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Are breastfeeding vouchers incentivising the practice – or shaming women

A controversial new study suggests that a financial incentive could boost dwindling breastfeeding statistics in the UK. The money could be better spent, says Rachael Sigee

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By Rachael Sigee on

In 2017, strong opinions on hot-button topics are not exactly hard to find. But amidst the cacophony of divisive viewpoints, one issue always garners attention: breastfeeding.

This week though, it’s not the usual outrage about a woman being asked to leave a posh restaurant or cover up on an aeroplane. It’s the news that offering women £200 in shopping vouchers could encourage them to breastfeed. Cue a lot of opinions.

The headlines came from the results of a pilot study which suggested that a financial incentive could persuade new mothers to breastfeed, and breastfeed for longer.

Over five years, 10 thousand new mothers in South Yorkshire, Derbyshire and north Nottinghamshire were offered £40 vouchers to breastfeed their babies at two days, 10 days, six weeks, three months and six months. The study found a six-per-cent increase in babies breastfed aged six- to eight-weeks-old (although no difference was measured at the later dates).

It is not exactly a monumental jump but with it estimated that the NHS could save £17 million a year if breastfeeding levels were raised (based on a reduction in short-term diseases in babies), the news made some noise.

Many reports have already made comparisons to Scandinavian nations – because it is almost as British to self-flagellate with superior Scandi statistics as it is to talk about the weather. In this case, we fall short to Norway, where 71 per cent of babies are still breastfed at six months, whereas in some areas of the UK just 12 per cent of babies aged six- to eight-weeks-old are breastfed.

Which is where the vouchers come in. The principal investigator of the study, Dr Clare Relton, from the University of Sheffield’s School of Health and Related Research (ScHARR), explained: “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… It seems that the voucher scheme helped mothers to breastfeed for longer. Mothers reported they felt rewarded for breastfeeding.”

While it is to be commended that women’s domestic (and physical) labour is finally being recognised, the scheme hasn’t escaped criticism. It arguably addresses the symptom rather than the cause – especially when you factor in a potential nationwide rollout.

It is complicated to call something an incentive when the necessary actions demanded might not be possible for everyone and to reward those women who can breastfeed has the flipside of appearing to penalise those who cannot

Women who want to breastfeed and can breastfeed will continue to do so – with a financial bump they didn’t ask for. Whereas women who want to breastfeed but cannot may feel further isolated, faced with another test in which it appears they’ve failed. It is complicated to call something an “incentive” when the necessary actions demanded might not be possible for everyone. Put it this way: to reward those women who can breastfeed has the flipside of appearing to penalise those who cannot.

Many women responded to the story on social media by discussing how being unable to breastfeed can create feelings of guilt and shame about not being able to provide for their newborns. During an appearance on Loose Women this week, Denise van Outen addressed the vouchers directly, revealing “I felt like a failure. It was because of the pressure that was put on me.”

The benefits of breastmilk are multitudinous; it is ideally nutritionally balanced for infants, strengthens the immune system and can boost maternal bonding. But there are various reasons why it may not be possible: lack of knowledge, low milk supply, postnatal depression, non-compatible medication, mastitis, tongue tie, latching issues and lactation failure amongst others.

On the Victoria Derbyshire Show one mother explained: “I don’t think bottlefeeding is the easy option. Some people can’t breastfeed. I chose to breastfeed for a month and then I had to go back on medication for a medical condition. I would have loved to have breastfed for longer. So to essentially bribe people to carry on breastfeeding, I think is shocking.”

The word “bribery” was scattered across discussions of the initiative and the conditions of the study are important. It took place in low income areas, with low rates of breastfeeding and 46 per cent of eligible mothers signed up. One reason why women stop breastfeeding earlier than they might otherwise is because of returning to the workplace. For women in less affluent households this might well be earlier than elsewhere, and vouchers for stores like Argos, Debenhams and Tesco could genuinely be of financial aid. But that is a wider issue of economic inequality and supporting working parents.

While in many ways it seems to be like offering someone with a broken toe a fiver to run a marathon and the reward appears to bear no relationship to the problem, funding – re-routed elsewhere – could still benefit new mothers and boost breastfeeding rates.

Rather than offering vouchers, which many found at best tone-deaf and at worst offensive, suggestions flooded in for how money could be better spent including better support services, breastfeeding counsellors, antenatal education on topics such as sharing workloads with partners and co-carers, and improved public facilities for breastfeeding women.

In a bigger sense, throwing money at one aspect of the problem ignores that a societal attitude shift needs to take place around breastfeeding. Women need to stop being shamed for breastfeeding in public spaces and women who either choose not to or cannot breastfeed should not face judgement from healthcare professionals, other new parents, family members and often total strangers. And for all the goodwill in the world, Argos vouchers probably aren’t going to help shift that conversation


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