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      Breastfeeding peer support by telephone in the RUBY randomised controlled trial: A qualitative exploration of volunteers’ experiences

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          Abstract

          Background

          There is growing evidence that peer support programs may be effective in supporting breastfeeding mothers. A randomised controlled trial (RCT) (the RUBY study) that tested peer support in the Australian context found that infants of first-time mothers who received proactive telephone peer support were more likely to be receiving breastmilk at six months of age.

          Methods

          This qualitative sub-study of the RUBY RCT explores the experiences and views of peer volunteers who delivered the intervention. Focus groups were conducted with 17 peers from the RUBY RCT between November 2015 and March 2016. All had provided peer support to at least one mother.

          Results

          We found that volunteers identified strongly with the mothers’ need for support when establishing breastfeeding. Key components of the support were strengthening the mothers’ self-belief through affirmation and sharing experiential knowledge. Volunteers found the role rewarding and personally therapeutic although some women reported challenges initiating and maintaining contact with some mothers. Data were analysed using a hybrid approach to thematic analysis combining inductive and deductive techniques

          Conclusions

          Breastfeeding peer support programs are reliant on recruitment of motivated volunteers who can provide empathetic mother-to-mother support. This study provides important information regarding volunteers’ experiences that may support the upscaling of breastfeeding peer support for new mothers.

          Trial registration

          Australian New Zealand Clinical Trials Registry, ACTRN 12612001024831.

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          Most cited references23

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          Support for healthy breastfeeding mothers with healthy term babies

          There is extensive evidence of important health risks for infants and mothers related to not breastfeeding. In 2003, the World Health Organization recommended that infants be breastfed exclusively until six months of age, with breastfeeding continuing as an important part of the infant's diet until at least two years of age. However, current breastfeeding rates in many countries do not reflect this recommendation.
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            Women's perceptions and experiences of breastfeeding support: a metasynthesis.

            Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women's perceptions and experiences of breastfeeding support, either professional or peer, to illuminate the components of support that they deemed "supportive." The metasynthesis included studies of both formal or "created" peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large-scale surveys if they reported the analysis of qualitative data gathered through open-ended responses. Primiparas and multiparas who initiated breastfeeding were included. Studies published in English, in peer-reviewed journals, and undertaken between January 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included. Meta-ethnographic methods were used to identify categories and themes. The metasynthesis resulted in four categories comprising 20 themes. The synthesis indicated that support for breastfeeding occurred along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. A facilitative approach versus a reductionist approach was identified as contrasting styles of support that women experienced as helpful or unhelpful. The findings emphasize the importance of person-centered communication skills and of relationships in supporting a woman to breastfeed. Organizational systems and services that facilitate continuity of caregiver, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence, involving supportive care and a trusting relationship with professionals. © 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.
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              Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: SupervisionRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                6 August 2020
                2020
                : 15
                : 8
                : e0237190
                Affiliations
                [1 ] Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
                [2 ] School of Nursing & Midwifery, College of Science and Engineering, La Trobe University, Bundoora, Victoria, Australia
                [3 ] La Trobe Rural Health School, Bendigo, Victoria, Australia
                [4 ] The Royal Women’s Hospital, Parkville, Victoria, Australia
                National University of Singapore, Singapore, SINGAPORE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                [¤]

                Current address: La Trobe Rural Health School, Bendigo, Victoria, Australia

                Author information
                http://orcid.org/0000-0002-8753-590X
                Article
                PONE-D-20-06021
                10.1371/journal.pone.0237190
                7410279
                32760148
                de8d1de6-faa8-4c12-86be-80be99bc6e15
                © 2020 Grimes et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 1 March 2020
                : 21 July 2020
                Page count
                Figures: 0, Tables: 2, Pages: 15
                Funding
                The RUBY trial was jointly funded by the Alfred Felton Bequest and a PhD scholarship from La Trobe University (HG). Neither funding source was involved in the conduct or dissemination of this research.
                Categories
                Research Article
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Breast Feeding
                Medicine and Health Sciences
                Pediatrics
                Neonatology
                Breast Feeding
                People and Places
                Population Groupings
                Families
                Mothers
                Medicine and Health Sciences
                Clinical Medicine
                Clinical Trials
                Randomized Controlled Trials
                Medicine and Health Sciences
                Pharmacology
                Drug Research and Development
                Clinical Trials
                Randomized Controlled Trials
                Research and Analysis Methods
                Clinical Trials
                Randomized Controlled Trials
                Social Sciences
                Sociology
                Culture
                People and Places
                Population Groupings
                Age Groups
                Children
                Infants
                People and Places
                Population Groupings
                Families
                Children
                Infants
                Research and Analysis Methods
                Research Design
                Qualitative Studies
                Social Sciences
                Sociology
                Human Families
                Biology and Life Sciences
                Psychology
                Behavior
                Verbal Behavior
                Verbal Communication
                Social Sciences
                Psychology
                Behavior
                Verbal Behavior
                Verbal Communication
                Custom metadata
                All relevant data are within the manuscript and its Supporting Information files.

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                Uncategorized

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