Breastfeeding Support : Close to Mothers
Between 1-7 August this year the World Alliance for Breastfeeding Action (WABA) and breastfeeding advocates in over 174 countries worldwide will be celebrating World Breastfeeding Week. This year the theme, Breastfeeding Support: Close to Mothers, aims to draw attention to the way peer counselling can offer support to breastfeeding women.
Many hospitals in GB have been accredited with, or are working towards, The Baby Friendly Initiative. This is a worldwide programme established in 1992 by the World Health Organization and UNICEF to encourage maternity hospitals to implement the Ten Steps to Successful Breastfeeding and to practice in accordance with the International Code of Marketing of Breastmilk Substitutes. Mothers should expect to receive good breastfeeding information and support after birth. Even so, many mothers who want to breastfeed still stop before they intended to, often in the first few days to six weeks after birth. In the past, new mothers would have been supported at home by other women in the family and community who had breastfed their own babies, but today many of us live far away from our family and may not know anyone who has happily breastfed. Many health workers cannot spend as much time as they would like with each mother and may not have been trained in ongoing breastfeeding support skills.
The World Health Organisation says that “The key to best breastfeeding practices is continued day-to-day support for the breastfeeding mother within her home and community” and this is an area where peer counselling can play a pivotal role. Peer counsellors (PCs) come from a woman’s local community. They have usually breastfed their own babies and understand and identify with the new mother, offering her support while she gains confidence in her ability to breastfeed. It has been shown that women who get that support are far more likely to continue to breastfeed.
La Leche League – the original mother-to-mother support group
La Leche League came into being 57 years ago because seven breastfeeding mothers recognised that there was a need for support. They realised that many other mothers who wanted to breastfeed could be enabled to do so if those around them, their peers, had the knowledge and skills to be supportive. Mother-to-mother support was born and La Leche League spread throughout the world.
Through LLL, women met up regularly in groups to share experiences and knowledge. LLL International also saw that there was sometimes a need for a different kind of support. In the 1980s they developed their Peer Counsellor Programme (PCP) offering training, education, and communication skills for women everywhere to offer support specifically suited for their own peers. In the 1990s LLLGB adapted the PCP for use here and over the years it led the way in offering training to health professionals, who went on to train women within the community. An independent evaluation showed that in 26 out of 28 areas where Peer Counsellor Programmes were introduced there was an increase in breastfeeding initiation rates, anything from 2 to 32 percentage points, and many areas demonstrated an increase in breastfeeding duration (Dr Sue Battersby, An Evaluation of La Leche League GB’s Breastfeeding Peer Counsellor Programme, 2007). La Leche League was the first breastfeeding organisation to offer peer counsellor training and, although our programme is no longer operational, it is a testament to its effectiveness that over the past few years many more similar peer support training schemes have been developed.
How to become a Peer Counsellor
A peer counsellor may be anyone who has had experience with a breastfeeding baby and who has a willingness and ability to actively work with women to support breastfeeding. It’s important for the PC to belong to the community she is volunteering or working in and educational background is not important. In some situations PCs are recommended by a local health professional or leader of the community.
To become a PC there is a training course to complete, usually a minimum of 20-30 hours. Trainers are often specially trained health workers and the courses are usually developed locally to take account of local culture. Peer counsellors may work from a health centre, their home, or in a hospital setting, and working as a counsellor has empowered some women to undertake paid work and other responsibilities both for themselves and the groups they are involved with. The goal of a PC is to help mothers get off to a good start and establish exclusive breastfeeding with accurate information that is specific to their needs. PCs also recognise when they are unable to address a problem and when to refer.
Five circles of support for Mothers and Children
For women to continue to breastfeed for as long as they wish they need to be in the centre of a circle of support; surrounded by those who will encourage and empower them. The five circles of support which are most helpful are: Family and Social Network (partners/family, friends and community support) ; Health Care Systems (which can offer a multitude of opportunities to support breastfeeding); Workplace and Employment (supporting continued breastfeeding for women who return to work);Government/Legislation (protection for optimal infant feeding, legislation to combat aggressive marketing of breastmilk substitutes, and paid maternity leave); and Response to Crisis or Emergency (having support in place if a woman finds herself in an unexpected and/or serious situation with little control).
Support when and where it is needed
There are a variety of ways for women to get support for breastfeeding - from hospitals adopting the Ten Steps to Successful Breastfeeding, to trained health professionals, lay breastfeeding organisations (such as La Leche League), Lactation Consultants, and peer counsellor supporters. As these circles of support grow we can look forward to a time when no woman will have to say “I wanted to breastfeed but…..” and instead can say “I wanted to breastfeed and I did”.
For information about local peer counsellor training schemes contact your local health authority or health worker.