Heather Trickey, & Gill Thomson et al, have recently published a paper looking at one-to-one breastfeeding peer support experiments conducted in developed country settings.
Below is a link to the December issue of the ‘National Childbirth Trust Perspective’ with a summary of the research and key points.
The realist review provides an evidence-based guide to what’s needed to give one-to-one breastfeeding peer support interventions the best chance of succeeding. One-to-one peer support interventions need to be relevant to the target population, properly embedded into existing health care pathways, and introduced in tandem with professional support.
The lessons from the review do not replace the need for evaluation, though they do suggest the need to re-think how evaluation of breastfeeding peer support programmes is done. Peer support experiments often just measure change in breastfeeding rates over a period convenient for data collection, without specifying clearly how change is expected to happen or to be sustained. More attention needs to be paid to intervention theory, design and implementation, bearing in mind the unique circumstances of each setting.
The UK continues to have internationally low breastfeeding rates and very high rates of ‘breastfeeding disappointment.’
Breastfeeding support can only be one cog in the wheel of change. Given a goal to improve UK breastfeeding rates, there is a pressing need to understand how all the cogs work together. There is a need to evaluate how and where peer supporters can contribute to sustained changes in attitudes and beliefs, in services and culture.