New mothers could be offered shopping vouchers to encourage breastfeeding

Breastfeeding in Norfolk. Photo: Norwich CCG

Breastfeeding in Norfolk. Photo: Norwich CCG - Credit: Norwich CCG

Offering new mothers financial incentives could significantly increase low breastfeeding rates, a 'groundbreaking' pilot study has found.

More than 10,000 new mothers across South Yorkshire, Derbyshire and north Nottinghamshire were involved in the trial, which offered shopping vouchers worth up to £120 if babies received breast milk - either by breastfeeding or with expressed milk - at two days, 10 days and six weeks old.

A further £80 of vouchers was available if babies continued to receive breast milk up to six months.

The trial, funded by the National Prevention Research Initiative and Public Health England, saw an increase of six percentage points in areas where the scheme was offered, compared with areas where the scheme was not available.

Breastfeeding levels in the UK are among the lowest in the world. In some areas just 12% of six to eight-week-old babies are breastfed.


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Community midwife Anahi Wheeldon, from Sheffield, said the scheme had helped to change attitudes towards breastfeeding.

'The vouchers really lifted mums and gave them recognition and acceptance,' she said.

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'Particularly with young mums 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.'

The research, conducted by the University of Sheffield and the University of Dundee, found 46% of eligible mothers signed up to the scheme and more than 40% claimed at least one voucher for breastfeeding.

Fiona Sutcliffe, 29, from Sheffield, who took part in the trial with her daughter, said: 'Breastfeeding is quite difficult in the beginning. The scheme is a really good way of keeping going - keeping motivated to stay on track rather than giving up and going for the bottle.

'It provides little milestones, little stepping stones and helps you get breastfeeding established.'

Dr Clare Relton, from the University of Sheffield's School of Health and Related Research (ScHARR), led the study.

She 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.

'As the scheme was tested in areas with low breastfeeding rates (just 28% of babies were receiving any breast milk at six to eight weeks), we were delighted that 46% of all eligible mothers signed up to the scheme and over 40% claimed at least one voucher. The trial found a significant increase in breastfeeding rates in areas where the scheme was offered.

'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.'

Mothers who took part were assessed by healthcare professionals who would already be expected to discuss feeding during routine visits, and would also look at the baby's general health.

Breastfeeding has a wide range of benefits for mothers and babies. It helps to prevent short and long-term illnesses in children and mothers and reduces health costs to the NHS.

It is estimated the NHS would save at least £17 million every year in hospital admissions and GP visits if more women were supported to breastfeed for longer.

Study co-author Mary Renfrew, professor of mother and infant health at 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.

'In the UK these barriers include the difficulty some women encounter when breastfeeding in public, widespread misleading marketing that formula is equivalent to breastfeeding, a lack of high-quality services to prevent and treat any problems if they arise, a lack of community support, a lack of education about breastfeeding for young children, and lack of support for women to breastfeed in the workplace.

'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.'

The study is published in JAMA Paediatrics.

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