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?

mildred, I get what you are saying.

Indeed one of the great things about bf is the empowerment of it - the way it is for you to give to your baby with no need for Business or Research or Marketing as an intermediary.

But.

Everything (everything) we do is mediated through our experience and our place in the world and our background and our views. We are, all of us, social beings, connected in some way with the world and the people round us. It's what makes us human.

While what you say about the 'purity' of breastfeeding is true, it is only true if we blind ourselves to experience, place in the world etc etc.

And if we want more mothers to share in the feeling of empowerment that bf can give (when it's going well...obv), we have to take on the other stuff.

How would you suggest we do it? Your idea of ensuring adequate support and help for bf is being done everywhere, and bf rates are rising...even in the areas targetted by the voucher scheme. So 'more of the same' might be your answer. Is there room for something more? If so, what?

"We are, all of us, social beings, connected in some way with the world and the people round us. It's what makes us human. "

Right, but it is not a given that relationships all contain some monetary element. Influencing people isn't only done by paying them.
A pro-bfing society is not necessarily one that pays bf-ing.

also

"Your idea of ensuring adequate support and help for bf is being done everywhere," - really? Why do so many women say they had undiagnosed tongue-tie; that it was diagnosed but could not be treated, or the wait was so long they couldn't hold out when every feed was agonising; that they were told they couldn't bf on medication, when they could; that thrush was mis-diagnosed and mis-treated (treated with antibiotics, as if mastitis, which as you know is a disaster for fungal infections); advice given like (to me, by a GP) "just don't breastfeed for a week or so" (when establishing bfing for a 3-week-old baby - fortunately I knew this was nonsense) - and so on, and so on. There is so much basic stuff that needs to be done to practically facilitate breastfeeding for women who already want to do it. Much if it will cost money, and I think it would be money well spent. I have nothing against money! Resources cost money. but the crude thing of giving money to mothers who bf is missing the point, and anyway bfing is already cheaper, so if money mattered they would already be doing it, like smoking costs a fortune but people still do it.

I think that the common barriers to bfing are:

Physical difficulties in the early days. GPs and other HCPs need to be much more clued up about bfing and every woman who wants to bf should have immediate access to an expert if they want to see someone. This does not actually happen.

Social pressure to ff. This is trickier. I am not convinced that giving money will combat this. Having £200 in your pocket doesn't make you feel less cow-like or dirty with a baby on your breast in your sneering MIL's sitting room. (disclaimer: I never felt cow-like or dirty but I didn't have a sneering MIL or anyone else sneering in my family) What could change this? It can only be a gradual process. We have this ridiculous celeb culture in this country, maybe plugging into that somehow; bf-ing could theoretically be as cool as a trendy new pram; a smooth breast could theoretically be as lovely an accessory as a smart bag - or you would like to think so anyway, but actually not, because the whole point about the bag and the pram is that they are new, branded, and cost money, and a lot of it. And this is really why I think flinging crappy little bits of money like £200 is neither here nor there, and takes away from what bf-ing does have going for it. You can't compete with the capitalist juggernaut by throwing £200 at the problem. You can only step aside from the juggernaut and say "no". There are precious few places left where this is possible; bf-ing is one of them. (Also don't forget that in many working class cultures to be seen to refuse hand-outs or cheaper options is very high-status. Don't get second hand, don't get unbranded, etc. I am MC and I think it's clever to go with the thrifty option; but bf-ing is already the thrifty option and I think that is part of what makes it seem declassé to some cultures; and so giving people handouts is just adding to that stigma. You won't get people boasting "I got £200 for bf-ing" any more than you would get people boasting "I saved £200 by buying an unbranded pram". Seriously? You couldn't afford full price? what is wrong with you?)

Long term exhaustion. This is a problem with bfing. I don't know what the solution is. Having mothers who will not get one full night's sleep in a year is outrageous and absolutely par for the course. I did it, twice. I almost resent it. What value does £200 have against the absolute loss of self caused by permanent extreme exhaustion? Only thinking I did the right thing has any equivalent value to the basic erasure of me, as a person.

mildred - "There is so much basic stuff that needs to be done to practically facilitate breastfeeding for women who already want to do it. "

I absolutely know this - my reference to increased support/help 'already being done' was to acknowledge that the argument (that bf needs support and help) has been won, and that everywhere in the UK - seriously, everywhere - has raised the profile of bf in the past 20 years or so. There is tons more to be done, and the sort of rubbish you report that some HCPs come out with is an everyday, routine, unremarkable occurence, that happens even in areas where they have paid a lot of attention to supporting breastfeeding.

