Volunteer counsellors for supporting breast feeding

Editor—We need not be too pessimistic about the potential of volunteer counsellors in supporting breastfeeding mothers. Graffy et al examined only a fairly limited intervention, which relied heavily on the new mother to suspect a breastfeeding problem and initiate contact with a counsellor.¹

A woman is more likely to initiate and maintain breast feeding if she has a relative or friend who has breast fed successfully,² and it is at least plausible that support provided by a trained volunteer peer counsellor might have a similar effect. However, many women, particularly those who are less motivated and less socially skilled, find it difficult to initiate contact with a comparative stranger and wait for help to be offered.³

Furthermore, many central questions about peer support have yet to be addressed in methodologically adequate studies.⁴ There is little objective information on the qualities of a successful volunteer supporter, the experience and training she should have, how peer support could be most effectively offered, and the comparative importance of befriending and imparting information during the peer support process.

Commentators are quick to blame society for breastfeeding failure. Volunteer peer supporters might be the interface between society and the new mother where change could be most readily instigated. We urgently need effective methods of supporting the maintenance of breast feeding; volunteer peer support is worth further investigation.