Availability of breastfeeding peer support in the United Kingdom: A cross‐sectional study

Grant, Aimee; McEwan, Kirsten; Tedstone, Sally; Greene, Giles; Copeland, Lauren; Hunter, Billie; Sanders, Julia; Phillips, Rhiannon; Brown, Amy; Robling, Mike; Paranjothy, Shantini

doi:10.1111/mcn.12476

Cited by 43 publications

(40 citation statements)

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“…A key driver for women seeking out social media support groups was a lack of practical support from health professionals and unavailability of peer breastfeeding support services. Given the significant recent cuts in breastfeeding support last year (Guardian, 27/07/, ) exacerbating patchy provision of peer support (Grant et al, ), this is unsurprising. Many health professionals describe how they want to provide the one‐to‐one, in‐depth, and emotional support that women value (Dykes, ), but staffing and resource pressures mean that they do not have the capacity (Burns, Schmied, Sheehan, & Fenwick, ; McInnes & Chambers, ).…”

Section: Discussionmentioning

confidence: 99%

“…Despite these benefits, many women report challenges in attending face‐to‐face peer support groups. Due to cuts in funding and services, breastfeeding peer support is not available equally to everyone in the United Kingdom (Grant et al, ). Women can also be reluctant to attend face‐to‐face groups due to anxiety or feeling like a failure (Hunt & Thomson, ).…”

Section: Introductionmentioning

confidence: 99%

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Experiences of online breastfeeding support: Support and reassurance versus judgement and misinformation

Regan

Brown

2019

Maternal & Child Nutrition

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Breastfeeding support is integral to many women's successful breastfeeding experiences. However, cuts to professional and peer support services, distance from family, and a predominant formula‐feeding culture mean that many women in the United Kingdom do not receive the support they need. Turning to online support is an increasingly popular means of gaining both informational and emotional support, but research into online breastfeeding support groups is sparse in the United Kingdom. Data from Australia and the United States tend to focus on the positives: Women value such groups, finding information, reassurance, and a feeling of belonging. This study explored 14 women's experiences of using online support for breastfeeding in the United Kingdom, using semistructured interviews to understand their motivations and positive and negative experiences. Mothers were drawn to online support due to a lack of professional, familial, and partner support. Online support was reassuring, empathetic, and available around the clock and less daunting than attending a face‐to‐face group. Many attributed their continued breastfeeding to the support they received. However, women also experienced negativities: judgement for using formula, polarised debate, and a lack of regulation, meaning that unhelpful information was sometimes posted. The findings have important implications for those working to support mothers. These groups provide a safe space for breastfeeding mothers, but moderation is needed of such groups to ensure information is accurate and debate respectful. Online support groups are currently plugging a gap in funded support; they should be in addition not in replacement to professional and trained peer support services.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Experiences of online breastfeeding support: Support and reassurance versus judgement and misinformation

Regan

Brown

2019

Maternal & Child Nutrition

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“…Health visitors could be better educated about the continued benefits of extended breastfeeding and trained to understand and offer support around some of the psychosocial challenges women who chose to breastfeed beyond six months can face. Peer support has worked very effectively for women earlier at earlier stages of breastfeeding but a recent UK survey showed how provision is very patchy with only 56% of the United Kingdom covered alongside additional concerns around the quality of some provision, integration with formal health and care and under-participation by poorer and more vulnerable women (Grant et al 2018). However some women who wish to breastfeed on a longer-term report moving away from general peer support networks because their choices can be challenged by other mothers.…”

Section: Discussionmentioning

confidence: 99%

Why aren't you stopping now?!’ Exploring accounts of white women breastfeeding beyond six months in the East of England

Newman

Williamson

2018

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Breastfeeding infants for a period of two years is endorsed by international health agencies such as the World Health Organisation. However, discourses of breastfeeding in a British context are complex and contradictory, juxtaposing representations of breastfeeding as healthy and a moral obligation for mothers with views of the act as unseemly and an expectation that nursing women practice 'socially sensitive lactation' especially in public spaces. Sustained breastfeeding rates in the UK are poor and most British women discontinue breastfeeding well before six months. Mothers who elect to feed their infants at the breast for longer than these normative periods appear to experience suspicion and disapproval, especially in a public context and breastfeeding women are only legally protected in feeding their infants in public for up to six months. Although breastfeeding research is flourishing, research on this particular population of mothers remains relatively limited. Therefore, in this study, we explore in-depth experiential accounts of eight women, resident in a town in the East of England, who breastfed their infants beyond six months. Using interpretative phenomenological analysis four themes are presented. Really horrible looks': stigma from families and the community', 'Feeling quite exposed': managing extended breastfeeding etiquette', 'Weird freaky paedophiles': representations of extended breastfeeding women in the media' and 'You really need that': the importance of support for longer-term breastfeeding women'. Applications to extended breastfeeding promotion and advocacy are discussed.

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“…A survey in 2014 of all known infant feeding co-ordinators in the UK had a 19.5% response rate, and covered of 58% of NHS trust/health board areas. 49 This study identified wide availability of breastfeeding support across the UK, with peer support available in 78% of areas and breastfeeding support groups available in 90% of areas. However, these may not be representative of all areas and the support may be provided only in selected localities within trust/health board areas.…”

Section: Chapter 1 Introductionmentioning

confidence: 93%

An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT

et al. 2020

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Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention in a randomised controlled trial. Design This was an individually randomised controlled feasibility trial; women were randomised in a 1 : 1 ratio to either the intervention group or the comparator (usual care) group. Setting Two separate English sites were selected because they had an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage and low rates of breastfeeding. Participants Women aged ≥ 16 years who were pregnant with their first child, irrespective of feeding intention (n = 103), were recruited by researchers in antenatal clinics. Interventions Proactive, woman-centred support, using an assets-based approach and including behaviour change techniques, was provided by an infant-feeding helper (a breastfeeding peer supporter trained in the ABA intervention) and delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks’ gestation and could continue until 5 months postnatally. Main outcome measures The main outcome measures were feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, infant-feeding helpers and maternity services; and feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow-up rates at 3 days, 8 weeks and 6 months postnatally, and outcomes for a future full trial were collected via participant questionnaires. A mixed-methods process evaluation included qualitative interviews with women, infant-feeding helpers and maternity services; infant-feeding helper logs; and audio-recordings of antenatal contacts to check intervention fidelity. Results Of the 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow-up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months, respectively. Feeding status at 8 weeks was obtained for 95.1% of participants. Recruitment took place from February 2017 until August 2017. It was possible to recruit and train existing peer supporters to the infant-feeding helper role. The intervention was delivered to most women with relatively high fidelity. Among the 50 women in the intervention group, 39 received antenatal visits and 40 received postnatal support. Qualitative data showed that the intervention was acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in the collection of postnatal feeding status data and in the offer of postnatal support. In addition, the intervention needs to better consider all infant-feeding types and did not adequately accommodate women who delivered prematurely. Conclusion It is feasible to deliver the intervention and trial. Future work The intervention should be tested in a fully powered randomised controlled trial. Trial registration Current Controlled Trials ISRCTN14760978. Funding This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.

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Availability of breastfeeding peer support in the United Kingdom: A cross‐sectional study

Cited by 43 publications

References 10 publications

Experiences of online breastfeeding support: Support and reassurance versus judgement and misinformation

Experiences of online breastfeeding support: Support and reassurance versus judgement and misinformation

Why aren't you stopping now?!’ Exploring accounts of white women breastfeeding beyond six months in the East of England

An assets-based intervention before and after birth to improve breastfeeding initiation and continuation: the ABA feasibility RCT

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