Breastfeeding peer supporters and a community support group: evaluating their effectiveness

Abstract

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.

Social Support Networks and Maternal Mental Health and Well-Being

“…50,104,105 Whereas supportive networks can be beneficial to mothers, the potentially negative aspects of networks have the potential to act as psychological stressors, causing cognitive, affective, and biological responses thought to increase the risk for poor health. 5 Providers need to assess a mother's social network in order to identify barriers and facilitators for positive behavior and aim to increase support for the mother.…”

“…47,48 Several studies have found that problematic social ties are more predictive of depression than is a lack of supportive relationships. 47,49,50 …”

Can community-based peer support promote health literacy and reduce inequalities? A realist review

“…107 In some programmes, peers decided to support each other by getting together informally or working together with participants, even although this was not a requirement of the programme.…”

“…For example, when exploring cultural beliefs within the Breastfeeding cluster, it was reported that 'the local community had very few breastfeeding role models and a bottle feeding culture predominates'. 107 Authors from the breastfeeding cluster reported that project teams that did not undertake cultural needs assessments came across difficulties during implementation stages. This suggests, in the context of the breastfeeding cluster, cultural needs assessments are an important initial aspect of the design process.…”

Increasing support for breastfeeding: what can Children’s Centres do?

“…It is notable that many of the proposals made were linked to existing evidence of good practice. Other studies have shown that peer supporters combined with a breastfeeding support group are an effective way of increasing breastfeeding prevalence in areas of low continuation (Ingram et al. 2005), but that women may prefer to attend group based peer support as groups may increase their confidence with breastfeeding (Hoddinott et al.…”