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RESEARCH: Christine MacArthur, Kate Jolly, Lucy Ingram, Nick Freemantle, Cindy-Lee Dennis, Ros Hamburger, Julia Brown, Jackie Chambers, and Khalid Khan Antenatal peer support workers and initiation of breast feeding: cluster randomised controlled trial BMJ 2009; 338: b131 [Abstract] [Full text]

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Experience of a New Mum

Eleanor J Midgley   (14 February 2009)

Effect of peer support service on the fall in intended method of feeding

S A Deshpande   (14 February 2009)

Experience of a New Mum 14 February 2009
Eleanor J Midgley, FY2 Doctor Milton Keynes General Hospital, MK65LD Send response to journal: Re: Experience of a New Mum	I read the results of Khan et al. study into the failure of community based breastfeeding peer support workers with interest. Sadly, given my experience as a new mum their results don't seem all that surprising. My husband and I dutifully went along to NHS antenatal classes (not at my hospital of work). The session on feeding began “We all know breast is best”. Good start. Then we were shocked to hear the midwife go on to complain about how she wasn't allowed to teach us about bottle feeding any more, fail to further mention breast feeding and proceed to promote bottle feeding anyway. Unfortunately, this hasn't been an isolated incident. On moving to a new area a health visitor asked me what formula I gave our baby and yesterday when the baby was upset after his eight week immunisations the practice nurse said soothingly “Give him a bottle to calm him down.”. Have we been unlucky to come across an outdated minority amongst the multidisciplinary team? Perhaps, but new mums put a huge amount of their trust into the information and support the MDT provides and not all mums have the confidence to selectively ignore its advice. How can we expect a team of peer supporters to succeed in increasing breastfeeding rates when the professional MDT (doctors not excluded) doesn't consistently expect and reinforce breast milk as the norm? Competing interests: None declared
Effect of peer support service on the fall in intended method of feeding 14 February 2009
S A Deshpande, Consultant Neonatologist Royal Shrewsbury Hospital, Shrewsbury SY3 8XQ Send response to journal: Re: Effect of peer support service on the fall in intended method of feeding	I read with interest the paper by MacArthur et al. I wondered if the authors found any differences between the two groups in the intended method of feeding before the first support contact? As a whole, it appears that nearly 80% of pregnant women either intended to, or were considering breastfeeding; yet, there was deterioration in the breast-feeding rates between the first support session and birth. Was this deterioration any less in the group receiving the peer support worker service? Competing interests: None declared