Well-structured, intensive breastfeeding support provided by hospital and community-based peer counselors is effective in improving exclusive breastfeeding rates among low-income, inner-city women in the United States.

These findings demonstrate that, in the United States, peer counselors can significantly improve breastfeeding initiation rates and have an impact on breastfeeding rates at 1 and 3 months post partum.

There are a growing number of publications evaluating various breastfeeding peer counseling (PC) models. We have systematically reviewed a) the randomized trials assessing the effectiveness of breastfeeding PC in improving rates of breastfeeding initiation, duration, exclusivity and maternal and child health outcomes; and b) scientific literature describing the scale-up of breastfeeding PC programs. Twenty-six peer-reviewed publications were included in this review. The overwhelming majority of evidence from randomized, controlled trials evaluating breastfeeding PC indicates that peer counselors effectively improve rates of breastfeeding initiation, duration and exclusivity. PC interventions were also shown to significantly decrease the incidence of infant diarrhea and significantly increase the duration of lactational amenorrhea. We conclude that breastfeeding PC initiatives are effective and can be scaled up in both developed and developing countries, as part of well-coordinated national breastfeeding promotion or maternal-child health programs.

In a Baby-Friendly hospital setting, SBFPC targeting overweight/obese women did not impact EBF practices but was associated with increased rates of any breastfeeding and breastfeeding intensity at 2 weeks postpartum and decreased rates of infant hospitalization in the first 6 months after birth.

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