title: 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.
  
  
  METHODS
  cluster randomised controlled trial (ISRCTN16126175).
  
  
  METHODS
  Primary Care Trust, UK serving a multi-ethnic, socio-economically disadvantaged population.
  
  
  METHODS
  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.
  
  
  METHODS
  PSW service provided in the antenatal and postnatal period.
  
  
  METHODS
  any and exclusive breast feeding at 10-14 days obtained from routine computerised records and at 6 weeks and 6 months from a questionnaire.
  
  
  RESULTS
  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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Public Health Building, University of Birmingham, Birmingham B15 2TT, UK. C.B.Jolly@bham.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Jolly
authors.forename: Lucy
authors.initials: L
authors.lastname: Ingram
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
authors.forename: Khalid
authors.initials: K
authors.lastname: Khan
authors.forename: Jacky
authors.initials: J
authors.lastname: Chambers
authors.forename: Ros
authors.initials: R
authors.lastname: Hamburger
authors.forename: Julia
authors.initials: J
authors.lastname: Brown
authors.forename: Cindy-Lee
authors.initials: CL
authors.lastname: Dennis
authors.forename: Christine
authors.initials: C
authors.lastname: Macarthur
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007398:Interpersonal Relations; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010379:Peer Group; D011181:Postnatal Care / Q000706:statistics & numerical data; D012944:Social Support; D006113:United Kingdom; D055815:Young Adult