standards. The data collection was finalized on June 30, 2025.
To analyse the specific literature focusing on the paternal role, a focused search strategy was employed. The search was conducted using the “Topic” (TS) field, which searches the Title, Abstract, Author Keywords, and Keywords Plus. The specific Boolean search string used was: TS = (“breastfeeding” AND “father support”)
Justification of Search Terms: Although broader terms such as “partner support” or “coparenting” exist in the literature, this study specifically aimed to map the research landscape explicitly defined by “father” terminology. Preliminary searches indicated that including generic terms (e.g., “partner”) led to literature on nonpaternal support figures, which fell outside the specific scope of the “paternal support” analysis intended for this study. Therefore, the terminology was restricted to “father support” to ensure the dataset’s specificity and homogeneity regarding the paternal figure.
Inclusion Criteria: The search yielded 516 documents. The inclusion criteria were set as follows:
• Database: Web of Science Core Collection.
• Document types: Articles, review articles, editorial materials, meeting abstracts, and proceedings papers. (Note: While peer-reviewed articles constitute the majority, a small number of conference outputs were retained to capture emerging research trends and topics currently in the dissemination pipeline).
• Language: English (to enable accurate keyword processing).
• Time Frame: 1989 to June 30, 2025.
Data Analysis
The identified records were exported in “BibTeX” format, selecting the “Full Record and Cited References” option to ensure complete metadata availability. Since the data might be downloaded in batches, the exported files were merged into a single dataset using the Latex Bibtex File Merger tool.
The final dataset was imported into RStudio (Version 1.4.1717) for analysis. The bibliometric analysis and visualization were performed using the bibliometrix R-package and its web-based interface, biblioshiny (Aria & Cuccurullo, 2017). This software was used to analyse descriptive characteristics (publications per year, most productive authors/countries) and to map the conceptual structure (keyword networks, thematic evolution) of the field.
Ethical Considerations
No formal ethical review was required for this study.
Results
This bibliometric analysis examined a total of 516 documents published between 1989 and 2025. The studies were obtained from 231 different sources (journals, books, etc.), and the average annual growth rate was calculated as 10.2%. The average age of the documents was 7.91 years, while the average number of citations per document was 24.08. The analysed documents contain a total of 15,867 references. In terms of content, 864 terms were identified in the “Keywords Plus” category, and 1,214 different terms were identified among the keywords specified by the authors (DE). The studies were produced by 2,275 different authors, and only 25 of these documents were published by a single author. The author collaboration rate is high, with an average of 5.01 coauthors per document. The international coauthorship rate is noteworthy at 28.68%. In terms of document types, articles constitute the majority with 458, followed by 47 reviews, six conference abstracts, three presentations, one correction, and one piece of editorial material.
Table 1 and Table 2 presents the annual distribution of scientific publications on breastfeeding and father support from 1989 to 2025. The most notable increase occurred between 2016 and 2021, when the number of publications exceeded 30. In 2021, production peaked, reaching approximately 45 publications. Although a relative decline was observed between 2022 and 2025, production levels remained high compared to previous years.
Basic Information About the Data.
Analysis of Number of Articles and Average Number of Citations by Year.
MeanTCperArt: Mean total citations per article.
MeanTCperYear: Mean total citations per year.
CitableYears: It refers to the period between the relevant year and the year in which the bibliometric analysis was conducted.
The average total citations received by the documents examined in this study over the years, the annual average citations, the number of articles, and the number of years cited were evaluated. According to the findings, studies published between 2000 and 2010, in particular, received a high number of citations. For example, the average total number of citations for the three articles published in 2001 was 152.33, the highest among all years. This period was followed by 2000 (107.33), 2005 (109.00), 2002 (105.00), and 2007 (89.00). This citation density indicates that the foundational studies published during this period continue to shape the field’s current conceptual framework. The annual average citation counts show a similar trend. For example, documents from 2001 received an average of 6.09 citations per year. This ratio reveals that they have been influential in the literature for many years and are frequently referenced by researchers.
