Document Type


Subject Area(s)

Breast Feeding (statistics & numerical data); Developed Countries; Developing Countries; Female; Humans; Peer Group; Postnatal Care (statistics & numerical data); Randomized Controlled Trials as Topic; Regression Analysis; Social Support; Socioeconomic Factors; United Kingdom (epidemiology)


OBJECTIVE: To examine the effect of setting, intensity, and timing of peer support on breast feeding. DESIGN: Systematic review and metaregression analysis of randomised controlled trials. DATA SOURCES: Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity (≥5 planned contacts), and timing of peer support (postnatal period with or without antenatal care), and analysed using metaregression for any and exclusive breast feeding at last study follow-up. RESULTS: Peer support interventions had a significantly greater effect on any breast feeding in low or middle income countries.

CONCLUSION: Although peer support interventions increase breastfeeding continuation in low or middle income countries, especially exclusive breast feeding, this does not seem to apply in high income countries, particularly the United Kingdom, where breastfeeding support is part of routine postnatal healthcare. Peer support of low intensity does not seem to be effective. Policy relating to provision of peer support should be based on more specific evidence on setting and any new peer services in high income countries need to undergo concurrent evaluation.

Digital Object Identifier (DOI)

APA Citation

Jolly, K., Ingram, L., Khan, K., Deeks, J., Freemantle, N., & MacArthur, C. (2012). Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing. BMJ, 344, d8287-d8287.