ABA-feed peer support did not improve breastfeeding rates versus usual care in UK nulliparous women.
A randomised controlled trial was conducted across 17 localities in the UK offering breastfeeding peer support as part of usual care between January 2022 and April 2024. The study population consisted of 2475 nulliparous women recruited between 20 and 35 weeks of gestation. Participants were randomised to receive either the ABA-feed (Assets based feeding help Before and After birth-feed) peer support intervention or usual breastfeeding support alone. The primary outcome was any breastfeeding at eight weeks after birth, with secondary outcomes including breastfeeding initiation, exclusive breastfeeding, formula feeding practices, anxiety, social support, and healthcare utilisation.
The primary analysis revealed no difference in any breastfeeding at eight weeks between the groups. The adjusted risk difference was 0.01, with a 95% confidence interval ranging from -0.03 to 0.04. Specifically, 1013 of 1452 women (69.8%) in the intervention group breastfed at eight weeks, compared to 698 of 1015 women (68.8%) in the usual care group. High rates of breastfeeding initiation were observed in both groups, at 94.2% for the intervention and 92.5% for usual care, though statistical significance was not reported for this comparison.
Regarding secondary outcomes, the intervention group reported higher social support at eight weeks, but this difference was not sustained at 16 weeks. No differences were observed for other secondary outcomes such as exclusive breastfeeding, formula feeding practices, anxiety, or healthcare utilisation. Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported in the study. The trial was unblinded, which represents a key limitation. Funding sources and potential conflicts of interest were not reported.
In the context of UK practice where breastfeeding peer support is part of usual care, this proactive, assets-based intervention did not improve breastfeeding rates compared with standard support. Clinicians should interpret these results as indicating that this specific intervention model may not offer additional benefit over existing usual care for this population.
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