Being ‘paid to breastfeed’ - your thoughts?

[SarahMumsnet]

The BBC's reporting this morning that new mothers living in some areas of Derbyshire and south Yorkshire are to be given vouchers for shops including Matalan, Mothercare and John Lewis if they breastfeed their babies. These will be given out as part of a study by the University of Sheffield, aimed at discovering whether “financial incentives” will increase the uptake of breastfeeding in parts of the country where rates are low; mothers will receive vouchers worth up to £120 if they breastfeed until six weeks, and another £80-worth if they continue to the six-month mark.

The scheme, according the senior researcher on the project, is intended "as a way of acknowledging both the value of breastfeeding to babies, mothers and society, and the effort involved in breastfeeding. Offering financial incentives ... might increase the numbers of babies being breastfed, and complement on-going support for breastfeeding provided by the NHS, local authorities and charities."

We've been asked by the beeb what Mumsnetters make of the idea; what's your reaction?

Don't feel guilty LittleBear. I had similar experience to you and couldn't do it either. People think we didn't try but some women just can't breastfeed.

I would be tempted to pretend just to get the vouchers....(ashamed of dishonesty...skulking away now....)

They'd be better off spending the money on increasing support for women wanting to BF. Having recently given birth in Derbyshire there was lots of info pre birth from my midwife but the support whilst in hospital was shockingly poor.

I expect someone else has already questioned HOW ARE THEY GOING TO KNOW?? ... for sure, that someone is continuing bf? Observe every baby on the boob and then hand the cash over? IDIOTS.

This - 'how are they going to know?' - will be one of the aspects tested for in the pilot.

Currently the plans are that HVs and midwives will verify. If they find that women are liable to lie about it (I don't think this is likely to happen a lot), this would be included in the evaluation.

But how will they verify? Are they planning to just ask the women? How will MWs and HVs decide that women are liable to lie - how does a subjective judgement ("she looked a bit shifty, I think she was lying") get incorporated into an objective evaluation of the scheme.

Disabled people are made to prove themselves before they are given some benefits. The government doesn't believe that they can be trusted to be honest. Are new mothers innately more trustworthy than disabled people, or are MWs and HVs just better at spotting liars than a GP?

Here's a cynical thought - the government want to improve the figures for breastfeeding because it will make them look good (especially if they've brought in an incentive/ can be seen to have done something) - they don't care if women lie about it in order to get some vouchers. It's easier to get more women saying they are breastfeeding (with a bribe) than actually to support more women breastfeeding for longer.

(contender for cynic of the year award ?!)

I think it's a good idea. I BF DS for 20months. I'm 11 weeks into BFing DD.

With DS BFing was not easy. I had bleeding nipples constantly until he was 6.5 months old and have permanent scarring as a result. I also had mastitis repeatedly. And DS was admitted to hospital with failure to thrive.

I've always said that I chose to continue BFing because BFing was such a high priority for the health benefits for DS were more important than the pain I was in. Maybe a financial incentive will encourage other women to put BFing higher up their list of priorities.

I don't know how they will verify - they may make mistakes and the occasional porky-pie teller will get some vouchers. The evaluation will (or should) include questions to the HCPs - how confident are you the vouchers went to the right mothers?

I think we have to live with a bit of uncertainty, to be frank. I really don't think it will be a major issue, and I don't understand why people are so worried about it (dozens of posts about it on this thread alone).

Utterly utterly stupid and misguided! This is sending the completely wrong message and means that mums who want to bf but can't (been there, done that, felt like a total failure) are not recognised or 'rewarded'. Money needs to go towards education and guidance before and during pregnancy.

I agree with those who have said the money would be better spent on breastfeeding support, advice and help to get it right. I do think women should be properly encouraged and supported to BF but not made to feel like a failure if it doesn't work out.

The number of women who are able to breastfeed successfully would be increased with better support. I was fortunate - i had the advice of a big sister who had already done it, as well as the benefit of a breastfeeding workshop prior to giving birth. And it helped that DS took to it really easily.

But i also have a friend who persisted with it even though it wasn't working out, because she felt she would be failing her dd if she gave up. Turned out her DD was not latching on correctly resulting in no milk for her dd, a crying baby who lost a lot of weight in the first week and a mum on the brink of depression. She had no support at all and ended up bottle feeding, which turned out to be much better for her. However, had she received the help at the outset she may have been able to continue.

I do think there is also a cultural change required though. It might sound silly, but the number of babies on soaps who are bottle fed always makes me a bit sad. I am no breastfeeding evangelist, I was bottle fed, as were my two sisters, but it's little things like that (along with appropriate support for new mums) which might help improve 'normalise' breastfeeding in our society.

