Financial incentives may increase breastfeeding rates

  • Research led by the University of Sheffield found breastfeeding increased in areas where shopping vouchers were offered to mothers
  • 46 per cent of all eligible mothers signed up to the scheme and over 40 per cent claimed at least one voucher for breastfeeding
  • Women reported that the vouchers were an incentive to continue breastfeeding

Breastfeeding baby

Offering new mothers financial incentives may significantly increase low breastfeeding rates, new research from the University of Sheffield and the University of Dundee has found.

More than 10,000 new mothers across South Yorkshire, Derbyshire and North Nottinghamshire were involved in the ground breaking study which offered shopping vouchers worth up to £120 if their babies received breast milk (breastfeeding or expressed milk) at two days, 10 days and six weeks old. A further £80 of vouchers was available if their babies continued to receive breast milk up to six months.

Breastfeeding levels in the UK are some of the lowest in the world – in some areas just 12 per cent of six to eight week-old babies are breastfed. The trial, funded by the National Prevention Research Initiative and Public Health England, saw an increase of six percentage points in the areas where the scheme was offered, compared with those areas where the scheme was not available.

Principal investigator Dr Clare Relton, from the University of Sheffield’s School of Health and Related Research (ScHARR), 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 per cent of babies were receiving any breast milk at six-eight weeks), we were delighted that 46 per cent of all eligible mothers signed up to the scheme and over 40 per cent 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.”

The study used the routine method of collecting information on breastfeeding; an assessment by healthcare professionals who already discuss feeding, along with the baby’s general health, during routine visits.

Mother Fiona Sutcliffe, 29, from Sheffield who took part in the scheme with her baby girl 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.”

Eight out of 10 mothers in the UK who start to breastfeed stop before they really want to. The voucher scheme helped mothers to breastfeed for longer. Mothers reported they felt rewarded for breastfeeding

Dr Clare Relton

Breastfeeding has a wide range of benefits for both mothers and babies1. It helps to prevent short and long-term illnesses in children and in mothers2 and also reduces health costs to the National Health Service2 (NHS). It is estimated that the NHS would save a minimum of £17 million every year in hospital admissions and GP visits2 if more women could be supported in order to breastfeed for longer.

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 change the culture and attitude towards breastfeeding. 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.”

Co-author of the study 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 five year NOurishing Start for Health (NOSH) study was funded by the National Prevention Research Initiative (NPRI). The NPRI was a national initiative made up of government departments, research councils and major medical charities that worked together to encourage and support research into chronic disease prevention. Its core aim was to develop and implement successful, cost-effective interventions that reduce people’s risk of developing major diseases by influencing their health behaviours. A review of the NPRI fed into the recently-launched UK Prevention Research Partnership.

Dr Gavin Malloch, programme manager for public health partnerships at the Medical Research Council which led the NPRI collaboration, said: “There is a wealth of evidence about the importance of breastfeeding for a child’s health and also the health of mothers. We also know that being breastfed as a baby has benefits for health later in life, reducing the risk of conditions such as diabetes which place an enormous pressure on the NHS.

“Breastfeeding rates in the UK are some of the lowest in the world. This study shows that vouchers might significantly improve rates in areas where they are below the national average. It will also help inform discussions around this issue at a global level.”

The trial findings are published in JAMA Pediatrics

To view the full paper please visit: http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2017.4523

Additional information

1Research has shown that breastfeeding has a wide range of short and long-term health benefits for both mothers and babies.

Breastfed babies have:
Less chance of diarrhoea and vomiting
Fewer chest and ear infections and having to go to hospital as a result
Less chance of becoming obese
Less chance of diabetes in later life
Less chance of leukaemia
Less chance of developing eczema.
Less chance of being constipated

Health benefits for mother include:
Reduces risk of breast cancer and ovarian cancer
Reduced risk of metabolic syndrome
Helps mother and baby bond
Naturally uses up to 500 calories a day

For more information please visit NHS Choices Breastfeeding: the first few days.

2 Potential savings to the NHS
If mothers breastfed more and for longer, then the NHS could save a minimum of £17 million every year just for avoiding the costs of treating four acute diseases in infants (GI infections, URTI infections, Otitis Media and NEC).

For more information please visit: NHS Choices More breastfeeding ‘would save the NHS millions’, UNICEF Breastfeeding in the UK and UNICEF Commissioning Guidance for Infant Feeding

Financial incentives have been shown to be effective in promoting positive health behaviours. For example, financial incentives for breastfeeding have been routinely provided in the Quebec region of Canada since the mid-1990s.

The University of Sheffield
With almost 27,000 of the brightest students from over 140 countries, learning alongside over 1,200 of the best academics from across the globe, the University of Sheffield is one of the world’s leading universities.

A member of the UK’s prestigious Russell Group of leading research-led institutions, Sheffield offers world-class teaching and research excellence across a wide range of disciplines.

Unified by the power of discovery and understanding, staff and students at the university are committed to finding new ways to transform the world we live in.

Sheffield is the only university to feature in The Sunday Times 100 Best Not-For-Profit Organisations to Work For 2017 and was voted number one university in the UK for Student Satisfaction by Times Higher Education in 2014. In the last decade it has won four Queen’s Anniversary Prizes in recognition of the outstanding contribution to the United Kingdom’s intellectual, economic, cultural and social life.

Sheffield has six Nobel Prize winners among former staff and students and its alumni go on to hold positions of great responsibility and influence all over the world, making significant contributions in their chosen fields.

Global research partners and clients include Boeing, Rolls-Royce, Unilever, AstraZeneca, Glaxo SmithKline, Siemens and Airbus, as well as many UK and overseas government agencies and charitable foundations.

Contact

For further information please contact:

Amy Huxtable
Media Relations Officer
The University of Sheffield
0114 222 9859
a.l.huxtable@sheffield.ac.uk