Would you breastfeed if — above and beyond the health benefits it has been linked to — you were paid to do so?
The U.K.’s National Health Service and a team of medical researchers are starting a pilot program that will do just this. 130 women with babies will be given up to £200 in shopping vouchers for supermarkets and other stores. The team behind the project says that, as breastfeeding has been a “cause of health inequalities,” they are seeking to encourage more women to nurse their babies. More children will then, it is hoped, accrue breast milk’s health benefits (preventing upset stomachs, asthma and chest infections); breast milk has also been linked to a child’s brain development.
The women in the U.K. pilot program are all from “deprived areas of South Yorkshire and Derbyshire” where breastfeeding rates are low. Indeed, by the time an infant is six to eight weeks old, only one in four women are breastfeeding in those parts of the U.K. In comparison, the national average for women breastfeeding in the U.K. is 55 percent, one of the worst rates for breastfeeding in developed economies.
In the United States, 77 percent of babies are breastfed on leaving the hospital. 49 percent of infants are still breastfed at six months and 27 percent at twelve months.
According to Unicef, £40 million could be saved a year if more women breastfed their babies because of the health benefits linked to breastfeeding.
Vouchers and Creating a Culture of Breastfeeding
Women in the U.L. program must breastfeed for a full six months to receive the £200 of rewards in their entirety. As encouragement, £120 of rewards will be provided for the first six weeks of breastfeeding. There are no restrictions as to what the vouchers can be spent on.
Clare Relton of Sheffield University, who is leading the project, says that she is hopeful that the vouchers will serve to foster a culture in which breastfeeding is “seen as the norm” as well as being “a way of acknowledging both the value of breastfeeding to babies, mothers and society.”
Some including Janet Fyle, of the Royal College of Midwives, question the initiative and its use of financial incentives. “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 well-being of her child,” Fyle says in the BBC. She emphasizes that, for the vouchers-for-breastfeeding program to work, women will need adequate support from health workers.
Previous Incentives Programs for Obesity and Smoking
Pounds for Pounds was created in 2009 in Kent and offered participants cash payments of up to £425 for losing weight. The program was not a success, with less than half of the participants experiencing significant weight loss and with a significant drop-out rate.
A two-year incentives program in Dundee, Scotland had more positive results. Smokers received £12.50 a week to quit. They were closely monitored, having to take regular breath tests which were highly accurate at telling whether they had smoked or not. By the end of three months, nearly a third of participants had stopped, more than twice the number in other smoking cessation programs.
If successful, the NHS plans to roll out the vouchers-for-breastfeeding program on a far larger scale.
While vouchers can be a first step to help people change their ways, creating an actual ”culture of breastfeeding” such as Sheffield University’s Reston calls for will likely call for additional efforts. What if, for instance, a woman is in a store to use one of her vouchers and her baby is hungry; will she be able to do so in a decent space and with impunity? Will she be looked at askance when nursing her baby in public?
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