Our study group addressed some of these factors in formative research identifying poverty and limited access to health systems facilities, water, sanitation and fear of stigma and rejection as key factors why not breastfeeding is considered a non-option in Burkina Faso and Uganda [33,40]. In a way in these two countries, breastfeeding was already an established norm, and the trial had to address the question whether “breast- feeding was really enough.” The peer-intervention training package provided enough essential information on stimu- lation and production of breast milk to address this [31].