I have a stack of anecdotes of my own, from personal and indirect experience. Heavens, reading mumsnet every day shows the misinformation and confusion out there.

You are spot-on about the importance given in some cultures to the brand-new and expensive, but this does not mean vouchers would not go down well with the same targetted group - this remains to be seen. There was a study a while ago which explored motivation among women who did not breastfeed from areas where no one breastfed. Not breastfeeding meant paying for formula (tokens/vouchers have never covered the whole cost of formula feeding) and this was in some way valued - the fact you had to pay for it increased its perceived value. Saying to women 'but breastfeeding is free!' was not a plus point.

However, this does not mean that if mothers were taxed somehow to breastfeed, if they had their child benefit reduced if they were breastfeeding, or they somehow had to pay for the privelege of breastfeeding, that breastfeeding would increase :)

But it gives a hint to suggest that recognising the importance of bf with a chunk of money might resonate with the same mindset.

I genuinely don't know. The study would need to be evaluated carefully and with assessors who can tease out these hidden effects.

Meantime, I have read some ill-informed column inches on the whole thing all over the media and I hope it stops soon :)

I notice you totally ignore my third point about long term exhaustion. Everybody does. la la la la la la

there is a thread running now by an OP who is concerned his wife might be ill because she is so tired she is walking into things. Nope, it seems to be agreed, that's just ebf.
Everyone knows who has done it, but no one will admit to it.

Sorry, should have addressed it.

The long-term exhaustion from breastfeeding is hard to separate from the long-term exhaustion of having a baby.

There is no research to indicate that generally speaking, breastfeeding makes a mother more exhausted than not breastfeeding. The little research we have indicates the opposite, in fact - that full breastfeeding = more sleep for parents (probably because bf babies settle back to sleep more quickly, and there is less faffing about with preparing/warming bottles).

Night waking (frequency of it) is not massively 'worse' in a bf baby and 'going through the night' only happens slightly later than with a ff baby.

You can get the gen at www.isisonline.org.uk.

Of course this general stuff does not predict what an individual mother will feel like or experience in her own real life. In addition, a lot of extra exhaustion comes from repeated attempts to settle the baby alone in a cot or crib, which causes the baby to become even more needy....lowering expectations and support for parents to cope better with their babies' sleep/wake patterns whether bf or ff would be good.

This would help with the 'complete erasure of me as a person'...which is an extreme response and indicates more going on than bf making you feel tired. Coping at night with a baby who wakes and needs contact/feeding several times can be done in a way that does not mean total exhaustion, but certain changes have to take place in some instances.

Most human beings do not sleep through the night without waking up. Ever. The point is, we usually go back to sleep again quickly. A baby who needs attention does not allow us to do this.....but a baby who co-sleeps and helps himself to the contact/feeding he needs makes it easier and almost unnoticed by the mother (see ISIS again for their observational research on this).

So.....'breastfeeding is really exhausting and means you go without sufficient sleep for at least a year' is a wild generalisation. I haven't seen the walking into things thread, but this is absolutely not inevitable or even very common with bf.

Though is long-term exhaustion really an inevitable consequence of breastfeeding? I've been tired, sure, but I thought a lot of that was just "having a baby". My EBF DS2 was actually a fantastic sleeper when he was younger (we will draw a veil over the months of horror around 9-10 months, or indeed last week's wakey festival of cold plus teething), I used to often get a good 7 hour chunk of sleep once he got past the teeny baby stage. It's not like if you EBF you are pretty much dooming yourself to never getting a good night's sleep until you wean (DS2 is 12 months and did 11 hours straight last night, woohoo), or indeed that FF mothers are never tired.

Ha, x posted with tiktok.

I will never know if I would have been as tired with ff babies, but I do know other bf-ers know what I am talking about (though not all)

I felt energy physically draining out of me when bfing. I stopped midday feeds with both when they were bigger and eating and drinking freely and felt so much less of a dish-rag in the afternoons. both compensated (without complaining at all) with very long feeds last thing, which was better as I didn't have to do anything after that. (I would have liked to. but I couldn't / didn't)

Co-sleeping is not real sleep. Sure I would rather bf a baby 4 times at night in bed than get up and sit in a chair. but it is not the same as going to bed and going to sleep alone for 8 hours while someone else deals with your baby. Or better still, the baby doesn't need anyone for 8 hours.

