Women’s and peer supporters’ experiences of an assets-based peer support intervention for increasing breastfeeding initiation and continuation: a qualitative study

Background and context.
Breastfeeding peer support is valued and well-liked by women, but trials have not demonstrated efficacy in the UK. The ABA feasibility trial offered proactive peer support underpinned by behaviour change theory and an assets-based approach to women having their first baby, regardless of feeding intention. This paper explores views
of women and infant feeding helpers (IFHs) of the ABA intervention.

Setting and participants.
Trained infant feeding helpers (IFHs) offered 50 women an antenatal meeting to discuss infant feeding and identify community assets in two English sites - one with a paid peer support service and the other volunteer-led. Daily contact was offered postnatally for the first 2 weeks after birth, followed by less frequent contact until 5 months.

Methods.
Interviews with 21 women and focus groups/interviews with 13 IFHs were analysed using thematic and framework methods.

Results.
Women talked positively about the antenatal meeting, mapping their network of support, receiving proactive contact from their IFH, keeping in touch using text messaging and access to local groups. The face-to-face antenatal visit facilitated the regular text-based communication both in pregnancy and in the early weeks after birth. Volunteer IFHs were more supportive of and enthusiastic about the intervention whereas most paid IFHs disliked some features of the intervention.

Conclusions.
Putting the ABA intervention into practice was challenging for some peer supporters. Despite this, breastfeeding rates may be improved by using a community assetsbased approach and focusing on infant feeding as an acceptable alternative to focusing on breastfeeding alone.