Figure 1 uses a Sankey diagram (three-field plot) to visualize the structural interactions among countries, key concepts, and universities in the literature on breastfeeding and father support. In this diagram, the width of the connecting lines (flows) represents the strength of the relationship; thicker lines indicate a higher frequency or intensity of the thematic or collaborative link.
Three-Field Plot (Sankey Diagram) Visualizing the Structural Interactions Between Countries (Left), Keywords (Middle), and Institutions (Right). The Width of the Connecting Lines Represents the Strength of the Relationship.
In the country-based analysis (left field), the United States (USA) emerges as the most significant contributor, followed by Australia, Canada, the United Kingdom, China, and Indonesia. Turkey also appears as a contributing country in this domain. At the keyword level (middle field), the most frequently used terms include “breastfeeding,” “fathers,” “exclusive breastfeeding,” “infant feeding,” “social support,” and “self-efficacy.” This terminology indicates that research focuses not only on the physiological act of breastfeeding but also extensively on the paternal role, social support mechanisms, parenting processes, and psychosocial factors.
In the institution-based analysis (right field), Curtin University (Australia) stands out as the institution with the highest publication volume. Additionally, institutions from diverse regions, such as Ahvaz Jundishapur University, the University of Indonesia, McMaster University, the University of North Carolina, the University of Toronto, and McGill University, are key scientific contributors. This pattern reflects a distinct institutional clustering, suggesting that the research landscape for breastfeeding and father support has been significantly shaped by specific academic centres that repeatedly reinforce the field’s dominant conceptual framework.
When examining the journals in which the 516 analysed documents were published, it is observed that publications on breastfeeding and father support are concentrated in specific specialist journals. The journal hosting the most publications is the International Breastfeeding Journal, which is the most influential source in this field, with a total of 33 articles. This is followed by the Journal of Human Lactation (n = 29), Maternal and Child Nutrition (n = 29), and Midwifery (n = 23) journals.
When examining productivity at the institutional level, Curtin University stands out in terms of the total number of publications. It has been determined that this institution has published 44 articles in the field of breastfeeding and father support. McGill University (24 articles) and Universitas Indonesia (20 articles) follow. The University of Toronto ranks fourth (19 articles), while Uppsala University ranks fifth with 17 articles. Emory University, McMaster University, and the University of North Carolina each published 15 articles, achieving a remarkable level of productivity. The National University of Singapore and the University of the Witwatersrand produced 14 articles each. This distribution shows that breastfeeding research is concentrated in certain centres at the institutional level.
The United States contributed the most with a total of 118 articles (22.9%), and 86.4% (102) of these publications were conducted through national collaboration (SCP), while 13.6% (16) were conducted through international collaboration (MCP). Australia ranked second with 50 articles (9.7%), with a notable 46% of its studies (23 articles) being international joint projects, one of the highest rates among countries. Of the 39 articles from the United Kingdom, 28.2% were prepared through international collaboration, as were 25.8% of the 31 articles from Canada and 25% of the 16 articles from Sweden. China leads in total productivity with 27 articles, while its MCP rate reaches a high value of 40.7%. South Africa has the highest international collaboration rate (53.8%) compared to its total number of articles. Production in Turkey and Indonesia was mainly carried out through national collaboration, with MCP rates remaining at 5.3% and 6.3%, respectively.
Canada stands out as the country with the highest impact level, averaging 53.5 citations per article. The United Kingdom and Sweden also stand out with high-impact levels, averaging 39.4 and 30.7 citations, respectively. Australia and the United States hold strong positions in total citation counts; the US leads with a total of 3,382 citations, while Australia has reached 1,452 citations. However, in terms of average citations, the US lags behind Canada and the United Kingdom with 28.7 citations per article. Finland has similarly generated a high impact with 28.6 citations per article. Italy and France have lower total citation counts, but their average citation levels are 25.8 and 18.7, respectively. China and Turkey rank lower in terms of both total citations and citations per article, with China averaging 15.4 and Turkey 13.6 citations. These data reveal significant differences between countries in the balance between productivity and impact. However, it should be interpreted cautiously; the high productivity of countries like the United States and Australia likely reflects their established research infrastructure and funding priorities regarding lactation, rather than solely indicating the prevalence of father support practices in these populations.
