shows baseline comparison data for the control and peer support groups. Recruitment of women ended when 225 of the planned 320 women had been recruited for reasons discussed below. With the exception of the five women lost to follow-up, questionnaires were completed by all women at 10 days, 8 weeks and 16 weeks.
Baseline comparison of control and peer support groups by stratum.
Of the 113 and 112 women recruited to the control and peer support groups, respectively, 60 (53%) and 61 (54%) started to breastfeed. The most common reason women gave for not breastfeeding was that they simply did not want to. Other reasons given were (control group/peer support group): difficult or premature labour or baby in special care (6 [5.3%]/7 [6.25%]); family circumstances or no family support (4 [3.5%]/6 [5.4%]); baby given bottle on hospital ward (0/1); told by midwife during labour not to breastfeed if undecided (0/1).
Of the 61 peer support group women who started to breastfeed, 13 stopped breastfeeding before receiving any peer support but were kept in the following analysis on an intention-to-treat basis.
gives the number and percentage of women in each group breastfeeding at birth, 10 days, 6 weeks, 8 weeks and 16 weeks plus the difference between groups at each of these times with CIs. It can be seen that although more women in the peer support group are still breastfeeding at all intervals the difference between groups at any point in time is not statistically significant. The trial would not have had the statistical power for the small differences seen between the groups even if the planned 320 women had participated.
Numbers of women recruited to each group; numbers of women who start breastfeeding and who are still breastfeeding at each time interval until 16 weeks. Data shown for all four strata combined.
shows the Kaplan–Meier survival plot for all women recruited to the two groups, pooled over all strata, on an intention-to-treat basis including those who did not initiate breastfeeding. Again, although the peer support group appears higher than the control group the difference is not statistically significant by log-rank test (P = 0.5). The median breastfeeding duration among women in the peer support group was 2 days compared to 1 day for the control group.
Kaplan–Meier plots of breastfeeding survival for the control and peer support groups with all strata combined. Plotted lines show the fraction of each group still giving any breastmilk up to 112 days after birth.
show the same comparison but only including women who intended to breastfeed (P = 0.4), those who started to breastfeed (P = 0.4).) and those who left hospital breastfeeding and were still breastfeeding at 10 days respectively (P = 0.26). Median breastfeeding durations in were 72 days (95% CI = 28 to 116) in the peer support group and 56 days (95% CI = 28 to 84) in the control group. In the medians were 72 days (95% CI = 6 to 138) in the peer support group and 56 days (95% CI = 22 to 90) in the control group. In more than half the peer support women were still breastfeeding at 112 days whereas in the control group the median was 102 days.
No significant differences were found between the groups in each of the four strata analysed separately by Kaplan–Meier plot and log-rank test. The median breastfeeding duration among primagravidae in the peer support group (7 days; 95% CI = 0 to 23) was greater than that for the control group (3 days; 95% CI = 0 to 13), while median breastfeeding durations in all other strata were 0 or 1 day except for those previously breastfeeding more than 6 weeks where more than half of both groups were still breastfeeding by 16 weeks. In the case of women previously breastfeeding for less than 6 weeks the median breastfeeding duration in the control group was 1 day compared to 0 days in the peer support group.
No statistically significant difference was found by Kaplan–Meier plot and log-rank test between the groups in the time to introduction of formula or solids in any of the strata separately or combined.
The median time to introduction of formula among primagravidae in the peer support group was 7 days (95% CI = 0 to 23) compared to 2 days (95% CI = 0 to 4). Among women who had previously breastfed for more than 6 weeks the median time to introduction of formula in the control group was 70 days (95% CI = 29 to 111) while in peer support group less than half the women had introduced formula by 112 days. In the case of women previously breastfeeding less than 6 weeks the Kaplan–Meier plot shows the peer support group introducing formula more quickly than the control group but the difference is not significant (P = 0.26) and the median time to formula introduction in both groups was 1 day. With all strata combined, median times for introduction of formula and solids were almost identical.
Women's questionnaire responses suggested satisfaction with peer support among women whose intention was to breastfeed, particularly among primagravidae. Some women also found the limited antenatal contact helpful in supporting their intention to breastfeed. A small number of previous formula feeders who wanted to try breastfeeding found that peer support helped them succeed. On the other hand, some women did not want peer support and of course half of the women in the population simply did not want to breastfeed. Formal analysis of questionnaire responses will be reported separately.