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A research team from the School of Nursing at the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) has found that video-call support from trained peer mothers helped first-time mothers breastfeed more successfully. Among mothers who received this support, the study revealed a 42.6% relative increase in the number of mothers exclusively breastfeeding their babies at two months after birth, along with greater confidence in breastfeeding. This is the first-of-its-kind randomised clinical trial in Hong Kong to evaluate video-call-based peer support for breastfeeding and is also one of the first trials globally to rigorously examine the effectiveness of this digital approach in improving breastfeeding outcomes. The research findings were published in JAMA Network Open [link to the publication].

Breastfeeding is widely recognised for its substantial health benefits for both infants and mothers. The World Health Organization recommends exclusive breastfeeding for the first six months of life, but breastfeeding rates remain suboptimal in many parts of the world. Peer support has long been recognised as a promising strategy to encourage breastfeeding, but there has been limited evidence on whether this support is equally effective when delivered online.

Video-call peer support demonstrates significant early benefits
The multicentre trial involved 442 first-time mothers with low confidence in breastfeeding, who were recruited from postnatal wards at four public hospitals in Hong Kong between January 2021 and June 2024. Participants were randomly assigned to receive either standard postnatal care or standard care plus a peer-support programme, which included at least two structured video-call sessions with trained peer support volunteers at 10 days and one month postpartum.

The key results were as follows:

• At two months after childbirth, 27% of mothers who received video-based peer support were exclusively breastfeeding, compared with 19% in the standard-care group, representing a 42.6% relative increase.
• Mothers in the intervention group also showed significantly greater improvement in breastfeeding confidence, with notably higher scores at four months postpartum.
• Although the primary outcome in the exclusive breastfeeding rate at six months (20% vs. 16%) was not statistically significant, longitudinal analysis confirmed consistently higher odds of exclusive breastfeeding over time in the intervention group, with the largest difference observed over two months.

Two video calls, real impact: a scalable, low-cost solution for new mothers
Professor Kris Lok Yuet-wan, Associate Professor in the School of Nursing, HKUMed, said, ‘Our findings show that even a modest intervention—just two video calls with a trained peer supporter— can significantly help new mothers continue breastfeeding during the critical early months. This is especially important given the Chinese cultural practice of ‘sitting the month’ and the reality that many mothers return to work early. The flexibility of video-based support allows us to reach mothers when and where they need it most.’

‘Although the difference in exclusive breastfeeding rates at six months was not statistically significant, the improvements seen at two months and in maternal confidence are clinically important. This model offers a practical, scalable way to integrate peer support into routine postnatal care, particularly in settings where face-to-face visits may be challenging,’ added Professor Lok.  

Given its low cost and ease of implementation, this approach offers a promising strategy for healthcare systems seeking to improve breastfeeding outcomes without requiring substantial additional resources.

‘As we observe World Breastfeeding Week from 1 to 7 August, this study provides important evidence for the effectiveness of video-based peer support, highlighting the potential of this innovative model to influence policy both locally and internationally,’ Professor Lok added.

About the research team
The study was led by Professor Kris Lok Yuet-wan, Associate Professor in the School of Nursing at HKUMed. The co-authors are Dr Ying Dai and Professor Patsy Chau Pui-hing, from the same School.

Acknowledgements
The research was supported by the General Research Fund and Early Career Scheme of the Research Grants Council, under the University Grants Committee of the Government of the Hong Kong Special Administrative Region.

Media enquiries
Please contact LKS Faculty of Medicine of The University of Hong Kong by email (medmedia@hku.hk).