I think it's really patronising to "reward" women for breastfeeding. Yes, I can see the wider arguments for this: incentivise bf'ing in poorer areas, try and make bf'ing the norm to change attitudes over time etc. But to me, it feels like some sort of prize or competition. And new mums do not need any more pressure.

I expect that if the vouchers are offered to women in low income areas, they will be able to cross check with formula vouchers ie if you claim formula vouchers you won't be eligible for the JL vouchers. I don't know much about the vouchers but do they cover the costs of formula for the week? I guess if they do the cost saving is not having to buy bottles, sterilising stuff etc.

I ebf my DD, who is 5 months and she fed really well from the off. My mum bf my brother and sister til they were two, I was ff (I'm no different to my brother and sister in health / intelligence) so I didn't feel under great pressure if I couldn't bf for any reason. She was amazing over the first few days with helping me. I had great support in hospital, from midwives at home visits and at a local breastfeeding clinic when I had a cracked nipple. My DH is very pro bf and therefore has been brilliant at helping me with baby and doing a huge amount of cooking / cleaning / supporting / thanking for feeding his baby etc. I've had a very positive experience all-round. I'm incredibly lucky. I've seen the bad: I've had other friend's who've had crap or no help and have felt like utter failures. I've seen them cry and beat themselves up. And I live in a very pro breastfeeding part of the country. I dread to think what it's like in other parts if the country.

Perhaps as many others have suggested the money would be better spent on resources - more help, bf'ing cafés, LLL drop ins etc. How about a pro breastfeeding bounty pack for new mums rather than big brand sponsored pack. A couple of books, leaflets on the pros and cons of different feeding methods, a tube of lansinoh, a mamascarf, money off nursing bras or a feeding vest / top? This could be put together for a fraction of £200, leaving money over for more support.

But, no, I do not think this pilot scheme is in any way helpful.

"And new mums do not need any more pressure."

Nobody's forcing them to take part in the pilot.

If they don't want to do it they can say 'no'. They're adults aren't they?

And the scheme isn't asking women not to use formula as far as I understand.

"Perhaps as many others have suggested the money would be better spent on resources"

My understanding is that it isn't coming out of the same budget - it's a trial, not part of normal NHS spending on breastfeeding support.

Princess - hope you won't mind me correcting some misinfo :)

• there is no such thing as 'formula vouchers' and has not been for many years. 'Healthy Start' vouchers are for women on low incomes and cover milk, plain fresh and frozen fruit and vegetables, and infant formula milk
• if you have a baby under the age of 12 mnths, you can get Babies under two vouchers a week worth a total of £6.20, which is a bit under the usual retail price of one pack of powdered formula
• there is no suggestion women getting shopping vouchers would have to give up their Healthy Start vouchers

Your breastfeeding gift pack sounds great - but is it not better to give mothers the choice of what to buy with their vouchers?

to clarify: "if you have a baby under the age of 12 mnths, you can get two vouchers a week worth a total of £6.20" - sorry, editing error

I think its a terrible idea. It feels like a kick in the teeth to be honest and make me feel like an failure as a mother.

I wanted more than anything to breastfeed ds2. I wanted to give myself/baby the best start I possibly could. I read lots of books/blogs, watched YouTube with people showing different ways to latch on etc. I had even found a breastfeeding support group whilst pregnant.

I felt that i had done everything i could to prepare myself. I breastfeed ds1 but only for a few weeks as it didn't seems to be easy for us and I give up which I regret.

Anyway to cut a long story short. The birth didn't go to plan. My uterus ruptured during labour and I spent the first few days after the birth in HDU and needed a 2nd operation 24 hours after ds2 was born. The midwives were great and tried to support us and help with feeding but I physically couldn't hold ds as I was just too poorly. I didn't even get to see ds2 until he was 24 hours old and the midwives had no choice but to feed him with formula.

I think it is grand, proper compensation for the time and energy that the medical research team will take up for these women who are more likely to have faced a lot of problems and issues with health care professionals.

The study specifically states they are getting the women's perceptions - ones often over looked when trying to make these campaigns. In the medical study my DS was in, this involved long surveys and conversations which will be invaluable in getting their own words and perspective to actually help rather than the typical top-down leaflets that ignore many real life social, financial, and environmental barriers to breastfeeding even if we really want to.

I find the attitude that these women obviously don't want to really breastfeed disgusting, and having success stories in their community will have a lot greater impact than success stories in a bf-friendly one. I think the media storm that has been dropped on their heads is disgraceful.

Sandy, that's a dreadful story - what a horrible start for you :(

Genuine question: why does a small study, targetting a handful of women in an area where there is very little social support for breastfeeding, feel like a 'kick in the teeth' for you??? Clearly, no one in their right mind would think anything ill of you for cutting short the struggle you had to breastfeed, or wonder why you didn't persist in order to get the 200 quid.

