Peer-Support Breastfeeding Program for Mothers in Severe Socioeconomic Deprivation: Feasibility Study

Feasibility Study of a Peer-Support Breastfeeding Resource and Support Program for Mothers Experiencing Severe Socioeconomic Deprivation

Breastfeeding provides well-established and "irreplaceable" health benefits for both mothers and infants. However, breastfeeding rates in France remain among the lowest in Europe and are strongly associated with socioeconomic status. Mothers experiencing severe socioeconomic deprivation, including those facing housing instability or migration-related challenges, may encounter additional barriers to breastfeeding, such as social isolation, limited access to health information, and linguistic or cultural obstacles.

Peer and community support have been shown to positively influence breastfeeding initiation and continuation. The Relais Allaitement Program (PRALL) is a peer-support program designed to promote breastfeeding and support early parenting through trained volunteer mothers. The PARTAGE project aims to adapt and pilot the PRALL program for mothers experiencing severe socioeconomic deprivation receiving care at the maternity unit of the Hôpital Femme Mère Enfant (HFME), in Bron, France.

This prospective, interventional, non-comparative feasibility study will evaluate the acceptability and feasibility of a peer-support breastfeeding program delivered by trained experienced mothers (peer supporters).

The intervention includes:

• the adaptation of PRALL educational materials and training to the needs of vulnerable populations using participatory approaches and accessible communication principles,
• the recruitment and training of two nursery nurses from the maternity unit to become network coordinators of the peer-support network,
• the recruitment of experienced mothers who will be trained by the 2 network coordinators, to become breastfeeding peer supporters,
• and the implementation of breastfeeding support by peer supporters for eligible mothers.

Eligible mothers experiencing severe socioeconomic deprivation will be offered support from a trained peer supporter during the postpartum period.

The primary outcome is the number of completed support interventions, defined as to have at least two in-person mother/peer supporter contacts and to last at least one month, unless breastfeeding cessation or infant death occurs earlier. Qualitative interviews with participating mothers and peer supporters will also be conducted to explore barriers and facilitators to breastfeeding support in this population.

The results will inform the adaptation of the PRALL program for vulnerable populations and assess the feasibility of implementing a peer-support breastfeeding intervention in this context. Findings may guide the development of a larger multicenter study to evaluate the impact of peer-support programs on breastfeeding outcomes among socially disadvantaged populations in France and potentially across Europe.

Inclusion Criteria:

• Mother with at least one infant hospitalized in the maternity or neonatal unit at the Hôpital Femme Mère Enfant (HFME)
• Who Intents to breastfeed
• Who is in a severe socioeconomic deprivation
• Having sufficient proficiency in French or in one of the languages spoken by the available peer supporters to allow communication
• Aged 18 years or older
• Given verbal consent to participate in the study

Exclusion Criteria:

• - Having a medical contraindication to breastfeeding
• Having an infant with a known congenital condition with life-threatening prognosis
• Having a severe psychiatric condition considered incompatible with participation in the peer-support intervention
• Being under legal guardianship