Professionalisation of a breast-feeding peer support service: Issues and experiences of peer supporters

Objectives: to describe the issues faced by breast-feeding peer supporters as their roles altered from a voluntary to a professionalisecl role with targets, accountability and more formalised interface with health professionals. Design: a descriptive qualitative study utilising group and individual semi-structured interviews, with thematic network analysis. Setting: 19 breast-feeding peer supporters were consulted from one peer support service located in the UK. Findings: thematic network analysis of the peer supporter data generated a global theme of 'Prolessionalising Breast-feeding Peer Support'. The three underpinning organising themes (and their associated basic themes): 'visibility and communication', 'guardianship of knowledge' and 'roles and boundaries' revealed the early and transitional tensions and anxieties that peer supporters faced when their role altered from a voluntary position to a formal model of service delivery, particularly within the clinical environment. Conclusions and implications for practice: professionalisation of peer support can lead to benefits in terms of providing a standardised and comprehensive service with increased capacity for service provision. However, the transitional difficulties faced by the peer supporters as they moved from a voluntary into a professionalised role included a lack of identity; restricted time to care for new mothers; pressures and anxieties of meeting targets and accountability of case recording and the hostility and gatekeeping practices experienced amongst some of the health professionals. Flexible systems incorporating service-user involvement and needs-led strategies may help to overcome these issues. (C) 2013 Elsevier Ltd. All rights reserved,