Experiences of the ABA-Feed Infant Feeding Intervention: A Qualitative Study With Women, Peer Supporters and Coordinators.

UK breastfeeding rates are low, with health inequalities in initiation and continuation. Breastfeeding peer support interventions are recommended in UK and global policy. The Assets-based feeding help Before and After birth (ABA-feed) trial tested the effectiveness of proactive, woman-centred support for infant feeding delivered by trained peer supporters (infant feeding helpers; IFHs) in addition to usual care at 17 UK sites. Using data from an embedded process evaluation, this paper reports the views and experiences of women receiving, and the IFHs and coordinators delivering, ABA-feed. Women (n = 2475) were recruited to the trial antenatally; 1458 were allocated to the intervention. Thirty women from five study sites took part in qualitative interviews between 9 and 23 weeks postnatal. IFHs (n = 72) and coordinators (n = 25) from across all sites participated in individual or group interviews towards the end of the intervention period. Interview transcripts were analysed alongside 1147 free-text responses from an 8-week postnatal follow-up survey using Framework Analysis. The ABA-feed intervention was highly acceptable to women, including younger women, those with less education, from diverse ethnic groups, single mothers, and those who intended to formula feed, as well as to IFHs and coordinators. Both remote and in-person support was acceptable. While women valued proactive daily contact during the first 14 days postpartum, some IFHs found this challenging, and some struggled with supporting women who chose formula feeding or were less engaged. This study highlights the value of flexible, proactive, woman-centred infant feeding support. TRIAL REGISTRATION: ISRCTN17395671.