近日，英国伯明翰大学Kate Jolly团队报道了同伴支持干预（ABA饲料）改善母乳喂养的效果，一项基于英国的多中心、平行组、随机对照试验。相关论文于2026年3月31日发表在《英国医学杂志》上。

为了评估在常规护理基础上，增加一种基于资产、主动式同伴支持的婴儿喂养干预措施，与仅提供常规母乳喂养支持相比，对母乳喂养率、配方奶喂养实践及其他结局的影响，2022年1月至2024年4月30日期间，研究组在英国开展了一项多中心、平行分组、非盲法、随机对照试验，选择英国17个将母乳喂养同伴支持作为常规护理一部分的地区。最终选择2475名妊娠20至35周之间的初产妇，按1.43:1的比例随机分组（考虑同伴支持者可能产生的群组效应）：1458名被分配至ABA-feed（产前及产后基于资产的喂养帮助）同伴支持干预组，1017名分配至常规护理组。

ABA-feed干预包括以人为中心、主动式的婴儿喂养同伴支持，其理论基础为基于资产的方法（关注参与者的自身能力和可用资源）以及行为改变理论，通过面对面、远程短信和电话等方式实施。常规护理包括助产士和健康访视员提供的常规照护，也可能包括母乳喂养小组中的同伴支持、咨询、热线电话及社交媒体支持群等提供被动式支持的服务。主要结局为产后8周时的任何母乳喂养率。次要结局包括产后8周、16周和24周时的母乳喂养启动率、任何及纯母乳喂养率、配方奶喂养实践、焦虑水平、社会支持度及医疗资源利用情况。分析基于意向性治疗原则。

干预组（1013/1452，69.8%）与常规护理组（698/1015，68.8%）在产后8周时的任何母乳喂养率方面无显著差异；校正后风险差为0.01，95%置信区间为−0.03至0.04。预先设定的亚组分析显示，干预措施与年龄、预先指定的喂养意愿、母亲受教育程度、多重deprivation指数五分位或婚姻状况之间均无交互作用。母乳喂养启动率较高（干预组94.2%；常规护理组92.5%）。干预组在产后8周时报告了更高的社会支持度，但这一差异在16周时未持续。其他次要结局未见差异。

研究结果表明，在英国背景下，与常规母乳喂养支持相比，ABA-feed同伴支持干预并未提高母乳喂养率。

附：英文原文

Title: Peer support intervention (ABA-feed) to improve breastfeeding: UK based, multicentre, parallel group, randomised controlled trial

Author: Kate Jolly, Joanne Clarke, Nicola Crossland, Stephan U Dombrowski, Eleni Gkini, Pat Hoddinott, Jenny Ingram, Debbie Johnson, Christine MacArthur, Mia Mann, Jennifer McKell, Ngawai Moss, Tracy Roberts, Julia Sanders, Nicola Savory, Alice Sitch, Beck Taylor, Sarah Tearne, Gill Thomson, Eleanor Williams, Rebecca Woolley

Issue&Volume: 2026/03/31

Abstract:

Objective To assess the effect of a proactive, assets based, peer support infant feeding intervention in addition to usual care on breastfeeding rates, formula feeding practices, and other outcomes, compared with usual breastfeeding support alone.

Design UK based, multicentre, parallel group, unblinded, randomised controlled trial.

Setting 17 localities in the UK that offered breastfeeding peer support as part of usual care between January 2022 and 30 April 2024.

Participants 2475 nulliparous women between 20 and 35 weeks of gestation were randomised 1.43:1, to account for potential clustering by peer supporter: 1458 to the ABA-feed (Assets based feeding help Before and After birth-feed) peer support intervention and 1017 to usual care.

Interventions The ABA-feed intervention comprised person centred proactive peer support for infant feeding underpinned by an assets based approach (focusing on the capabilities of, and resources available to, participants) and behaviour change theory delivered in person and remotely by text and telephone call. Usual care included universal care from midwives and health visitors and could also include services that provided reactive support such as peer supporters in breastfeeding groups, counselling, helplines, and social media support groups.

Main outcome measures The primary outcome was any breastfeeding at eight weeks after birth. Secondary outcomes at eight, 16, and 24 weeks after birth included breastfeeding initiation, any and exclusive breastfeeding, formula feeding practices, anxiety, social support, and healthcare utilisation. Analyses were based on the intention-to-treat principle.

Results Rates of any breastfeeding at eight weeks did not differ between the intervention group (1013/1452; 69.8%) and usual care group (698/1015; 68.8%); adjusted risk difference 0.01, 95% confidence interval 0.03 to 0.04. Preplanned subgroup analyses showed no interactions between the intervention and age, prespecified feeding intentions, mother’s education, index of multiple deprivation fifth, or relationship status. Breastfeeding initiation rates were high (intervention 94.2%; usual care 92.5%). At eight weeks the intervention group reported higher social support, but this was not sustained at 16 weeks. No differences were observed in other secondary outcomes.

Conclusion The ABA-feed peer support intervention did not improve breastfeeding rates compared with usual breastfeeding support in a UK context.

DOI: 10.1136/bmj-2025-086558

Source: https://www.bmj.com/content/392/bmj-2025-086558