Breastfeeding peer counselors in the United States: helping to build a culture and tradition of breastfeeding.

Traditionally, women have relied upon the wisdom and experience of other women to learn about mothering and breastfeeding. In the United States, however, this once-standard mother-to-mother interaction was almost nonexistent by the mid-20th century. Recent advances in the understanding of the benefits of breastfeeding for maternal and child health have led most professional organizations to advocate breastfeeding as the norm of infant feeding. Promotional breastfeeding efforts over the past 3 decades include strategies to strengthen support for breastfeeding in the health care system and in the community. Breastfeeding peer counseling represents a model of mother-to-mother support which emerged in the 1980s as a community-based resource to provide mothers with the support and assistance needed to establish and maintain breastfeeding in the early weeks and months postpartum. This article describes the role, training, and effectiveness of breastfeeding peer counselors and discusses ways that mothers and peer counselors might benefit from the connection and relationship that develops between the breastfeeding mother and her peer counselor. An exemplar of a breastfeeding peer counseling program is presented.