When Michelle Chan gave birth to her daughter in Hong Kong, she felt uncertain about breastfeeding. Like many first-time mothers, she had read books and watched videos, but nothing prepared her for the reality of nursing a newborn. Then she received a video call from a peer supporter — a mother who had breastfed her own child and been trained to help others. Two short conversations over a screen made all the difference. By the time her baby was two months old, Michelle was still exclusively breastfeeding, something she had not believed she could do.
A new study from the University of Hong Kong shows that Michelle's experience may not be unique. Researchers found that video-call support from trained peer mothers dramatically improved breastfeeding outcomes for first-time mothers in Hong Kong. The study, published in the journal JAMA Network Open, was the first randomized clinical trial in Hong Kong and among the first worldwide to rigorously test whether online support could help mothers breastfeed.
The trial recruited 442 first-time mothers from postnatal wards at four public hospitals in Hong Kong between January 2021 and June 2024. All the mothers started with low confidence about breastfeeding. Half received standard postnatal care, while the other half got standard care plus at least two structured video calls with trained peer supporters — one at 10 days after birth and another at one month. The peer supporters were mothers who had personal experience breastfeeding and received special training to guide others.
The results were striking. At two months after childbirth, 27 percent of mothers who received video-call support were exclusively breastfeeding, compared with only 19 percent of those who received standard care alone. That represents a 42.6 percent relative increase — meaning mothers in the peer support group were nearly half as likely again to still be breastfeeding exclusively at that critical stage. Mothers who got the video calls also reported feeling significantly more confident about breastfeeding, with higher confidence scores still visible at four months after birth.
The difference at six months was smaller and not statistically significant, meaning researchers could not rule out that it happened by chance. But the researchers noted that the overall pattern showed consistently higher breastfeeding rates in the peer support group over time, with the biggest gap appearing at two months.
Professor Kris Lok Yuet-wan from the University of Hong Kong's School of Nursing led the research. She said the findings suggest that even a modest intervention — just two video calls — can meaningfully help new mothers continue breastfeeding during the early months, which are often the hardest. She noted that this matters especially in Hong Kong, where many mothers follow the traditional practice of "sitting the month" after birth and where many return to work relatively early. Video calls can reach mothers wherever they are, without requiring anyone to visit in person.
The researchers say the approach is low-cost and easy to scale, making it a practical option for health systems looking to improve breastfeeding rates without major new spending. As World Breastfeeding Week runs from August 1 to 7, the team hopes the findings will influence both local and international health policy. Breastfeeding offers important health benefits for both babies and mothers, and the World Health Organization recommends exclusive breastfeeding for the first six months of life. Yet rates remain low in many places, and the new study suggests that something as simple as a video call with a supportive peer might help change that.