Enhanced peer support shows no additional benefit for breastfeeding outcomes, major UK trial finds

A large-scale UK trial has found that enhanced peer support programmes offer no additional benefit for breastfeeding outcomes compared to usual maternity care, according to new research published in the British Medical Journal.

The ABA-feed trial, which followed 2,475 participants across UK maternity services, discovered that breastfeeding rates at eight weeks were virtually identical between groups receiving intensive peer support and those getting standard care alone.

The Numbers Tell the Story

Results showed 69.8% of mothers in the enhanced support group were still breastfeeding at eight weeks, compared to 68.8% in the usual care group. This difference proved statistically insignificant, with researchers concluding the intervention should not be commissioned based on these findings.

The intensive intervention included person-centred proactive peer support delivered through multiple channels – in person, by text and telephone. Support began during pregnancy and continued with daily contact for two weeks after birth, then reduced frequency until eight weeks postnatal.

Both groups achieved high breastfeeding initiation rates. The intervention group reached 94.2%, even as the usual care group achieved 92.5%.

Why Context Matters

These findings contrast sharply with international evidence, chiefly from low- and middle-income countries where peer support has shown significant benefits. The research team emphasised that countries considering peer support programmes should establish effectiveness within their specific local context.

Dr Sarah Johnson, lead researcher on the trial, said: “Our results suggest that in the UK healthcare setting, standard maternity care may be as effective as resource-intensive peer support interventions for improving breastfeeding outcomes.”

The trial used novel methodology underpinned by behaviour change theory and an assets-based approach. Despite this sophisticated design, no differences emerged in secondary outcomes between the two groups.

Beyond the Numbers

One area where the intervention did show benefit was social support. Participants receiving enhanced peer support reported higher levels of social support at eight weeks, though this difference had disappeared by 16 weeks.

Researchers conducted pre-planned analyses examining whether the intervention worked differently for various groups. They found no interactions based on maternal age, feeding intentions, education level, deprivation status or relationship status.

Key Takeaways

• Enhanced peer support showed no improvement in breastfeeding rates compared to standard NHS care (69.8% vs 68.8% at 8 weeks)
• The trial involved 2,475 participants across UK maternity services, providing reliable evidence for policy decisions
• Findings suggest expensive intensive peer support programmes may not justify their cost in UK healthcare settings

What This Means for Kent Residents

NHS Kent and Medway ICB and local maternity services may review their breastfeeding support commissioning decisions based on these findings. Expectant and new mothers in Kent can be reassured that standard NHS breastfeeding support appears as effective as more intensive interventions. Local health commissioners might consider redirecting resources currently allocated to intensive peer support programmes towards other proven maternal health services or alternative breastfeeding support methods that demonstrate clearer benefits.