{
  "abstract": "Abstract Objective To assess the effect of a proactive, assets based, peer support infant feeding intervention in addition to usual care on breastfeeding rates, formula feeding practices, and other outcomes, compared with usual breastfeeding support alone.Design UK based, multicentre, parallel group, unblinded, randomised controlled trial.Setting 17 localities in the UK that offered breastfeeding peer support as part of usual care between January 2022 and 30 April 2024.Participants 2475 nulliparous women between 20 and 35 weeks of gestation were randomised 1.43:1, to account for potential clustering by peer supporter: 1458 to the ABA-feed (Assets based feeding help Before and After birth-feed) peer support intervention and 1017 to usual care.Interventions The ABA-feed intervention comprised person centred proactive peer support for infant feeding underpinned by an assets based approach (focusing on the capabilities of, and resources available to, participants) and behaviour change theory delivered in person and remotely by text and telephone call. Usual care included universal care from midwives and health visitors and could also include services that provided reactive support such as peer supporters in breastfeeding groups, counselling, helplines, and social media support groups.Main outcome measures The primary outcome was any breastfeeding at eight weeks after birth. Secondary outcomes at eight, 16, and 24 weeks after birth included breastfeeding initiation, any and exclusive breastfeeding, formula feeding practices, anxiety, social support, and healthcare utilisation. Analyses were based on the intention-to-treat principle.Results Rates of any breastfeeding at eight weeks did not differ between the intervention group (1013/1452; 69.8%) and usual care group (698/1015; 68.8%); adjusted risk difference 0.01, 95% confidence interval −0.03 to 0.04. Preplanned subgroup analyses showed no interactions between the intervention and age, prespecified feeding intentions, mother’s education, index of multiple deprivation fifth, or relationship status. Breastfeeding initiation rates were high (intervention 94.2%; usual care 92.5%). At eight weeks the intervention group reported higher social support, but this was not sustained at 16 weeks. No differences were observed in other secondary outcomes.Conclusion The ABA-feed peer support intervention did not improve breastfeeding rates compared with usual breastfeeding support in a UK context.Trial registration ISRCTN Registry ISRCTN17395671.",
  "authors": [
    {
      "affiliations": [
        "Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, UK"
      ],
      "name": "Kate Jolly"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, UK"
      ],
      "name": "Joanne Clarke"
    },
    {
      "affiliations": [
        "Maternal, Parental, and Infant Nutrition and Nurture Unit, University of Lancashire, Preston, UK"
      ],
      "name": "Nicola Crossland"
    },
    {
      "affiliations": [
        "Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada"
      ],
      "name": "Stephan U Dombrowski"
    },
    {
      "affiliations": [
        "Birmingham Clinical Trials Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"
      ],
      "name": "Eleni Gkini"
    },
    {
      "affiliations": [
        "Centre for Healthcare and Community Research, University of Stirling, Stirling, UK"
      ],
      "name": "Pat Hoddinott"
    },
    {
      "affiliations": [
        "Centre for Academic Child Health, University of Bristol, Bristol, UK"
      ],
      "name": "Jenny Ingram"
    },
    {
      "affiliations": [
        "Centre for Academic Child Health, University of Bristol, Bristol, UK"
      ],
      "name": "Debbie Johnson"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, UK"
      ],
      "name": "Christine MacArthur"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, UK",
        "NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK"
      ],
      "name": "Mia Mann"
    },
    {
      "affiliations": [
        "Institute for Social Marketing and Health, University of Stirling, Stirling, UK"
      ],
      "name": "Jennifer McKell"
    },
    {
      "affiliations": [
        "Patient author, Southend-on-Sea, UK"
      ],
      "name": "Ngawai Moss"
    },
    {
      "affiliations": [
        "Health Economics Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"
      ],
      "name": "Tracy Roberts"
    },
    {
      "affiliations": [
        "School of Healthcare Sciences, Cardiff University, Cardiff, UK"
      ],
      "name": "Julia Sanders"
    },
    {
      "affiliations": [
        "School of Healthcare Sciences, Cardiff University, Cardiff, UK"
      ],
      "name": "Nicola Savory"
    },
    {
      "affiliations": [
        "Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham B15 2TT, UK",
        "NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK"
      ],
      "name": "Alice Sitch"
    },
    {
      "affiliations": [
        "Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK"
      ],
      "name": "Beck Taylor"
    },
    {
      "affiliations": [
        "Birmingham Clinical Trials Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"
      ],
      "name": "Sarah Tearne"
    },
    {
      "affiliations": [
        "Maternal, Parental, and Infant Nutrition and Nurture Unit, University of Lancashire, Preston, UK"
      ],
      "name": "Gill Thomson"
    },
    {
      "affiliations": [
        "Health Economics Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"
      ],
      "name": "Eleanor Williams"
    },
    {
      "affiliations": [
        "Birmingham Clinical Trials Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"
      ],
      "name": "Rebecca Woolley"
    },
    {
      "affiliations": [],
      "name": "on behalf of the ABA-feed study group"
    }
  ],
  "title": "Peer support intervention (ABA-feed) to improve breastfeeding: UK based, multicentre, parallel group, randomised controlled trial",
  "uid": "6b1137b4-ab85-502f-a8a5-2b3a84320255"
}