Evaluation of a breastfeeding peer support service in Newcastle, and recommendations for service re-design
Evidence Hub
Quick-read summary
Breastfeeding has both short-term and long-term health benefits for women and infants. The World Health Organisation (WHO) recommends that infants are exclusively breastfed for the first 6-months after birth.
However, exclusive breastfeeding rates remain low, with many women in the UK stopping breastfeeding within a few weeks of their infant’s birth.
Researchers carried out an evaluation of the Breastfeeding Peer Support (BPS) service in Newcastle which have led to recommendations for service redesign.
Study overview
- The study involved interviews with women using the service, and practitioners, volunteers and healthcare professionals delivering the service.
- Overall, the BPS was considered an important and supportive service by all. Collaborative working with healthcare professionals outside of the organisations was seen as mutually beneficial but also brought significant challenges in terms of awareness and referrals.
- Building a community and the normalisation of breastfeeding was seen as a crucial element of the service, but also presented potential barriers for new mothers. Despite a focus on reaching families living in the most deprived areas of the city, challenges delivering the service to different populations were frequently described.
- Mothers described issues of accessibility of the groups, and occasionally feeling they did not belong or were not being heard. However, there were many positive reported outcomes for mothers who did engage with the service, including confidence building, feeling empowered to make decisions around infant feeding, validation of their experiences, and encouragement to continue breastfeeding.
- Mothers often reflected that without the support of the practitioners, volunteers and other servicer users, they would not have felt able to continue breastfeeding.
- These findings from this study are important because they provide valuable insights into a regional breastfeeding support service, from the perspective of service users, practitioners and volunteers and healthcare professionals.
- The study allowed researchers to explore the barriers and challenges to accessing and engaging with the service, and delivering the service.
- It has led to the development of actionable recommendations for service improvement and redesign.
Who is this evidence useful for?
This research provides a series of recommendations to improve service design and delivery for breastfeeding women, including on how to engage populations who often do not engage with services.
These recommendations would be useful for any commissioners and policy partners who are designing breastfeeding peer support services, along with healthcare professionals who are delivering breastfeeding services in the community.
Findings: Four key themes
Mechanisms of service
The normalisation of breastfeeding was identified as a core mechanism underpinning the service, facilitated within group settings, allowing for an environment that validates both the challenges and success of breastfeeding. The mechanism of service was also underpinned by the cycle of support. Practitioners and volunteers had experience of breastfeeding themselves and often had previously accessed the support offered as service users, before becoming volunteers themselves through training delivered by the service. However, this provided a limitation to the service, as the service users, volunteers and practitioners lacked diversity of age and ethnicity, as they were being recruited from the service.
Support offered by the service
Service users felt that the community social groups were a great place to receive emotional and social support from a variety of people, including practitioners, volunteers and other mothers. The groups were reported as being welcoming and friendly, providing a supportive space for women. The support provided also extended beyond the group settings, with messaging groups being created, so mums could continue to support each other outside of the group. Knowledgeable practitioners were reported as a strength of the service, with women reported trusting the information shared with them, while some did note that they received conflicting advice between their healthcare professional and practitioners within the service.
Impact of the breastfeeding peer support service
Service users reported that the groups allowed for breastfeeding to be normalised, while also identifying additional outcomes and practical benefits with the service, including building confidence. Service users reported developing friendships, receiving advice on returning to work, receiving validation of their breastfeeding experiences, education specific to their child, empowerment to make the best decision for them and their family and encouragement to continue breastfeeding. Practitioners and volunteers reported that working within the BPS provided them with a sense of accomplishment by allowing them to support other service users and allowing them the opportunity to ‘give back’ to the community that had previously provided support to them.
Challenges to service delivery
A significant challenge facing the service was ensuring that the service was being delivered to different population groups, including those in more deprived areas, those for whom English is not a first language, and those who are under 25 years. The groups were placed in areas of lower breastfeeding rates and more deprived areas. However, practitioners reported the service users who were attending would travel to the services from more affluent areas. The absence of interpretation services also created challenges for women, as reported by practitioners, while healthcare professionals reflected that the service had a lack of representation of Black and minoritised ethnicities amongst the practitioners and volunteers.
The findings and recommendations are illustrated in the infographic below.
Recommendations for service re-design
- Host some groups in the evenings and weekends in areas that are well serviced by public transport
- Provide initial one-to-one appointments with a practitioner in the service user’s home
- Increase representation from minoritised groups in practitioners and volunteers to enable culture to be understood and shared
- Use interpreters and translators in services
- Tailor specific groups to service users under 25 years of age
Find out more
Read the full research paper (PLOS One, July 2026)
If you would like more information about the study, please email kerry.brennan-tovey@newcastle.ac.uk
This study was funded by Newcastle City Council and delivered by researchers funded by the NIHR Applied Research Collaboration (ARC) North East and North Cumbria.