Perceptions of Public Breastfeeding Images and Their Association With Breastfeeding Knowledge and Attitudes Among an Internet Panel of Men Ages 21-44 in the United States.

Background: Men's attitudes toward public breastfeeding may influence a woman's decisions about breastfeeding and her perceived comfort with public breastfeeding. Research aim: This study aimed to evaluate factors associated with men's visual perception of images of public breastfeeding.
Methods: A 95-item online survey was administered to 502 U.S. men ages 21 to 44. Respondents were presented with four images of women breastfeeding and asked to evaluate agreement with 15 adjectives describing each image. Based on factor analysis, 13 of these adjectives were combined to create the Breastfeeding Images Scale for each image. An 8-item Situational Statements Scale and the 17-item Iowa Infant Feeding Attitude Scale (IIFAS) were used to assess breastfeeding knowledge and attitudes. Multiple regression was used to evaluate the association between breastfeeding attitudes and knowledge and the Breastfeeding Images Scale.
Results: The image depicting a woman breastfeeding privately at home had the highest mean score of 71.95, 95% confidence interval (CI) [70.69, 73.22], on the Breastfeeding Images Scale, compared with 61.93, 95% CI [60.51, 63.36], for the image of a woman breastfeeding in a public setting. The overall mean scale score for the IIFAS was 56.99, 95% CI [56.27, 57.70], and for the Situational Statements Scale was 28.80, 95% CI [27.92, 29.69]. For all images, increasing breastfeeding knowledge and attitudes measured by the IIFAS and the Situational Statements Scale were associated with a more positive perception of the image.
Conclusion: Images of public breastfeeding are viewed less favorably by men in the sample than are images of private breastfeeding. Knowledge and attitudes toward breastfeeding are positively associated with perception of breastfeeding images.