This table compares the ten most influential articles in the field by total citations, average citations per year, and normalized citation value. The top 10 most-cited articles on breastfeeding and father support are listed in Table 6. Citation analysis is an important method used to evaluate the impact, influence, and prevalence of studies in the scientific literature (Tomaszewski, 2023). The article titled “Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice” tops the list with the highest total number of citations, receiving 379. The annual average is 23.69 citations, with a normalized TC value of 6.93. This article stands out for its long-term impact and stable citation rate (Earls & Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics, 2010). The article titled “Major Factors Influencing Breastfeeding Rates: Mother’s Perception of Father’s Attitude and Milk Supply” has the second-highest total number of citations (Arora et al., 2000). The article titled “Individual or Group Antenatal Education for Childbirth or Parenthood, or Both” is a Cochrane systematic review with high reliability and has received a total of 259 citations (Gagnon & Sandall, 2007). The article titled “Involving Men to Improve Maternal and Newborn Health: A Systematic Review of the Effectiveness of Interventions” is the leader in annual citation rate, with 31.63 citations per year, making it the study with the fastest impact for its period. Its normalized TC value is also the highest at 9.32 (Tokhi et al., 2018). A high normalized citation count indicates the article’s relative impact, independent of the year it was published. Tokhi (9.32) and Johnston (7.84) stand out in this field. The journal Pediatrics has proven itself to be one of the leading publishing platforms in this field, hosting four of the studies on the list. It is important to emphasise that the specific clinical findings summarized in Table 6 (e.g., effectiveness of interventions) represent the evidence from these primary studies, distinct from the bibliometric metadata analysis.
Figure 2 presents a word cloud of the relative frequency of author keywords, with each term’s font size directly reflecting its prevalence in the literature. The dominance of core concepts such as “fathers,” “mothers,” “support,” “breastfeeding duration,” and “frequency” suggests a research landscape heavily focused on parental dynamics and the supportive mechanisms essential for sustaining breastfeeding. Furthermore, the prominence of terms such as “women,” “health,” “attitudes,” “initiation,” “impact,” and “experience” indicates that the literature views breastfeeding not merely as a biological function but as a multifaceted process encompassing psychosocial, behavioural, and experiential dimensions. Collectively, this lexical distribution underscores that father support has moved to the centre of breastfeeding research, framing social and familial networks as critical determinants in both the initiation and maintenance of breastfeeding.
Word Cloud of Author Keywords. The Font Size of Each Term Corresponds to Its Frequency in the Literature.
This tree diagram presents the relative frequencies of the most frequently used keywords in publications on father support and breastfeeding. Interpretive guidance: In this hierarchical visualization, the surface area of each rectangle is directly proportional to the keyword’s occurrence frequency; therefore, larger rectangles represent the most dominant and recurring themes in the research landscape (Figure 3).
Tree Map of Keyword Frequencies. The Surface Area of Each Rectangle is Proportional to the Keyword’s Occurrence Frequency.
The keywords “Fathers” and “Mothers” stand out as the most dominant terms with equal frequency (each appearing 109 times, 7%), indicating that both parents occupy a central position in the literature. The high frequency of the keywords “Duration” (100, 6%) and “Support” (93, 6%) suggests that a significant portion of the studies focused on breastfeeding duration and factors supporting its continuation.