I am not doubting your feelings, and I think they exemplify the sensitive nature of this whole thing. If the pilot study reveals that for some women in the area, the shopping vouchers add to their pain, then this would be taken into account. It might be that it reveals a need for a service where women are enabled to feel supported after a bad experience like your own.

I think what would be better is if they paid trained breastfeeding counsellors to make home calls to women who are struggling with breastfeeding or loaned double pumps to these mothers for free.

My baby had severe reflux and developed an aversion to breastfeeding fairly early and lost a bunch of weight as a result. Breastfeeding went from being a lovely calm bonding experience that I was proud of to a screaming battle that broke down my relationship with my baby and destroyed my confidence as a mother. I went to La Leche meetings, various breastfeeding drop-ins and had various Health visitors round (one of them stayed with once me for hours trying various things to get baby to feed but ended up admitting that although they were trained, they weren't experts in breastfeeding - especially with unusual cases). The message I was always left with was that breast is best but if baby refuses to latch when your positioning etc is correct there's nothing you can really do short of lots of skin2skin co-bathing etc.
So at 4 months I gave up and did a combo of expressed and formula which baby took. But then I found it hard to keep my clingy baby happy while I pumped and ended up switching to mostly formula only at 5 months. I still feel upset and guilty that I couldn't feed my baby the way that I wanted - the natural way - that would give her the best start in life.

I think what I needed was a continuation of care with a trained breastfeeding professional. Someone who could visit my home on a regular basis in the same way as a MW or HV - but who had EXPERT breastfeeding knowledge - particularly regarding difficult cases.

Failing that (or even better - as well as that) I think that loaning hospital grade double pumps for free to struggling mothers would be an amazing incentive - at least to get the benefits of breastmilk into baby. I couldn't afford a double pump but would have expressed for longer if pumping was quicker.

I wish I had the money to start a charity to provide both services!

As a side note I dont think any mother should be bribed to adopt a particular parenting style. If they are presented with the facts about the benefits of breastfeeding and decide to bottle-feed anyway - that is completely their choice and decision regardless of their reasons. The money should be spent helping those who want to bf but are struggling.

Oh tiktok come on.

This stuff is often deeply emotive and personal. I think many women find media about this issue personally difficult. That says a lot about breastfeeding in our society and the reality for so many women that their experiences were difficult and unsupported in many situations.

I agree with Spork. This is a standard compensation attempt for participation in a large scale study that has nothing really to do with financially incentivising bfing and is more to improve compliance to allow for more data collection on the myriad of barriers faced by women of low income.

Interesting how the media has picked it up.. and what that in itself says about perceptions of bfing in society.

But why would £200 of John Lewis / Matalan vouchers help. It's insulting that the researchers think if you give a woman some shopping money to buy herself something pretty she'll have a go at breastfeeding.

It doesn't say much for the intelligence levels the researchers ascribe to their volunteers.

I got a £5 Boots voucher for filling in questionnaires about perinatal OCD. Took about half an hour. £200 will reflect how much time the women are expected to give the research team, nothing more or less.

I wasn't being paid for having had OCD....

I have two children - the first I could not breastfeed as she had a cleft lip and palate and the second I breastfed to 7 months. I don't think money as an incentive is a good idea. I think it would be preferable to invest that money in free access to specialist lactation consultants or setting up cafes/coffee shops that welcome breastfeeding mothers. It does make sense to try to get more women to breastfeed, especially those that are struggling financially as you do save a significant amount by breastfeeding. Does the state currently provide milk tokens to those that choose not to breastfeed ?To me, if it's your own personal choice not to then I'm not really sure the state should be funding that choice. Whose to say some women aren't taking the tokens and actually breastfeeding and selling the tokens on? But of course I wouldn't want the baby to go hungry either. I got great support from my local children's centre when it came to breastfeeding and there was a local drop in breastfeeding support clinic too. More of this sort of thing would make better use of the money in my view. And this should start in the hospital. It is here, during the first few days after giving birth, where I think support for mothers wanting to breastfeed is lacking.

I'm not 'completely wrong'. There are mothers out there who choose not to breastfeed. Just the same as there are mothers out there who try to feed but encounter problems. I agree that perhaps the money would be better spent on helping those who desperately want to breastfeed. Both of those groups need help and support.

working....yes, this stuff is deeply personal and emotive. Thank you for pointing that out to me . Like I don't know it, like I don't acknowledge it, in the same post....

I was asking Sandy if she could perhaps think why she felt that way. I am interested in the reasons why - beyond the flamin' obvious that it is emotive.