Table 2 Characteristics of the included articles

McLardie-Hore et al. (2022)^[18]

Australia

10 mothers

Qualitative methods/Semi-structured in‑depth interview

Women’s experience of receiving proactive telephone-based peer support in a trial which was able to successfully increase breastfeeding maintenance at six-months

Home/20–65 min

Proactive telephone-based breastfeeding support from a trained peer volunteer for up to six months postpartum

Nonjudgmental support and guidance: nonjudgmental, compassionate and understanding positive experiences; practical advice; a social connection– more than just breastfeeding, not all support from family and friends is supportive

Clapton-Caputo et al. (2021)^[19]

Australia

10 mothers

Qualitative descriptive approach/Semi-structured in‑depth interview

Mothers’ experiences and expectations of breastfeeding support in social media groups

Video chat or telephone/unstated duration

Social media support group

(1) Expecting and experiencing emotional support; (2) Receiving information to manage exclusive expressing

Lok et al. (2021)^[8]

China/ Hongkong

5 mothers

Qualitative methods/In-depth interview

Mothers’ experiences of breastfeeding peer support

Telephone/Unstated duration

Five postnatal home-based visits with a trained volunteer peer supporter over a six month period

(1)Peer supporters provide positive knowledge and emotional support; (2)Peer support helps to increase confidence in breastfeeding; (3)Desire for peer support early and more contact via digital technologies

Black et al. (2020)^[20]

UK/Northern Ireland

8 mothers

Exploratory qualitative approach/Semi-structured interview

Mothers’ experiences of breastfeeding support in a Facebook social media group

Public coffee shops/20–40 min

Social media breastfeeding support provided by volunteer peer supporters and moderated by administrators to ensure evidence-based information is being provided

(1)Increased breastfeeding self-efficacy; (2) Contributing factors: ‘education’, ‘accessibility’, ‘normalizing’, ‘extended goals’, and ‘online community’

Clarke et al. (2020)^[12]

UK/England

30 mothers

Qualitative methods/ Interview

Mothers’ experience, acceptability, and satisfaction with breastfeeding peer support and perceived barriers or facilitators to effective delivery

Home/

45–90 min

Proactive, woman-centred support using an assets-based approach provided by a paid peer support service or volunteers

(1) Care about the timing to receive the support; (2) Active support is valuable, prefer short message support; (3) Peer support provides social support and restructure the social environment

Ingram et al. (2020)^[21]

UK/England

21 mothers

Qualitative methods /Semi-structured interview

Mothers’ views of the different components of breastfeeding peer support

Home/45–90 min

Proactive, woman-centred support using an assets-based approach provided by a paid peer support service or trained volunteers

(1) Early opportunities for infant feeding conversations/continuity of helper; (2) Mapping the friends and family tree; (3) Keeping in touch using proactive texting; (4) Knowing about local groups and assets; (5) Woman-centred approach

Kabakian-Khasholian et al. (2019)^[11]

Lebanon

22 mothers

Cross-sectional, prospective, two group qualitative

design/In-depth interview

Mothers’ experiences of breastfeeding peer support and the influence of the intervention on their social support system

Home/unstated duration

Postpartum peer telephone support provided by trained volunteering mothers

(1)Mothers valued the support from their peers and the IBCLCs. They appreciated the support provided by the IBCLCs much more than the peer support. (2) The main contribution of peer supporters as perceived by the mothers was the provision of moral support, which was perceived to be important in encouraging breastfeeding continuation; (3)Breastfeeding women did not enhance their social groups by including the peer supporters; (4)Breastfeeding mothers reached out to other mothers in their social circle.

Quinn et al. (2019)^[13]

Ireland

15 mothers

Exploratory qualitative methods/Semi-structured interview

Mothers’ experiences of breastfeeding support groups

Online video/unstated duration

Volunteer breastfeeding support groups which are held in the community, are ongoing, with contact initiated by the mother, and run by trained breastfeeding counsellors

(1) Complexity of breastfeeding support; (2) Community and connection; (3) Impact of culture on breastfeeding needs; (4) The journey; (5) Passing on; (6) What mothers want.