Furthermore, the prominence of keywords such as “Women” (87), “Health” (63), “Attitudes” (58), “Initiation” (56), “Impact” (52), and “Experiences” (47) indicates that women’s health, individual attitudes, the initiation of breastfeeding, and breastfeeding experiences are frequently addressed. However, as noted in the limitations, these findings reflect bibliometric trends and conceptual densities rather than providing causal or clinical inferences regarding the direct effect of paternal support on breastfeeding outcomes.
Discussion
This study has provided a general overview of paternal support during breastfeeding. The high level of interest among researchers, which has increased over time, indicates that this field of research will continue to expand. As shown in Table 1, research on breastfeeding and paternal support began to be published in 1989, indicating a relatively high level of international collaboration and that most publications were in article format. In this study, 88.8% of the research articles were original studies, while 9.1% were reviews, indicating that the literature on the subject also has theoretical depth. In addition, the international coauthorship rate was 28.68%, indicating global interest in the subject and that cultural differences are also being researched. Literature cited within our analysis highlights that, particularly in patriarchal societies, men’s “emotional and practical support role” in breastfeeding processes is generally perceived as low, but as this support increases, it leads to increased motivation and success (Uludağ et al., 2023; Zhou et al., 2024).
This study not only identified research trends but also comprehensively analysed research productivity—the most productive researchers, regions, institutions, and collaboration networks. The increasing volume of research is supported by clinical evidence; for instance, meta-analyses have reported that interventions involving fathers significantly increased breastfeeding rates (e.g., increases of 28% in the first week) (Zhou et al., 2024). This suggests that interest in father support will increase. Furthermore, the WHO and UNICEF have highlighted the importance of father support during breastfeeding. Unlike Özen’s study, there has been an increase in interdisciplinary studies (sociology, public health, midwifery, paediatrics), and since studies in this area have made significant contributions to the literature regardless of field, no field restrictions were imposed (Ayele et al., 2025; Edelblute & Altman, 2021; Ozen Cinar, 2025).
As shown in Table 2, academic interest in paternal support during breastfeeding has increased significantly, particularly between 2016 and 2021, and research activity in this field has intensified, especially over the last decade. This increase in publication output can be attributed to the impact of social awareness, multidisciplinary approaches, and global health policies in this field (Cinar, 2025; Ozen Cinar, 2025). The dataset shows high average citation counts in the early years, while in recent years, although the number of articles has increased, the average citation count has decreased due to the decline in citation lifetime, reaching 1.39 and 0.27 in 2024–2025, respectively, with citable years approaching zero. This situation suggests that the literature is relatively new and that its visibility will increase over time, leading to higher values.
In bibliometric analysis, a three-field diagram can combine different dimensions of the literature into a single visual representation. It facilitates understanding the conceptual structure of the literature by presenting, in a single graph, the interactions among prominent countries, key concepts, and universities in publications on breastfeeding and father support. In the country-based analysis, the United States (USA) is seen as the country making the greatest contribution. At the keyword level, the most frequently used terms are breastfeeding, fathers, and exclusive breastfeeding. In the institution-based analysis, Curtin University (Australia) stands out as the institution producing the most publications. Visualizing this type of three-area diagram facilitates interpretation (Sabancı Baransel et al., 2023).
As shown in Table 3, among the most relevant journals, the International Breastfeeding Journal was the most relevant, followed by the Journal of Human Lactation, Maternal and Child Nutrition, and Midwifery. In the study that performed only a bibliometric analysis of breastfeeding, the Journal of Human Lactation ranked first (Ozen Cinar, 2025; Sabancı Baransel et al., 2023). Similar to our findings, these four journals are present, but their order changes. Furthermore, the Journal of Human Lactation and Maternal and Child Nutrition, in particular, are among the leading sources in the discipline with high h- and g-indices. The high m-index of the Maternal and Child Nutrition journal suggests that it is rapidly impacting the field despite its relatively short publication history. The presence of journals such as Midwifery, BMC Public Health, and Pediatrics indicates that this field is approached within a multidimensional context encompassing midwifery, women’s health, paediatrics, public health, and family dynamics. This highlights the need for a holistic approach to this field.
