| Summary: | <p><strong>Background</p></strong>
Breastfeeding support interventions are associated with longer breastfeeding duration.
Contemporary nationally representative data on breastfeeding support as reported by women
in England is lacking. Using English national maternity survey data, we describe sources and
modes of breastfeeding support as reported by women who gave birth in 2020; sources of
support are compared with earlier maternity surveys (2014, 2016, 2018). We also explore the
characteristics associated with source/mode of support in 2020 (n=4,611).
<p><strong>Methods</p></strong>
Women who breastfed were asked about sources of breastfeeding support (midwife; other
health professional; other formal breastfeeding support such as breastfeeding specialist,
breastfeeding support group, peer supporter; and partner/friend/relative), how this help was
given and whether they would have liked more help from a health professional with
breastfeeding. Adjusted risk ratios (aRR) for the association between sociodemographic and
pregnancy-related variables and each source/mode of support were estimated using modified
Poisson regression.
<p><strong>Results</p></strong>
From 2014 to 2020 support from midwives and other health professionals declined (from
84.0% to 64.7%, and 61.6% to 15.5% respectively) whereas other formal breastfeeding
support and informal support from partners/friends/relatives remained constant at 27-31% and
34-38% respectively. The proportion of women who wanted more help with breastfeeding
increased from 30% in 2014-2018 to 46% in 2020. In 2020, women most likely to want more
help with breastfeeding were nulliparous (aRR=1.64, 95%CI:1.50-1.79), younger (aRR=1.21,
95%CI:1.03-1.42) and of Pakistani ethnicity (aRR=1.30, 95%CI:1.06-1.60). Receiving
breastfeeding support over the phone (35%) was more common than via video call (13%) or
text message (5%); these percentages varied according to socio-demographic and
pregnancy-related factors.
<p><strong>Conclusions</p></strong>
Breastfeeding support has declined in recent years, and did not meet the needs of many
women during the pandemic. Planning for a future emergency should include adequate
provision of breastfeeding support particularly if staff are redeployed into other roles. The
characteristics associated with support can inform service planning and delivery. Future
research should use these factors to develop novel ideas for intervention, such as directly
targeting partners or other informal networks with educational or psychosocial interventions
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