Tools- of Changes

Video-Based Peer Support Can Boost Breastfeeding Rates and Maternal Confidence

In this randomized clinical trial video-call support from trained peer mothers helped first-time mothers breastfeed more successfully.

The World Health Organization recommends exclusive breastfeeding for the first six months of life, but breastfeeding rates remain suboptimal in many parts of the world. Peer support has long been recognized as a promising strategy to encourage breastfeeding, but there has been limited evidence on whether this support is equally effective when delivered online. This multicenter, randomized clinical trial enrolled first-time mothers with low breastfeeding confidence from four public postnatal wards in Hong Kong from January 31, 2021, to June 30, 2024. Participants were randomly assigned (1:1) to intervention or control. The primary analysis was conducted from July 1 to 31, 2024, with final data analysis completed by December 31, 2025. Among 442 participants, 224 were allocated to the intervention group and 218 were allocated to the control group. Among mothers who received this support, the study revealed a 42.6% relative increase in the number of mothers exclusively breastfeeding their babies at two months after birth, along with greater confidence in breastfeeding. Although the primary outcome of the exclusive breastfeeding rate at six months (20% vs. 16%) was not statistically significant, longitudinal analysis confirmed consistently higher odds of exclusive breastfeeding over time in the intervention group, with the largest difference observed at two months.