Most Relevant Academic Sources.
When examining the scientific literature on breastfeeding and paternal support from an institutional perspective (Table 4), Curtin University’s clear lead in productivity suggests that academic activities in this field may be linked to institutional support and interdisciplinary collaboration. The inclusion of Canadian institutions such as McGill University, the University of Toronto, and McMaster University at the top of the list demonstrates that the country has become an important centre of production for breastfeeding research. Furthermore, the inclusion of Universitas Indonesia in the top three shows that the breastfeeding literature is not limited to Western countries, but that there are also important research activities based in Asia (Tables 5 and 6).
Corporate-Level Productivity.
Corresponding Author’s Countries and Most-Cited Countries.
Articles: Total number of publications with at least one author from the relevant country.
Articles (%): Percentage share of the relevant country’s publications within all publications analysed.
SCP (single country publications): Number of publications produced solely by authors from a single country.
MCP (multiple country publications): Number of publications involving authors from more than one country—that is, involving international collaboration.
MCP (%): Percentage of publications involving international collaboration within the total publications from the relevant country.
Most-Cited References.
Total Citations (TC): Represents the total number of citations received by the publication up to the analysis date. This indicator shows the extent to which a publication is referenced in the literature.
TC per Year: Represents the annual average number of citations obtained by dividing the total number of citations received by the publication by the number of citable years from the year of publication to the analysis date. This indicator is used to partially balance the time difference between older and newer publications.
Normalized TC (normalized total citations): A relative impact indicator obtained by dividing the total number of citations a publication has received by the average number of citations for publications published in the same year.
Normalized TC = 1 → The publication is at the average citation level of studies published in the same year.
Normalized TC > 1 → The publication has received above-average citations for the same year.
Normalized TC < 1 → The publication has received below-average citations for the same year.
The data obtained in this study clearly show that breastfeeding and father support have become a global research area. From a bibliometric perspective, the United States contributes a considerable share of publications and citations to the field. Studies conducted in the United States are generally based on large-scale, nationally representative data sets and bring a multifaceted approach to the subject from the perspectives of public health, behavioural sciences, and health policies (Arora et al., 2000; Parker et al., 2025). Although the United States has a clear leadership in total publication volume, the relatively low rate of international co-publications (13.6%) indicates that the country’s domestic academic capacity is strong, but the potential for external collaboration is more limited. Although Canada ranks fourth in terms of publication numbers (n = 31), it has the highest average number of citations per article (53.50 citations/article). This indicates that publications originating from Canada have a particularly strong academic impact. In Canada, family-centred care models, postnatal parental support, and gender equality-based approaches form the cornerstone of breastfeeding policies (DeMontigny et al., 2018). The fact that the MCP rates of the United Kingdom, Canada, and Sweden are around 25% indicates that researchers in these countries are inclined towards interdisciplinary and cross-border collaborations. Turkey, a developing country, has a 3.7% share among countries producing publications in this field (n = 19), with a lower citation rate of 13.60 per article. The vast majority of studies originating from Turkey are conducted in a local context, with an international coauthorship rate of 5.3%. The increase in interdisciplinary studies based on midwifery, women’s health, and fatherhood in recent years can be considered a positive development (Ozen Cinar, 2025; Sabancı Baransel et al., 2023; Uludağ et al., 2023). Although China ranks high in terms of productivity (n = 27), its citation impact is low (15.40). This difference may stem from factors such as the quality of publications, international accessibility, and language barriers. On the other hand, China’s international coauthorship rate of over 40% indicates an effort to balance this situation. Furthermore, the fact that even small-scale countries such as Finland (28.6) achieve high average citations demonstrates the impact of focused and high-quality publishing rather than production. Generally speaking, high-income countries lead the literature on breastfeeding and paternal support in terms of both production and citation impact. However, the contributions of developing countries are critical, particularly in studies aimed at better understanding the cultural context. To achieve a more balanced global literature, research from low- and middle-income countries must be encouraged, and these countries must be further integrated into international collaborations. International collaborations, publishing in high-impact journals, and strategies to increase visibility play a critical role.
