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Study pilots ‘paying’ new mums to breastfeed

New mothers are to be paid to breastfeed their babies as part of a research project examining whether or not uptake rates will increase if they are offered financial incentives.

Vouchers for Matalan, John Lewis or Mothercare - as well as supermarkets - will be dished out to new mothers if they feed their babies with breast milk.

Researchers from the University of Sheffield are examining ways to boost the low rates of breastfeeding.

Despite numerous attempts to encourage new mothers to breastfeed their babies, rates remain stubbornly low in parts of the UK.

The new study is to be trialled in Derbyshire and South Yorkshire - in areas where breastfeeding uptake rates are low.

Mothers will be given shopping vouchers worth up to £120 if their babies receive breast milk until they are six week old, and a further £80 if their babies continue to be breastfed until they are six months.

If the “feasibility” project is successful, the authors will conduct a national research project into the scheme.

The NHS recommends that mothers exclusively breastfeed their babies during the first six months. Despite this, only 34% of UK babies are breastfed at six months, with only 1% exclusively breastfed at this stage said principle investigator Dr Clare Relton.

The senior research fellow at the University of Sheffield said breastfeeding is “stigmatised” in parts of the UK - for example, some advertising for formula milk sends out subliminal negative messages about breastfeeding which contributes to low uptake rates, she said.

“The UK has one of the worst breastfeeding rates in the world and breastfeeding rates vary very widely across different parts of the country,” said Dr Relton.

“If you are a six-week-old baby the chances of you being breastfed vary depending on where you live. If you live in an affluent area you are four times more likely to be breastfed than if you live in a deprived area.

“Babies who are breastfed have fewer health problems such as upset tummies and chest infections, and are less likely to develop diabetes and obesity when they are older. Breast milk is perfectly designed for babies and provides all they need for the first six months of their life.

“The scheme offers vouchers to mothers who breastfeed as a way of acknowledging both the value of breastfeeding to babies, mothers and society, and the effort involved in breastfeeding.

“Offering financial incentives for mothers to breastfeed might increase the numbers of babies being breastfed, and complement on-going support for breastfeeding provided by the NHS, local authorities and charities.”

The preliminary study will focus on up to 130 mothers who give birth between November and March.

If the mothers breastfeed their children for a full six months they will receive £200 shopping vouchers - half for supermarkets and half for high street stores.

The vouchers, which are being funded by the National Prevention Research Initiative, will be dished out in five stages of £40 each.

The initiative will not be rigorously policed and will simply require the participating mother and their health visitor or midwife to sign off to say they are breastfeeding.

Dr Relton said the test will not only ascertain whether or not the payment improves uptake rates, they will look at whether women think they are being “bribed or rewarded” after they receive the vouchers.

“We’re testing whether this is a way of increasing the perceived value of breastfeeding.”

Janet Fyle, professional policy advisor at the Royal College of Midwives, said: “Whilst we are not against financial incentives for the right reasons, there is a much bigger social and cultural problem here that needs to be tackled instead of offering financial incentives for mothers to breastfeed.

“In many areas, including those in this study, there are generations of women who may not have seen anyone breastfeeding their baby, meaning it is not the cultural norm in many communities.

“The motive for breastfeeding cannot be rooted by offering financial reward. It has to be something that a mother wants to do in the interest of the health and well-being of her child.

“Investing in midwives and improving ante-natal and post-natal care will go a long way to reversing the worryingly low levels of breastfeeding that we are seeing in certain communities.”

 

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Readers' comments (15)

  • What a waste of money! And how patronising too. So the idea is "you are too stupid or stubborn to do as we tell you with your breasts but we bet you will do it for money!"

    Outrageous.

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  • Ellen Watters

    I agree Sarah, why not employ more nurses to support the new mums instead, or is that too simple.. I'd have loved to have had a dedicated breast feeding support nurse when I was a new mum.

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  • That seems to be the way Gov does it-throw money where it isn't appropriate and take it from where it is needed, just liike Labour Party would. If a mum cant be persuaded that its right for baby and would save her time and money, then financial bribery wont either. She'll take the money, try to feed for a day or two and then onto the bottle

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  • Does the rest of the world bribe mothers to breastfeed, what a waste of money!
    Perhaps investing in a few more community support staff would help.
    Long term this could only be financed by the POOR long suffering tax payer - never, never never!!!!

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  • From what I have read here, this is a feasibility study. So the conclusion may be that the offering of financial incentives to increase the amount of mums who breast feed isn't feasible, and no further studies will be carried out. We know from previous studies into incentives in other areas (eg smoking cessation) that engagement is improved and, that as an adjunct to improved support, outcomes are better. There is no suggestion that, "the motive for breastfeeding....." should "....be rooted by offering financial reward.", or that financial incentives should replace improvements in ante-natal and post-natal care.

    The use of incentives in any healthcare setting always induces apoplexy and outrage. I wonder how many have read the background and methodolgy of this feasibility study and/or any other published work on the use of incentives and the results.

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  • why all the shock and horror? midwives need to look at their own practices. this country has among the lowest breastfeeding rates worldwide. that is disgraceful and it isn't to do with lack of resources or staff. a small input now to save much later on in healthier individuals who have benefitted from breast feeding.
    stop leaving babies in cupboards and open your minds!

