Peer support and its effect on breastfeeding initiation and continuation: a randomised controlled trial, systematic reviews and a qualitative study

Ingram, Lucy Anne (2014). Peer support and its effect on breastfeeding initiation and continuation: a randomised controlled trial, systematic reviews and a qualitative study. University of Birmingham. Ph.D.

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Abstract

Background: Breastfeeding has the potential to significantly improve public health. As part of UK government policy peer support interventions have been recommended to increase breastfeeding rates but the evidence base for this is of low quality. Methods: The aim of this thesis was to investigate the effect of breastfeeding peer support on initiation though a systematic review; on continuation through an RCT and a systematic review; and to explore women’s experiences through a qualitative study. Results: Universal peer support to improve breastfeeding initiation was ineffective. Peer support for breastfeeding continuation in both the RCT and review findings appears to be effective in low/middle income countries; when provided in an intensive schedule of contacts (>5 contacts); and given in the postnatal period. Women’s experience of peer support is generally positive and those interviewed gave several suggestions to how current local services may be modified. Conclusions: Peer support per se, in any format in the UK-setting, has not been supported. Targeted and intensive peer support may improve breastfeeding rates in the UK but this must be evaluated using high-quality methodologies. Peer support appears to be effective in the developing world, were it is intensive and targeted to those already considering breastfeeding.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):