The analysis of the most-cited publications that define the intellectual structure reveals the topics around which prominent studies in the literature are concentrated and the extent to which they are embraced by the scientific community. Earls’ study has been the most cited (Earls & Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics, 2010). This study suggests that a perinatal depression diagnosis can lead to problems such as cessation of breastfeeding and family dysfunction.
These findings reveal that breastfeeding and father support have become a multinational and interdisciplinary field of research, shaped by international collaborations around specific concepts. In particular, the widespread consideration of psychosocial themes such as the role of fathers, social support, and self-efficacy indicates that the current approach in the field is shifting toward a family-centred and holistic structure rather than a biomedical model. The studies shown in this table have scientifically demonstrated that fathers’ attitudes toward breastfeeding are decisive in mothers’ preferences (Arora et al., 2000) and that structured intervention programs for father support significantly increase the duration of exclusive breastfeeding (Pisacane et al., 2005). In addition, system-level models examining the relationship between parental health and behaviour and childhood health indicators provide important contributions in terms of evaluating long-term public health outcomes (Hawkins et al., 2009). The cited publications are important in that they are the most widely used in the field and contain important developments and trends. Citation analysis is a fundamental method aimed at enabling researchers to access relevant and effective literature. In this context, citations are an important tool for measuring both the impact of scientific studies in their fields and the visibility of unindexed sources (Tomaszewski, 2023).
A word cloud, as one of the text mining techniques, is an effective tool that visually represents key concepts in a field and is frequently used in the initial assessment of conceptual structure (Cobo et al., 2011). As shown in the word cloud (Figure 2), fathers, mothers, duration, and support are the most dominant concepts. This indicates that the roles of both mothers and fathers, the duration of breastfeeding, and support mechanisms are the focus of the studies. Words such as women, health, attitudes, initiation, impact, and experiences are also used with significant frequency, revealing that the initiation of breastfeeding, health outcomes, attitudes, and experiences have been studied extensively. Furthermore, terms such as knowledge, education, intervention, promotion, and controlled trial suggest that education, intervention, and controlled studies are emphasised. Different actors surrounding the family, such as infants, pregnancy, children, grandmothers, and expectant fathers, are also found in the literature.
In bibliometric studies, it is possible to reveal the conceptual structure of the relevant research field through word-based analyses. These analyses contribute to understanding the knowledge structure of the field by identifying prominent themes, key concepts, and the relationships between these concepts in the literature (Atabay & Güzeller, 2021). The tree map includes fathers (n = 109, 9%), mothers (n = 109, 9%), duration (n = 100, 8%), and support (n = 93, 6%). This distribution suggests that the literature increasingly frames breastfeeding as a shared parental behaviour. Cited primary studies linked to these keywords confirm that the supportive role of the father is a key factor that significantly affects the duration of breastfeeding (Pisacane et al., 2005; Scott et al., 2001). Similarly, the prominence of psychosocial concepts such as attitudes, perceptions, social support, depression, and experiences indicates that researchers approach breastfeeding behaviours not only as physiological events but also through the lens of individual attitudes and life experiences (Arora et al., 2000). In particular, fathers’ positive attitudes toward breastfeeding support mothers’ decisions to start and continue breastfeeding; this highlights the importance of the psychological support mechanism in the father-mother-baby triangle. This visual shows that parental roles, breastfeeding duration, health outcomes, and social support systems are at the forefront in the literature. The tree diagram contributes significantly to understanding the thematic densities in the literature. The presence of application-oriented concepts such as intervention (n = 55), education (n = 21), and program (n = 23) in the treemap is also noteworthy. This highlights the importance of breastfeeding-supportive health services and, in particular, father-focused intervention programs. The literature shows that prenatal programs that include father education both increase breastfeeding duration and raise the level of joint decision-making between mothers and fathers (Tokhi et al., 2018).
