A scheme that rewards women with shopping vouchers if they breastfeed their babies is to be extended after successful results from in an initial pilot.
Offering financial incentives to persuade women to breastfeed is controversial, but the results of the pilot scheme called Nosh in Derbyshire and South Yorkshire suggest many mothers would sign up. A larger trial involving 4,000 women will now get underway.
The UK has one of the lowest breastfeeding rates in the world, even though it is considered the healthiest start to life for a baby and beneficial for the mother as well. The World Health Organisation recommends exclusive breastfeeding for six months, but in the most deprived communities as few as 12% of mothers are breastfeeding by six to eight weeks.
The Nourishing Start for Health scheme was started by academics a year ago with a pilot study involving 108 women living in three areas where breastfeeding rates were low. If they breastfed their baby, they could claim £40 of vouchers for supermarkets and high street shops at five different stages - when their baby was two days, ten days, six weeks, three months and six months old, worth £200 if they stayed the full course.
Critics of the idea, when the project was announced, said it was bribery and would penalise women who were unable to breastfeed. The deputy prime minister, Nick Clegg, on his radio phone-in programme, said: “It’s not going to be government policy to say we’re going to pay people.”
But the pilot found that over half the eligible women – 58 mothers – chose to join the scheme, 48 claimed the two-day vouchers, 45 claimed 10-day vouchers and 37 claimed the six to eight-week vouchers (34.3%).
Data on those who continued to claim at three months and six months is still being collected, but the researchers say the results, published in the Lancet, are promising and that the scheme is acceptable both to the women and to the midwives and healthcare visitors who have to co-sign the claim form to certify that the mother is breastfeeding her baby. One midwife in Sheffield commented: “I don’t think it’s difficult to tell if a woman is breastfeeding as you are talking to them about breastfeeding anyway.”
The principal investigator, Dr Clare Relton from the University of Sheffield’s School of Health and Related Research (ScHARR), said: “For several decades now the majority of babies in the UK have not been getting enough breast milk, and despite many efforts, this situation has not improved. Now we need to conduct the full trial to find out if offering vouchers for breastfeeding can significantly increase our stubbornly low breastfeeding rates and be a cost effective use of UK public funds.
“Last year, there was a lot of controversy about the scheme and we didn’t know if it would be acceptable, so we have been delighted to see how enthusiastic local mothers and healthcare professionals have been.”
Mothers taking part in the project reported spending the vouchers on groceries as well as nappies, baby clothes and toys. Some women used the scheme to set personal goals, and saw the vouchers as a reward for breastfeeding to two days, 10 days or six weeks. One mother said: “Sometimes you think ‘should I just move on to the bottle now?’ and then I think ‘oh but then I won’t get the money to be able to treat them’, so it does help.”
The larger trial will be run by researchers at the Universities of Sheffield, Dundee and Brunel.
