Mothers are being “bribed” to breastfeed their babies for the first six months of infancy by the lure of shopping vouchers. This financial incentive as a boost to breastfeeding has been widely condemned since it was announced today. Women in the northern English areas of South Yorkshire and Derbyshire are to be offered £200 ($340) to nurse their newborns.
Britain has one of the lowest rates for breastfeeding in the world, and many years of ardent campaigning have not made any significant impact. However, senior figures in the medical profession were unconvinced that a financial motivation would alter this situation.
The vouchers, to be given out in £40 increments, are half for John Lewis, Matalan and Mothercare stores, with the other half for supermarkets. They are to be paid for by the National Prevention Research Initiative. Proof will be provided by means of a form which is signed off. There is no suggestion that the scheme will be “policed” rather it will rely on the participating mother and her health visitor to be honest
The professional policy advisor at the Royal College of Midwives, Janet Fyle, said it was a problem in culture and society, and before this was adequately addressed, breastfeeding will not be seen as the norm. “There are generations of women who may not have seen anyone breastfeeding their baby” she explained, “The motive for breastfeeding cannot be rooted by offering financial reward.” Her remarks were echoed by many women flocked onto website forums who felt, like her, that “It has to be something that a mother wants to do in the interest of the health and well-being of her child.”
The professor of diet and population health at the University of Oxford, Susan Jebb, agreed with Fyle’s views. She said that while other areas of health had seen some marginal improvements with the spur of a financial incentive, the issue of breastfeeding needed “a public conversation about whether this should be adopted into policy.”
It is Ms Fyle’s opinion that investment in midwife services and improved post and ante-natal care would do a great deal more good in getting the “Breast is Best” message across. 1 in 4 British midwives are said to be so disheartened that they are considering quitting their jobs. Tolerance, understanding and support are key parts of a midwife’s role and they are less likely to be offering these essential services if they are feeling undervalued. Many midwives are unhappy with their pay and conditions. According to a survey by the Royal College of Midwives they feel “demoralised, disillusioned and burned-out.”
Research from Sheffield University warns that women feel stigmatised about breastfeeding in the UK. A staggeringly low 1% of all babies are still being exclusively breastfed at 6 months old. This is in direct refutation of the NHS advice that seeks to reassure mothers that their milk still contains all the essential nutrients at this stage, and that weaning should not begin before this age. It seems to be an uphill battle to get this message across.
Dr Clare Relton of Sheffield University said that affluent mothers were proven to be four more times inclined to breastfeed than those in lower-income and deprived parts of the country. This has a knock-on effect to the health of those babies, as breastfed infants have far fewer infections or tummy upsets and go on to have lower rates of diabetes and obesity. Relton’s team, who have conducted the feasibility study, are in favour of this trial if it helps with uptake rates.
Relton is unapologetic about the “bribery” angle, and has plans to investigate the relevance of this to the women involved, in the aftermath of the first test run. She says, “Money is really interesting isn’t it? …it’s a very quick way of communicating with people regardless of their age, their gender, their ethnicity, their level of deprivation or their education.” If this trial is regarded as a success, it is planned to roll it out nationally.
Nobody really seems to understand why breastfeeding rates in the UK are so low. With its many indisputable health benefits, its convenience, and the fact that it is free neither influencing the majority of women or affecting take up at all. One theory is that the “laddish” culture, where breasts are often displayed in the media, makes it difficult for women to want to expose their own. Could this be the source of the stigma? A UNICEF report in 2012 found that it was costing the NHS up to £40 million a year.
UNICEF said that if two-thirds of the babies sent home from neonatal units went on to be breastfed this would reduce re-admissions to hospital with gastroenteritis by 3,285 babies. If 45% of babies were still being breastfed at 4 months old there would be 5,916 less admissions for respiratory conditions, 21,045 fewer ear infections and 361 fewer cases of necrotising enterocolitis, which can prove fatal.
Their findings have been backed time and time again by academic research and reports, and yet as a public health issue it just does not get through. A third of British women never even try to feed. The National Breastfeeding Helpline is one of serval organisations that tries to turn this trend around. They state, “Breastfeeding is arguably the single most important health measure on the planet and yet so many women in the UK struggle to breastfeed.” They offer mum-to-mum phone support and encouragement.
Maybe this new incentive to bribe mothers to breastfeed will bring about the shift in acceptability that has so long been campaigned for by the health profession.
By Kate Henderson