Availability of breastfeeding peer-support in the UK: a cross-sectional survey

Peer-support is recommended by the World Health Organisation for the initiation and continuation of breastfeeding, and this recommendation is included in UK guidance. There is a lack of information about how, when and where breastfeeding peer-support is provided in the UK. We aimed to generate an overview of how peer-support is delivered in the UK and to gain an understanding of challenges for implementation. We surveyed all UK Infant Feeding Coordinators (n=696) who were part of UK based national Infant Feeding Networks, covering 177 NHS organisations. We received 136 responses (individual response rate 19.5%), covering 102 UK NHS organisations (organisational response rate 58%). We also searched NHS organisation websites to obtain data on the presence of breastfeeding peer-support. Breastfeeding peer-support was available in 56% of areas. However, coverage within areas was variable. The provision of training and ongoing supervision, and peer-supporter roles, varied significantly between services. Around one third of respondents felt that breastfeeding peer-support services were not well integrated with NHS health services. Financial issues were commonly reported to have a negative impact on service provision. One quarter of respondents stated that breastfeeding peer-support was not accessed by mothers from poorer social backgrounds. Overall, there was marked variation in the provision of peer-support services for breastfeeding in the UK. A more robust evidence-base is urgently needed to inform guidance on the structure and provision of breastfeeding peer-support services.