Abstract
In many high‐income countries such as the United Kingdom, inequalities in breastfeeding initiation and continuation rates exist, whereby socio‐economically advantaged mothers are most likely to breastfeed. Breastfeeding peer support interventions are recommended to address this inequality, with non‐profit breastfeeding organisations providing such support in areas of deprivation. As these organisations' roots and membership are often formed of relatively highly resourced women who have different backgrounds and experiences to those living in areas of deprivation, it is important to understand their practices in this context. In order to explore how UK non‐profit organisations practice breastfeeding peer support in areas of socio‐economic deprivation, a systematic review and meta‐ethnography of published and grey literature was undertaken. Sixteen texts were included, and three core themes constructed: (1) ‘changing communities’ reveals practices designed to generate community level change, and (2) ‘enabling one to one support’, explains how proactive working practices enabled individual mothers' access to supportive environments. (3) ‘forging partnerships with health professionals’, describes how embedding peer support within local health services facilitated peer supporters' access to mothers. While few breastfeeding peer support practices were directly linked to the context of socio‐economic deprivation, those described sought to influence community and individual level change. They illuminate the importance of interprofessional working. Further work to consolidate the peer‐professional interface to ensure needs‐led care is required.
Highlights
The health gains of breastfeeding in high, middle- and low-income countries are indisputable (Grummer-Strawn & Rollins, 2015), yet rates remain below recommendations internationally (WHO, 2019)
Many studies included the perspectives of women, peer supporters and health professionals
This meta-ethnography focuses on UK non-profit Breastfeeding peer support (BPS) organisations' practices related to the context of deprivation
Summary
The health gains of breastfeeding in high, middle- and low-income countries are indisputable (Grummer-Strawn & Rollins, 2015), yet rates remain below recommendations internationally (WHO, 2019). Qualitative research highlights peer support's value in promoting breastfeeding continuation and maternal well-being (e.g., Thomson, Crossland, & Dykes, 2012), and additional support from lay supporters and professionals has been found to effect breastfeeding outcomes positively (McFadden et al, 2017). Despite this mixed evidence, UK commissioning of BPS continues, and it is provided in 56% of areas (Grant et al, 2018).
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