Abstract
Breastfeeding has known positive health benefits for babies and mothers, yet the UK has one of the lowest breastfeeding initiation rates in Europe. Despite national guidance that recommends provision of breastfeeding peer support, there is conflicting evidence regarding its effectiveness, especially in high-income countries, and a lack of evidence among young mothers. This study evaluates the effectiveness of a breastfeeding peer support service (BPSS) in one UK city in increasing breastfeeding initiation and duration in young mothers. Routinely collected data were obtained on feeding method at birth, 2 and 6 weeks for all 5790 women aged <25 registered with a local general practitioner and who gave birth from April 2009 to September 2013. Segmented regression was used to quantify the impact of the introduction of the BPSS in September 2012 on the prevalence of breastfeeding at birth, 2 and 6 weeks, accounting for underlying trends. Results showed that breastfeeding prevalence at birth and 2 weeks began to increase month-on-month after the introduction of the BPSS, where previous figures had been static; prevalence at birth increased by 0.55 percentage points per month (95% CI 0.10-1.00, P = 0.018) and at 2 weeks by 0.50 percentage points (95% CI 0.15-0.86, P = 0.007). There was no change from an underlying marginally increasing trend in prevalence at 6 weeks. In conclusion, our findings suggest that a one-to-one BPSS provided by paid peer supporters and targeted at young mothers in the antenatal and post-natal periods may be beneficial in increasing breastfeeding initiation and prevalence at 2 weeks.
Highlights
Breastfeeding promotes and protects the health of infants and mothers (Horta et al 2007; Ip et al 2007), and exclusive breastfeeding is recommended for the first 6 months of an infant’s life (World Health Organisation 2003)
Prior to the introduction of the breastfeeding peer support service (BPSS), the proportion of mothers giving birth each month who breastfed at birth and the proportion who were feeding at 2 weeks showed no month-on-month change; the baseline trend for breastfeeding at 6 weeks was increasing by 0.09% per month prior to the introduction of the BPSS
There was no immediate change in the proportion of women who breastfed at birth, 2 or 6 weeks following the introduction of the BPSS
Summary
Breastfeeding promotes and protects the health of infants and mothers (Horta et al 2007; Ip et al 2007), and exclusive breastfeeding is recommended for the first 6 months of an infant’s life (World Health Organisation 2003). Just over a third of mothers in England are still breastfeeding at 6 months with the greatest drop in prevalence occurring during the first 2 weeks following birth (Health and Social Care Information Centre 2012a). Factors positively associated with breastfeeding prevalence at 6 weeks in the UK Infant Feeding Survey include being of non-White ethnicity, being aged 30 or more and being a mother from a managerial or professional occupation (Health and Social Care Information Centre 2012b). Common reasons that mothers give for stopping breastfeeding during the first 2 weeks postpartum include the baby not sucking and painful nipples (Health and Social Care Information Centre 2012a); these issues are likely to be due to poor positioning and attachment to the breast. Negative moral norms about breastfeeding and embarrassment of breastfeeding in public are key barriers to breastfeeding (Ingram et al 2008; Dyson et al 2010)
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