Peer support for breastfeeding mothers has often been promoted as a way of increasing rates in communities with low breastfeeding prevalence, where there are few breastfeeding role models and a bottle-feeding culture predominates. This study evaluated the effectiveness of a peer support initiative, which trained peer supporters who then set up a support group, in an area of social and economic deprivation in South Bristol, UK. The effects of training on 6 local women were explored; the combined effect of peer support and the group on breastfeeding prevalence assessed; and mothers' views on what they had gained from the breastfeeding support group reported. Focus groups were held with the peer supporters, who also completed questionnaires before and after their training. Questionnaires were sent to all mothers (35) who attended the support group over the first 5 months to ascertain their views. Breastfeeding rates were extracted from routinely collected sources for both the local area and the wider Bristol population (excluding the peer support area). The initial training increased the peer supporters' knowledge about breastfeeding and their confidence in talking to and supporting mothers. The number of mothers attending the breastfeeding support group increased from 3 per week in May to 10 per week by September 2001. Mothers who attended the group particularly appreciated being able to talk about breastfeeding and getting consistent breastfeeding advice. Breastfeeding rates in the area for 12-months before and after the start of the peer support initiative showed a significant increase at 8 weeks (7%), which was higher than the overall increase in the wider Bristol area (3%). This evaluation suggests that peer supporters combined with a breastfeeding support group are an effective way of increasing breastfeeding prevalence in areas of low continuation.

We discuss some of the issues that have arisen during the development and introduction into practice of information materials for health professionals and patients that aim to promote clinical effectiveness and informed patient participation in clinical decision making.

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The Informed Choice Initiative aims to make available to both professionals and users a range of leaflets about topics related to pregnancy and childbirth which are based upon the best available scientific evidence. For each topic covered there are two leaflets — one for health care professionals and one for patients. They are intended to facilitate women's involvement in decisions about their health care and help promote clinical effectiveness. The initiative is the result of a collaboration between the Midwives Information and Resource Service and the NHS Centre for Reviews and Dissemination. The article describes the rigorous development process of the leaflets and discusses some of the issues raised by initiatives such as Informed Choice.

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