Training peer counselors to promote and support exclusive breastfeeding in Bangladesh

Exclusive breastfeeding is rare in Bangladesh. About 90% of women have home deliveries, so the Baby-Friendly Hospital Initiative has no mechanism to reach them. Mother support groups do not exist, and community health workers do not have time to promote and support exclusive breastfeeding. To provide this kind of support at the community level, an area in Dhaka was selected for a peer-counseling intervention program. Using certain selection criteria, 1 woman from each community was trained as a peer counselor. The training was based on the World Health Organization/United Nations International Children's Emergency Fund 40-hour breastfeeding counseling course and related books. Counseling skills were taught using demonstrations and role play, followed by practical training in the project area. The intervention was very successful, as 70% of the mothers in the project area breastfed their infants exclusively for 5 months compared to only 6% in the control area. The authors describe the peer counseling training, strategies used for peer counseling visits, and lessons learned.