Intensive peer support fails to boost breastfeeding rates in major UK trial

A major UK trial has found that intensive peer support programmes designed to boost breastfeeding rates offer no advantage over standard NHS care.

The study, published in the British Medical Journal, tracked 2,475 first-time mothers across 17 UK localities between January 2022 and April 2024. Results showed 69.8% of women in the enhanced support group were still breastfeeding at eight weeks, compared to 68.8% receiving usual care alone.

Researchers at the University of Birmingham tested an intensive intervention called ABA-feed. Women received proactive support from trained peers during pregnancy and for eight weeks after birth through face-to-face visits, text messages and phone calls.

But the extra help made no measurable difference. Breastfeeding initiation rates were already high in both groups — 94.2% for those receiving enhanced support versus 92.5% for standard care.

Why UK Results Differ

The findings contrast sharply with international studies showing peer support can improve breastfeeding outcomes. Previous UK trials have also failed to demonstrate benefits from similar programmes.

Researchers suggest several reasons why peer support may be less effective in the UK context. These include the timing of support after birth and the need for parents to actively seek help rather than receiving it proactively.

The intervention group did report higher social support at eight weeks. Yet this boost didn’t last — by 16 weeks, the difference had disappeared entirely.

The Numbers Behind the Study

The trial involved 1,458 women receiving intensive peer support and 1,017 getting usual care. All participants were expecting their first child and were recruited between 20 and 35 weeks of pregnancy.

Researchers found no differences in secondary outcomes either. Anxiety levels, healthcare use and other measures remained similar between both groups throughout the study period.

The study’s scale and rigorous design make its findings chiefly significant for NHS commissioners considering whether to fund such programmes.

What Went Wrong

The ABA-feed intervention was built on behaviour change theory and an assets-based approach. Peer supporters received extensive training to provide evidence-based breastfeeding guidance.

Despite this solid foundation, the programme failed to move the needle on breastfeeding rates. The researchers conclude that intensive peer support programmes should not be commissioned based on these results.

One factor may be that UK usual care is already quite effective. With breastfeeding initiation rates above 92% in both groups, there may be limited room for improvement through additional peer support alone.

Key Takeaways

• Intensive peer support programmes showed no benefit over standard NHS breastfeeding care in major UK trial
• Breastfeeding rates at eight weeks were virtually identical between enhanced support (69.8%) and usual care (68.8%) groups
• High initiation rates suggest current UK maternity services are already providing effective breastfeeding support

What This Means for Kent Residents

Kent and Medway Integrated Care Board should carefully consider these findings before commissioning similar peer support interventions for local maternity services. The research suggests that intensive peer support programmes would represent poor value for money, with resources better directed towards other evidence-based maternal health initiatives. Expectant mothers in Kent can be reassured that standard NHS breastfeeding support provided through midwives, health visitors and existing services appears just as effective as more intensive peer support models, with local maternity units already achieving high breastfeeding initiation rates comparable to the national trial results.