One-to-One or Group-Based Peer Support for Breastfeeding? Women's Perceptions of a Breastfeeding Peer Coaching Intervention

Authors

  • Pat Hoddinott MBBS, DCH, DRCOG, FRCGP, MPhil,

    Corresponding author
    1. Pat Hoddinott is Senior Clinical Research Fellow at The Centre For Rural Health, Aberdeen University, Inverness, Scotland; Maretta Chalmers is a Grampian Primary Care Trust Research Training Fellow and Midwife at Fraserburgh Hospital, Aberdeen, Scotland; and Roisin Pill is Professor Emeritus at The Department of General Practice, Cardiff University, Centre for Health Sciences Research, Cardiff, Wales.
      * Dr. Pat Hoddinott, The Centre For Rural Health, Aberdeen University, The Green House, Beechwood Business Park North, Inverness IV2 3ED, Scotland.
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  • Maretta Chalmers RGN, RM, DipDN,

    1. Pat Hoddinott is Senior Clinical Research Fellow at The Centre For Rural Health, Aberdeen University, Inverness, Scotland; Maretta Chalmers is a Grampian Primary Care Trust Research Training Fellow and Midwife at Fraserburgh Hospital, Aberdeen, Scotland; and Roisin Pill is Professor Emeritus at The Department of General Practice, Cardiff University, Centre for Health Sciences Research, Cardiff, Wales.
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  • Roisin Pill BA, MScEcon, PhD, HonFRCGP

    1. Pat Hoddinott is Senior Clinical Research Fellow at The Centre For Rural Health, Aberdeen University, Inverness, Scotland; Maretta Chalmers is a Grampian Primary Care Trust Research Training Fellow and Midwife at Fraserburgh Hospital, Aberdeen, Scotland; and Roisin Pill is Professor Emeritus at The Department of General Practice, Cardiff University, Centre for Health Sciences Research, Cardiff, Wales.
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  • This project received funding from Grampian Primary Care NHS Trust, Aberdeen, and The Chief Scientist Office, Scottish Executive Research Practice Scheme, Edinburgh, Scotland, United Kingdom.

* Dr. Pat Hoddinott, The Centre For Rural Health, Aberdeen University, The Green House, Beechwood Business Park North, Inverness IV2 3ED, Scotland.

Abstract

Abstract: Background:Studies reporting one-to-one peer support interventions have been successful in some countries with high breastfeeding initiation rates, but less so in Great Britain, where low uptake of peer support has occurred. We conducted a peer coaching intervention study in rural Scotland that improved breastfeeding initiation and duration. This study reports qualitative data about participants’ perceptions of the coaching intervention. The aim was to investigate why group-based peer support was more popular than one-to-one peer support. Methods:Qualitative data were collected and analyzed from an initial focus group; 21 semi-structured interviews; and 31 coaching group observations and respondents (n = 105/192) in response to an open question about reasons for not choosing a personal coach in a survey of breastfeeding experiences. We developed a coding frame, identified themes, and constructed charts for analysis and interpretation of data. Results:Analysis revealed that groups were more popular because they normalized breastfeeding in a social environment with refreshments, which improved participants’ sense of well-being. Groups provided flexibility, a sense of control, and a diversity of visual images and experiences, which assisted women to make feeding-related decisions for themselves, and they offered a safe place to rehearse and perform breastfeeding in front of others, in a culture where breastfeeding is seldom seen in public. Women often felt initial anxiety when attending a group for the first time, and they expressed doubt that one set of “breastfeeding rules” would suit everyone. Conclusions:Pregnant women and breastfeeding mothers will voluntarily engage in an activity to support breastfeeding if there is a net interactional (verbal, visual, emotional and gustatory) gain and a minimum risk of a negative experience. One-to-one peer coaching was perceived as a greater risk to confidence and empowerment than group- based peer coaching. (BIRTH 33:2 June 2006)

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