Abstract / Summary
Despite high breastfeeding initiation rates in Hong Kong, duration remains far below World Health Organization recommendations. Although fathers significantly influence breastfeeding choices, few studies have simultaneously evaluated paternal and maternal perspectives on influencing factors in Hong Kong’s high-density urban context. This study aimed to (1) describe parental breastfeeding intentions and practices, (2) examine correlations between parental knowledge and breastfeeding duration, and (3) compare how fathers and mothers rate factors influencing breastfeeding choices. A cross-sectional study was conducted in Hong Kong (2017–2024) using convenience and snowball sampling across Maternal and Child Health Centres, community groups, and social media. Overall, 433 parents (221 fathers, 212 mothers) with a child under three years completed a self-administered questionnaire assessing demographics, breastfeeding knowledge (score 0–5), practices, and 19 potential influencing factors (5-point Likert scale). Data were analysed using descriptive statistics. Overall, 28% of infants were exclusively breastfed for six months, and 2.5% were breastfed for 24 months, despite high future breastfeeding intentions (92.4%). Mean knowledge scores did not differ significantly between mothers (3.12) and fathers (3.03). Knowledge positively correlated with exclusive breastfeeding duration in both mothers ( r = 0.27, p < 0.001) and fathers ( r = 0.25, p < 0.001). “Promoting baby’s health” was the highest-rated factor for both parents (mean = 4.45). Significant gender differences were found for two factors: “sufficient milk production” (mothers: 4.24 vs. fathers: 4.05, p = 0.007) and “adequate facilities” (mothers: 4.08 vs. fathers: 3.82, p = 0.001), with mothers rating both as more important. While both parents prioritize infant health, mothers perceive structural and physiological barriers, specifically facility availability and milk sufficiency, as significantly more critical than fathers do. Fathers may consequently underestimate the daily physical and environmental challenges faced by mothers. To improve breastfeeding duration, interventions should (1) deliver couple-based, skills-focused antenatal education addressing milk supply cues, (2) educate fathers on logistical barriers, and (3) expand public and workplace baby-friendly facilities. Not applicable.