Table 3 Content of MI-base breastfeeding peer-support during the antenatal and postnatal periods and corresponding BCTTv1 techniques
Mode of delivery | Scope of session content | Intervention functions | Behaviour change techniques (BCTT v1) |
|---|---|---|---|
Antenatal period | Engagement and building a rapport with mother and significant others (if present) | Restructuring social environment | Social support (unspecified) |
 Face-to-face visit (or telephone if this is a mother’s preferred option) | |||
Information about accessing the intervention: what it’s about, how it works, letting us know when their baby has arrived | Education, training | Instruction on how to perform a behaviour | |
Discuss an agenda with mothers: what can they expect and what they would like to get from the program | Enablement | Action planning | |
Affirmation of the mothers’ strengths and capability, emphasising her autonomy | Enablement, restructuring social environment | Social support (emotional), social reward | |
Explore mothers’ current knowledge and information needs and provide information as appropriate. Use open questions, reflective listening, and elicit-provide-elicit approaches to exchanging information with mothers | Education, training | Instruction on how to perform a behaviour, information about health, and social, environmental and emotional consequences | |
Guide mothers in understanding their beliefs, motivations and intentions with regard to breastfeeding. Strengthen ‘change talk’ about breastfeeding and soften sustain talk about not breastfeeding | Education, Enablement | Identity associated with changed behaviour, framing/reframing, incompatible beliefs, pros and cons, goal setting (behaviour and outcomes), self-talk | |
Planning for breastfeeding (e.g. how to overcome difficulties, how to get support) | Training, enablement | Instruction on how to perform a behaviour, problem solving, action planning | |
Postnatal period | Engagement & building a rapport – introductions, congratulations on the new arrival (first visit), seek collaboration. Convey empathy, affirm mothers’ strengths and capability, and emphasise her autonomy | Enablement, restructuring social environment | Social support (unspecified and emotional), social comparison, social reward, demonstration of behaviour |
 Face-to-face visit within 48 h of birth, either in hospital or at home (or contact by phone/text if this is not possible)  Contact at least every other day (face-to-face, by phone, or by text) from days 3 to 14, including a visit close to the 72 h weighing of the baby | |||
Use open questions and reflective listening to elicit from the mother how she is doing, how the feeding is going, and what support (if any) she would like. Explore ambivalence and concerns, and identify potential barriers and facilitators to continued breastfeeding. Provide information and skills training based on individual needs on breastfeeding relevant to the first few days and weeks | Education, training, enablement | Review behaviour & outcome goals, instruction on how to perform a behaviour, information about health, and social, environmental, and emotional consequences, identity associated with changed behaviour, pros and cons, framing/reframing, incompatible beliefs, social support (practical) | |
Provide a role model for continued breastfeeding | Modelling | Demonstration of the behaviour | |
Normalising experiences | Restructuring social environment | Social comparison | |
Strengthen ‘change talk’ about continuing to breastfeed and soften ‘sustain talk’ about discontinuing breastfeeding earlier than the mother would like to | Enablement | Commitment, self-talk | |
Planning for overcoming barriers to breastfeeding | Enablement | Problem solving, action planning | |
Ending the intervention | Use open questions and reflection to elicit from mothers what other sources of breastfeeding support they might need now and in the longer term. Signpost/refer to relevant services, act as an advocate when required. Offer practical support to overcome barriers to accessing support, such as accompanying mothers to a breastfeeding group or to a public place (e.g. local café) if they have concerns about feeding in public | Enablement, training | Action planning, instruction on how to perform a behaviour, social support (practical) |
 Provide a graded exit from the intensive one-to-one service from 2 weeks onwards |