We need not be too pessimistic about the potential of volunteer
counsellors to assist breastfeeding mothers. Graffy et al have examined
only a fairly limited intervention, which relied heavily on the new mother
to suspect a breastfeeding problem and initiate contact with a
counsellor.(1)
A woman is more likely to initiate and maintain breastfeeding if she
has a relative or friend who has breastfed successfully(2) and it is at
least plausible that support provided by a trained volunteer peer
counsellor might have a similar effect. However, many women,
particularly the less motivated and less socially skilled, find it
difficult to initiate contact with a relative stranger and wait for help
to be offered.(3) Furthermore, many central questions about peer support
have yet to be addressed in methodologically adequate studies.(4) We
have little objective information on the qualities of a successful
volunteer supporter, the experience and training she should have, how peer
support could be most effectively offered and even the relative importance
of befriending and imparting information during the peer support process.
Commentators are quick to blame 'society' for breastfeeding failure.
The volunteer peer supporter might well represent the interface between
cultural influences and the new mother at which change could be most
readily instigated. We urgently need effective methods of supporting the
maintenance of breastfeeding; volunteer peer support is worth further
investigation.
References
1. Graffy J, Taylor J, Williams A, Eldridge S. Randomised
controlled trial of support from volunteer counsellors for mothers
considering breast feeding. BMJ 2004;328:26-9.
2. Hoddinott P, Pill R. Qualitative study of decisions about
infant feeding among women in east end of London BMJ 1999;318:30-4.
3. Hoddinott P, Pill R. Nobody actually tells you: a study of
infant feeding. BJ Midwifery 1999;7(9):558-65.
4. Protheroe L, Dyson L, Renfrew MJ. The effectiveness of public
health interventions to promote the initiation of breast feeding:
Evidence briefing. NHS Health Development Agency 2003. www.hda.nhs.uk/evidence.
Competing interests:
None declared
Competing interests:
No competing interests
18 January 2004
Carol MA Campbell
Community Paediatrician (staff grade)
Community Paediatric Unit, Bridgeview House, Gransha Park, Londonderry BT47 1TG
Rapid Response:
Peer support is worth further investigation
We need not be too pessimistic about the potential of volunteer
counsellors to assist breastfeeding mothers. Graffy et al have examined
only a fairly limited intervention, which relied heavily on the new mother
to suspect a breastfeeding problem and initiate contact with a
counsellor.(1)
A woman is more likely to initiate and maintain breastfeeding if she
has a relative or friend who has breastfed successfully(2) and it is at
least plausible that support provided by a trained volunteer peer
counsellor might have a similar effect. However, many women,
particularly the less motivated and less socially skilled, find it
difficult to initiate contact with a relative stranger and wait for help
to be offered.(3) Furthermore, many central questions about peer support
have yet to be addressed in methodologically adequate studies.(4) We
have little objective information on the qualities of a successful
volunteer supporter, the experience and training she should have, how peer
support could be most effectively offered and even the relative importance
of befriending and imparting information during the peer support process.
Commentators are quick to blame 'society' for breastfeeding failure.
The volunteer peer supporter might well represent the interface between
cultural influences and the new mother at which change could be most
readily instigated. We urgently need effective methods of supporting the
maintenance of breastfeeding; volunteer peer support is worth further
investigation.
References
1. Graffy J, Taylor J, Williams A, Eldridge S. Randomised
controlled trial of support from volunteer counsellors for mothers
considering breast feeding. BMJ 2004;328:26-9.
2. Hoddinott P, Pill R. Qualitative study of decisions about
infant feeding among women in east end of London BMJ 1999;318:30-4.
3. Hoddinott P, Pill R. Nobody actually tells you: a study of
infant feeding. BJ Midwifery 1999;7(9):558-65.
4. Protheroe L, Dyson L, Renfrew MJ. The effectiveness of public
health interventions to promote the initiation of breast feeding:
Evidence briefing. NHS Health Development Agency 2003.
www.hda.nhs.uk/evidence.
Competing interests:
None declared
Competing interests: No competing interests