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  • What a total waste of money. New mums either want to breastfeed or they don't, it should be a personal choice untainted by money. And why should resources be taken out of struggling NHS coffers to support such a stupid idea. If there is money available they pay your staff what they worth. Talk about rubbing salt in wounds!

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  • Stupid stupid waste of money!

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  • Use the money to invest in staff? Did you read the article? £200 given out in £40 lots, I.e. 5 times. To 1300 women. Which is £2600 in total. A tenth of a qualified nurse. This isn't about politics, this is the same old faffing about with tiny amounts of money on small scale projects to see if something will work, like when they gave ipod prizes to teenagers to try and improve chlamydia screening rates. It either fails or works but fizzles out because it's so small and funds non recurrent. Give the £2600 to the midwifery staff and ask them how best to spend it.

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  • So no one has read the background or rationale for this study? Result. Ignorant comments comprising mostly of mock outrage. One doesn't need to look far to understand why so few nurses lead any research.

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  • Anonymous | 13-Nov-2013 5:32 pm

    "Give the £2600 to the midwifery staff and ask them how best to spend it."

    Don't be so silly!!

    They have signally and consisently failed to tackle the health inequalities in pregnancy. eg smoking cessation rates in pregnancy are the WORST of any group of smokers.
    The UK has just about the worst breastfeeding levels in the world (do we need to go into the benefits in terms of long term health and financial savings which many posters here appear to ignore?).

    Seriously, someone please do some reading. By all means disagree. But be sure about what you disagree about and are doing so from a position of some knowledge.

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  • Yes, I understand our poor performance as a nation (I was one of the earlier posters). But is this entirely down to midwifery? What about the low staffing levels? There's a lot of research recently covered in the media that shows we spend 20 to 25% of funds on litigation. And isn't the postnatal support down to health visitors too? Not trying to start a row, just asking a question.

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  • Anonymous | 14-Nov-2013 1:44 am

    I am a midwife working in Glasgow and I totally understand the reactions of some of the posters.
    However, a study was introduced into our healthboard a couple years ago which offered incentives to pregnant women who smoked. There was a mixed reaction to this in our team. Some were very much against 'rewarding' smokers whilst others were interested to see how it would work. There was already a scheme in Tayside which offers shopping vouchers as a reward for not smoking. Tayside has claimed that this has doubled the amount of pregnant smokers who quit during pregnancy in their area. But there was no control group and I believe that there were changes to the way the service was run.
    In Glasgow, midwives were failing to achieve CO testing targets at the ante-natal stage by a huge margin. No amount of training, information or warnings improved our performance. It is a small part of routine care involving no need for extra staff or resources, but midwives didn't seem to see the point given the smoking culture. Not enough importance was placed on smoking cessation by midwives. You know how we always think we are right. Finally, a small team of smoking cessation advisors was formed and any pregnant smokers were referred to them, but many failed to even turn up for appointments. After about a year, the study using incentives started. A few hundred were recruited, half eligible for the vouchers and half not. All were given the same support available from the smoking cessation team. As far as I'm aware the final report has not yet been produced, but preliminary results show that the quit rates amongst those who receive vouchers is significantly higher. Perhaps because the incentives got them through the advisor's door in the first place. Engagement is such a key issue. I did some background reading at the time of the study introduction because my initial reaction to the idea was as others have posted on this topic.
    Incentives are never seen in isolation in the research literature. They are seen as part of a range of measures to improve uptake of service and improvements to the services available. But of course, the headlines will only talk in terms of 'paying women' and 'bribery'.
    I have questions about the breastfeeding study. For example, how will breastfeeding be validated? In the smoking cessation study, CO levels and cotinine samples were obtained to test whether or not subjects were smoking. Incentives were not given if they were smoking. I would think that any breastfeeding initiatives will involve midwives, Health Visitors, GPs, etc, so one would think that they will be aware and included, as we were in the smoking cessation study.
    There are obviously many other barriers to breastfeeding in this country which need to be addressed. If incentives don't increase uptake, they can honestly say, "We tried that under study conditions and the evidence says that it doesn't work.", ditch that debate and move on. But it might work. So we have to find out.

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  • Anonymous | 14-Nov-2013 10:09 am

    Thank you so much for answering my question with such a detailed and thoughtful reply. I wish you every success in your work in Glasgow.

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  • Breast feeding is not 'easy' for most mothers initially. They need constant, often intensive help, during their first week or two. It is the norm though for mothers to only stay on the ward for between six and 24 hours, during which time they may get a little help if the poor busy midwife or healthcare assistant has time. (I wont even include those mothers following LSCS and how they are expected to cope) After that they are at home, their breast fill, their hormones fall and often their is no one to aid or advise them. The community staff are so thin on the ground that unless their is a physical problem with mum or baby, they will be lucky to receive a phone call and one visit before they are discharged. I mention this as only one of the many reasons that mothers are not successful at establishing breastfeeding. I could go on and mention the draconian rules about topping up any baby that is screaming at the top of its lungs but will not fix at the breast etc to illustrate that the whole subject is complex. I know from experience that breast feeding rates at six weeks will never increase without massive changes in the way mothers are cared for during those first two weeks, sadly!

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