Regan et al. (2019)^[22]

UK/South Wales

14 mothers

Descriptive

qualitative approach/Semi-structured interview

Mothers’ experiences of breastfeeding support in social media groups

Unstated setting/

30–60 min

Online breastfeeding support: Facebook groups and forums where individuals engaged with each other

(1) Mothers were drawn to online support due to a lack of professional, familial, and partner support. (2) Benefits of online support: reassurance and normalizing, someone who has been through it, circle of peer support. (3) Limitations of online support: judgement, polarised debate; lack of regulation.

Robinson et al. (2019)^[17]

America

22 African-American mothers

Prospective, cross-sectional qualitative study/Focus group

Experiences of African American mothers who participate in breastfeeding support groups on Facebook; mothers’ breastfeeding beliefs, decisions, and outcomes

Online video conferencing/

60–90 min

Facebook group providing mom-to-mom breastfeeding support

(1) Creating a community for Black mothers; (2) Online interactions and levels of engagement; (3) Advantages of participating in online support groups, (4) Critiques of online support groups; (5) Empowerment of self and others, (6) Shifts in breastfeeding perceptions and decisions.

Robinson et al. (2016)^[23]

America

9 African mothers

Qualitative methods/Focus group

Mothers’ breastfeeding experiences and the effect of breastfeeding peer counselors

Unstated

Peer support through clinic visits, telephone calls during the pregnancy and postpartum time periods, and in-hospital and in-home visits

(1) Educating with truth; (2) Validating for confidence; (3) Countering others’

negativity; (4)Supporting with solutions.

Ingram et al. (2013)^[24]

UK/Bristol

163 mothers for survey and 14 mothers for interview

Concurrent triangulation mixed methods approach/On-line questionnaire survey and semi-structured interview

Mothers’ views of the targeted peer support service

Telephone and face-to-face interview/Understated

Targeted service of trained peer supporters providing antenatal and postnatal breastfeeding support

(1)Antenatal opportunity for knowledge; (2)Postnatal reassurance; (3)Encouragement and self-confidence; (4)Challenges of peer support–partners, building trust, role conflict.

Thomson et al. (2012)^[25]

UK/north-west England

47 mothers

Qualitative exploratory approach/Focus group/Semi-structured in-depth interview

Mothers’ experiences, facilitators, barriers and challenges faced in the introduction of a breastfeeding peer support service

Face-to-face interviews were held at women’s homes/telephone interview/25–80 min

The Star Buddies service comprises trained paid and voluntary local breastfeeding mothers who provide antenatal/hospital and community breastfeeding peer support

(1) Providing realistic assessments across varying situational contexts; (2) Forming strategies and plans to help women overcome any obstacles; (3) Making women aware of any negative outcomes; (4) Mobilising external and personal resources to facilitate goal attainment; (5) Providing evaluations and feedback on women’s (and infants’) progress; (6) Helping women to focus their energy to achieve their breastfeeding goals.

Nankunda et al. (2010)^[26]

Uganda

370 mothers

Mixed methods/Semi-structured interview

Women’s experiences of peer counselling for exclusive breastfeeding in an East African setting

Mothers’ homes/unstated duration

Individual peer counselling was offered to women, scheduled as five visits: before childbirth and during weeks 1, 4, 7 and 10 after childbirth. The trained peer counsellors were regularly supervised.

(1) Satisfaction with explanations by peer counsellors; (2) Spending enough time; (3) Usefulness of visits by peer counsellor, (4) Free interaction between peer counsellors and the women; (5) Future peer counselling is welcome.

Hoddinott et al. (2006)^[27]

Scotland

206 women for survey/21 women for interview/8 groups for observation

Multi-method action research approach/Semi-structured interview/Observation/Focus group/Questionnaire survey

Women’s perceptions of one-to-one and group-based breastfeeding peer coaching and why groups were more popular

Interview held at women’s homes/Unstated duration

Group-based and one-to-one untrained peer coaching

Reasons for breastfeeding groups more popular than one-to-one coaching: socialising, normalising, and improving well-being by attending groups; visual experiences and breastfeeding during a group; diversity of communication in groups. Women often felt initial anxiety when attending a group for the first time, and they expressed doubt that one set of ‘‘breastfeeding rules’’ would suit everyone. One-to-one peer coaching was perceived as a greater risk to confidence and empowerment than group-based peer coaching.