title: Building social capital through breastfeeding peer support: insights from an evaluation of a voluntary breastfeeding peer support service in North-West England.
abstract: BACKGROUND
  Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013.
  
  
  METHODS
  Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed.
  
  
  RESULTS
  Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with'bonding', 'bridging' and 'linking' forms of social capital. These insights illuminate how the peer support service facilitates 'bonds' with its members, and within and between women who access the service; how the service 'bridges' with individuals from different interests and backgrounds, and how 'links' were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified.
  
  
  CONCLUSIONS
  Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted.
authors.affiliation: Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Thomson
authors.affiliation: Research in Childbirth and Health Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE UK.
authors.forename: Marie-Clare
authors.initials: MC
authors.lastname: Balaam
authors.affiliation: East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Haslingden Road, Blackburn, Lancashire BB2 3HH UK.
authors.forename: Kirsty
authors.initials: K
authors.lastname: Hymers
keywords: Breastfeeding peer support; Professionals; Qualitative; Social capital; Voluntary; Women