Among the strengths of the study is that it is the first to evaluate existing breastfeeding and father support studies using bibliometric analysis. Unlike systematic reviews and meta-analyses, this method examines all studies in the field in a shorter time according to specified criteria, revealing their descriptive, conceptual, social, and intellectual structures.
Limitations
This study has several limitations inherent to bibliometric analysis that should be considered when interpreting the findings. First, bibliometric methods describe publication patterns, citation trends, and thematic emphases in the literature but do not evaluate the methodological quality, risk of bias, or clinical effectiveness of individual studies. Consequently, the results cannot be used to draw conclusions about the effectiveness of father support interventions or causal relationships between paternal involvement and breastfeeding outcomes.
Second, the analysis is dependent on the coverage and indexing policies of the Web of Science database. Relevant studies published in journals not indexed in this database, as well as grey literature, may not have been captured. In addition, the inclusion of predominantly English-language publications may have led to an underrepresentation of research conducted in non-English-speaking countries, potentially influencing country-level and collaboration analyses.
Third, citation-based indicators such as total citations, citations per year, and normalized citation scores are influenced by factors unrelated to scientific quality, including publication age, journal visibility, self-citation practices, and disciplinary citation norms. Older publications have had more time to accumulate citations, while newer studies may be underrepresented despite potential relevance to current clinical practice.
Fourth, the keyword and thematic analyses rely on author-provided keywords and indexing terms, which may vary in terminology and specificity over time. Differences in how concepts such as “father support,” “partner involvement,” or “coparenting” are labelled may affect the observed thematic structure and keyword frequencies.
Finally, this study provides a descriptive overview of research trends rather than an evaluative or practice-guiding synthesis. The findings should therefore be interpreted as reflecting the evolution and distribution of scholarly attention in this field, rather than evidence of clinical impact or best practice.
Conclusion and Recommendations
The bibliometric analysis conducted in this study reveals that scientific interest in paternal support during breastfeeding has increased in recent years and that this topic is addressed within a multidimensional framework. The fact that US-based studies rely on large datasets indicates that the topic is addressed holistically within the context of public health, behavioural sciences, and health policies. The most frequently used key concepts in the literature include fathers, mothers, support, duration, and attitudes; this indicates that the scientific community increasingly recognizes that not only mothers but also fathers play an active role in the breastfeeding process. The prominence of concepts such as self-efficacy, intervention, perceptions, and experiences indicates that the psychosocial dimensions of breastfeeding behaviours are strongly represented in the studies. At the same time, concepts such as decision, barriers, and transition, which appear less frequently, indicate a need for further research on the structural and cultural barriers encountered during the breastfeeding process. The prominent themes reveal that breastfeeding processes are shaped not only at the individual level but also at the social and political levels. It is understood from the synthesised literature that paternal support is not limited to providing physical assistance; it encompasses multifaceted functions such as emotional support, information sharing, motivation, and participation in joint decision-making processes. In this context, it is important to actively involve fathers in the counselling services provided by health professionals, to plan breastfeeding education programs with a dual focus, and to adopt family-centred approaches at the policy level. Furthermore, a more comprehensive analysis of factors such as gender roles, social norms, level of access to information, and the supportive structure of health systems in breastfeeding behaviours will contribute to filling existing knowledge gaps. In this regard, it is recommended that future studies prioritize research supported by qualitative data, considering the cultural context and focusing on gender equality.
Footnotes
Acknowledgements
The authors would like to acknowledge all participants.
Ethical Considerations
Ethics approval and consent to participate: Ethics approval and consent to participate are not required for bibliometric studies.
Author Contributions
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
In this analysis, data was taken from the Web of Science as a bıbtex file and can be accessed again.
Informed Consent
All authors of this study have agreed on the journal to which the article will be submitted and have reviewed and approved the final submitted version for publication.