Whilst primary outcomes of improving numbers of breastfeeding mothers were not met, other benefits including reducing anxiety were noted in a new study.
An intensive peer support programme for new mothers didn’t lead to a significant uptake in overall rates of breastfeeding, according to a large new UK trial.
In the new paper published in the BMJ and funded by the National Institute for Health and Care Research (NIHR), a team of clinical researchers led from the University of Birmingham recruited more than 2,400 first-time expectant mothers at 17 UK locations.
Participants either received personalised, intensive peer support intervention which included an antenatal meeting and daily check-ins by phone or text for the two weeks after the birth, or usual care.
New mothers who took part in the peer support programme, called ABA-feed, were not more likely to be breastfeeding after eight weeks with 69.8% continuation, compared with 68.8% of mums receiving usual care. Overall levels of breastfeeding initiation were high, with 94.2% in the intervention group and 92.5% in the usual care group.
The study found that the new mothers in the ABA-feed group had short-term improvements in anxiety and were more likely to feel that they were being socially supported than those who had usual care.
The research team also found a small, but not statistically significant difference that those most likely to benefit from ABA-feed were those with lower educational achievements and those living in areas of high socioeconomic deprivation.
The high proportion of women in the usual care group who began breastfeeding, and continued to do so at eight weeks suggests, that existing support models are already effective in the population of women who joined the trial.
Professor Kate Jolly, from the University of Birmingham and corresponding author of the study, said: “ABA-feed delivered an intensive and proactively offered form of infant feeding peer support for all women, not only those planning to breastfeed. The trial didn’t see any significant difference in rates of breastfeeding between those who received the intensive peer support programme and those who had the usual care available.
"The high proportion of women in the usual care group who began breastfeeding, and continued to do so at eight weeks suggests, that existing support models are already effective in the population of women who joined the trial. This indicates that current levels of provision are providing a meaningful level of care for women who are motivated to breastfeed - however, women who were supported by ABA-feed were very positive about the support they received.”
The study’s primary outcome was whether babies were breastfed at eight weeks, either exclusively or in combination with formula. Researchers also recorded secondary outcomes including longer term breastfeeding rates, diagnosis of tongue tie in babies, and anxiety and support measures.
Anxiety levels were significantly lower in the intervention group (average score of three out of seven on GAD-7 scale) compared to the usual care group (four out of seven). Social support was higher in the intervention group (score of 90.6) compared to 84.4 in usual care. However, the differences were not maintained at the 16-week postnatal time point nor significant differences observed in the health-related quality of life outcome at eight or 16 weeks.
Dr Joanne Clarke, from the University of Birmingham and co-author of the study, said: “The trial was primarily designed to look at breastfeeding after eight weeks at a population level, but we note that there’s a possibility that having interventions like ABA-feed targeted towards certain groups - such as those in area of high deprivation - might have a stronger impact.”
While ABA-feed did not increase breastfeeding continuation at eight weeks, the researchers’ findings provide valuable evidence that demonstrates how existing support can positively influence early postnatal experience for mothers: particularly around reducing anxiety levels and the impact of perceived social support.
Further research is needed to explore how tailored versions of ABA-feed could be integrated alongside existing services to maximise benefits for families in communities where breastfeeding rates remain lowest.
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Notes to editor:
The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, educators and more than 40,000 students from over 150 countries.
England’s first civic university, the University of Birmingham is proud to be rooted in of one of the most dynamic and diverse cities in the country. A member of the Russell Group and a founding member of the Universitas 21 global network of research universities, the University of Birmingham has been changing the way the world works for more than a century.
The University of Birmingham is committed to achieving operational net zero carbon. It is seeking to change society and the environment positively, and use its research and education to make a major global contribution to the UN Sustainable Development Goals. Find out at www.birmingham.ac.uk/sustainability.
The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between nine organisations who collaborate to bring healthcare innovations through to clinical application:
University of Birmingham
University Hospitals Birmingham NHS Foundation Trust
Birmingham Women's and Children's Hospitals NHS Foundation Trust
Aston University
The Royal Orthopaedic Hospital NHS Foundation Trust
Sandwell and West Birmingham Hospitals NHS Trust
Health Innovation West Midlands
Birmingham and Solihull Mental Health NHS Foundation Trust
Birmingham Community Healthcare NHS Foundation Trust
About the National Institute for Health and Care Research
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
Funding high quality, timely research that benefits the NHS, public health and social care;
Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK international development funding from the UK government.
Professor of Public Health and Primary Care
Professor Kate Jolly is Professor of Public Health and Primary Care and head of the Unit Public Health, Epidemiology & Biostatistics at the University of Birmingham.
Research Fellow
Joanne Clarke is a Research Fellow for the ABA-feed Study within the Department of Applied Health Sciences.
