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Shopping vouchers may act as incentive for women to breastfeed, finds UK research

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Offering new mothers financial incentives, in the form of shopping vouchers, may significantly increase low breastfeeding rates, according to a study by UK researchers.

More than 10,000 new mothers across South Yorkshire, Derbyshire and North Nottinghamshire were involved in the ground-breaking study by the University of Sheffield and the University of Dundee.

“It seems that the voucher scheme helped mothers to breastfeed for longer”

Clare Relton

Participants were offered shopping vouchers worth up to £120 if their babies received breastmilk – via breastfeeding or as expressed milk – at two days, 10 days and six weeks old. A further £80 of vouchers was available if their babies continued to receive breastmilk up to six months.

The trial, funded by the National Prevention Research Initiative and Public Health England, saw an increase of six percentage points where the scheme was being offered, compared with other areas – 37.9 versus 31.7% at six- to eight-weeks.

Mothers who took part in the scheme described it as a “really good way of keeping going” via “little milestones” that helped them get breastfeeding established.

“The vouchers really lifted mums and gave them recognition and acceptance”

Anahi Wheeldon

Anahi Wheeldon, a community midwife from Eckington in Sheffield, said the vouchers “really lifted mums and gave them recognition and acceptance”.

“The scheme has really helped changed the culture and attitude towards breastfeeding,” she said. “You used to be the odd one out if you breastfed, but now they know people who’ve breastfed, there is a network between mums, so it’s become more normal.”

Breastfeeding levels in the UK are some of the lowest in the world – in some areas just 12% of six- to eight-week-old babies are breastfed, noted the researchers.

Principal investigator Dr Clare Relton, from the University of Sheffield, said: “Our scheme offered vouchers to mothers as a way of acknowledging the value of breastfeeding to babies and mothers and the work involved in breastfeeding.

“We were delighted that 46% of all eligible mothers signed up to the scheme and over 40% claimed at least one voucher”, she said, noting that the scheme was tested in areas with low breastfeeding rates.

“This is the first large-scale study to show an increase in breastfeeding in communities where rates have been low for generations”

Mary Renfrew

She added: “Eight out of 10 mothers in the UK who start to breastfeed stop before they really want to. It seems that the voucher scheme helped mothers to breastfeed for longer. Mothers reported they felt rewarded for breastfeeding.”

Study co-author Professor Mary Renfrew, from the University of Dundee, said: “This is the first large-scale study to show an increase in breastfeeding in communities where rates have been low for generations, and where it can be particularly difficult for women to breastfeed without strong family and community support, because of strong societal barriers.”

She identified a range of barriers including the difficulty encountered by some when breastfeeding in public, misleading marketing that formula was equivalent to breastfeeding, a lack of high quality services to prevent and treat any problems, lack of community support, lack of education about breastfeeding for young children, and a lack of support for women to breastfeed at work.

She said: “The incentive scheme was designed together with local women and staff to make sure it was feasible and appropriate, and breastfeeding support services were widely available in all the areas where the trial took place.

“Thanks to all the mothers and staff who supported this study, we now know much more about what might work to help new mothers to breastfeed,” she added.

“The motive for breastfeeding cannot be rooted by offering financial reward”

Gill Walton

The findings from the five-year NOurishing Start for Health (NOSH) study were published on Monday afternoon in the journal JAMA Pediatrics.

The Royal College of Midwives said it was “interested” in the findings but argued that 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 wellbeing of her baby and its growth into a child,” said RCM chief executive Gill Walton.

“If midwives and healthcare professional have enough time to spend with women to not only to offer them the information about the benefits that breastfeeding has for both mother and baby, but also to support them in starting this would help,” she said.

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Gill Walton

Ms Walton also warned that low breastfeeding rates in parts of the UK indicated a “much bigger social and cultural problem that needs to be tackled”.

“There are some areas where many generations of women haven’t been given the example of breastfeeding or offered the right support to enable them to initiate and sustain breastfeeding if the can and chose to do so,” she said.



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