Views and experiences of women, peer supporters and healthcare professionals on breastfeeding peer support: A systematic review of qualitative studies

Abstract

Objective: To examine and synthesise qualitative evidence of women's, peer supporters' and healthcare professionals' views and experiences of breastfeeding peer support. Design: The Joanna Briggs Institute (JBI) approach to systematic reviews of qualitative studies was followed. Seven databases: CINAHL, MEDLINE, EMBASE, PsycINFO, Scopus, Maternal & Infant Care, and Web of Science were searched. Included papers were critically appraised using the JBI Critical Appraisal Checklist for Qualitative Research. JBI's meta-aggregation approach was used to synthesise findings. JBI's ConQual process was followed to assess confidence of evidence. Participants and setting: Primiparous and multiparous women, lay breastfeeding peer supporters, and healthcare professionals based in high, middle, and low income countries. Findings: Twenty-three papers presenting findings from 22 studies were included. The synthesised findings included: (1) Positive characteristics, approaches and benefits of peer support(ers); (2) Relationships between healthcare professionals and peer supporters; (3) Improving women's access to peer support services; (4) Barriers and enablers to provide peer support. Key conclusions and implications for practice: Breastfeeding peer support increased women's self-esteem and confidence in breastfeeding while reducing social isolation. Peer supporters valued the experience, which gave them a sense of purpose and confidence, and felt good about helping the women they supported. Women appreciated peer supporters who were caring, spent time with them, shared experiences, provided realistic information, practical and emotional support. Although there were tensions between some healthcare professionals and peer supporters, many valued the mutual support offered. Embedding peer supporters in healthcare systems for them to work alongside healthcare professionals, combined with good communications and building trusty relationships could be a useful strategy to reduce tensions between them.