Effect of a peer support service on breast-feeding continuation in the UK: a randomised controlled trial

Abstract

Objective: to assess the effectiveness of a peer support worker (PSW) service on breast-feeding continuation.

Design: cluster randomised controlled trial (ISRCTN16126175).

Setting: Primary Care Trust, UK serving a multi-ethnic, socio-economically disadvantaged population.

Participants: 2,724 women giving birth following antenatal care from 66 clinics: 33 clinics (1,267 women) randomised to the PSW service and 33 clinics (1,457 women) to usual care. 848 women consented to additional follow-up by questionnaire at 6 months.

Intervention: PSW service provided in the antenatal and postnatal period.

Measurements: any and exclusive breast feeding at 10-14 days obtained from routine computerised records and at 6 weeks and 6 months from a questionnaire.

Findings: follow-up: 94% at 10-14 days, 67.5% at 6 months. There was no difference in any breast feeding at 10-14 days between intervention and usual care, odds ratio (OR) 1.07 (95% CI 0.87-1.31, p=0.54). Proportion of women reporting any breast feeding in the intervention group at 6 weeks was 62.7% and 64.5% in the usual care group OR 0.93 (95% CI 0.64-1.35); and at 6 months was 34.3% and 38.9%, respectively, OR 1.06 (95% CI 0.71-1.58).

Key conclusions: universal antenatal peer support and postnatal peer support for women who initiated breast feeding did not improve breast-feeding rates up to 6 months in this UK population.

Implications for practice: with high levels of professional support part of usual maternity care it may not be possible for low intensity peer support to produce additional benefit. More intensive or targeted programmes might be effective, but should have concurrent high quality evaluation.