I actually get quite cross at things like "indicates more going on than bf making you feel tired. Coping at night with a baby who wakes and needs contact/feeding several times can be done in a way that does not mean total exhaustion," because it is telling me that my experience did not happen, or if it did it was because I was doing it wrong. I tried everything. I ate well, I made friends and arranged social things for me and the baby, I walked fast / far with the pram to try and get / stay fit (seeing black spots with tiredness sometimes), I went to bed early, I tried to rest while the baby was napping, I was laissez faire with the housework and abandoned demanding hobbies completely, etc etc etc. The ONLY thing that worked was being able to express (with dd1, I never fitted it in with dd2) and using that to buy a night's sleep (thanks to dp). I gave up on that after her 4 month sleep regression when the nice easy 1 x feed at 3 am turned into 2 or 3 and she stayed like that until she was 10 months and I was a much much smaller, more limited, person by the end of that (although I recognise that in the grand scheme of things this is pretty minor I was not the person I used to be when I didn't get a full night's sleep for months on end. I was just not)

I could have brought in formula and made it an arrangement with dp that once a week, with each baby in turn, till they were night-weaned, I would get a full night off for 8 hours. I could have done that and I didn't, and I don't know why. I feel twistedly proud that my babies never had formula. but I also wonder whether I could actually have enjoyed some of maternity leave if they had.

mildred, I think I love you

I know that the plural of anecdote does not data make and none of us can step outside of our own experience.

I take tiktok's point the the success of this scheme remains to be seen, but I am sceptical. And I still think it devalues BFing for many of the reasons quoted.

Rather than 'Breast is best' and all that lark, IMO less flippant (wahey, it rhymes), more factual information would be a small step forward: "Did you know that FF is made of cow's milk?"
"All FF are essentially the same - use the one you can afford and that is readily locally available"
"BF is the most convenient was of feeding your baby once established"
etc etc. I am sure I could think of more.

AND more support, more skilled and timely support - for mothers, fathers, grandparents etc.
I think every BFing mother who feeds in public performs a public service by normalising BFing - maybe vouchers should be available for public BFing? Particularly discrete feeding?

I started a thread on "is bf-ing intrinsically tiring?" and got a range of answers:

www.mumsnet.com/Talk/breast_and_bottle_feeding/1916608-bf-ing-do-you-think-it-is-in-itself-tiring-more-than-just-having-a-baby-would-be?msgid=43106259#43106259

I think there are enough people having experiences similar to mine that the "something else going on / you are an anomaly" response isn't quite right

Pacific, you are right about anecdotes, but wrong (I hope) that no one can step outside of their own experience. Individual stories and experiences are real - doubting their generality does not mean they're not true. The slogan 'breast is best' has not been part of any campaign I'm aware of (it was the title of a book published in the 1970s, at the very start of widespread awareness that feeding had an impact on health). Nevertheless, I agree that factual information, rather than slogans, is essential, but even factual information can rile people. All your (factual) suggestions will piss someone off, believe me.

mildred, I am not disbelieving when you say breastfeeding made you feel very tired. If you re-read my post you will see it was your memory of feeling 'complete erasure of me as a person' that indicated there was more than just breastfeeding happening. That's very serious mental and emotional health stuff....and blaming breastfeeding alone for such severe effects on well-being and identity is misplaced.

Edited post from my other thread (After a very interesting post from minipie):

I think a lot of the interesting stuff in your post is about habits that bf-ing can promote - things that are not intrinsic to bfing but you can very easily go that way if you bf. Among those things I would count a disproportionate amount of responsibility falling on the mother. I know there are things you can do about this, and I am sure I have talked about this and advocated them myself. But these things do happen.

And I think the issues arise more for the marathon than the sprint. Newborns are very hungry, very demanding, they turn your life upside down, fine. If your dp is trying to soothe a baby who could very well be hungry AGAIN (they are so often hungry AGAIN when they are tiny) and hands it to you, well, fine. But it just creeps into being a thing where Mummy is always the backstop and when the baby is 10 months old and still waking a lot in the night, it's just not fair. Somehow this then creeps into a thing where Mummy is always the one who replenishes the changing bag etc. I don't know why this is. I have not been able to challenge it although I think it is quite logical to say "I am the one who HAS to breastfeed, so could you do the changing bag?" or even "Only I can actually express, so I NEVER want to wash up and sterilise the expressing things".

But it doesn't work like that. It is like everything associated with the baby becomes associated with the breastfeeder. Similarly unfairly, my dp doesn't drive, so I think he should get out in the rain and put petrol in. But no, because it is to do with the car it is to do with me.

The reason why I do not / have not challenged these things is because it sounds so grimly legalistic, tit for tat (ha ha ha nice pun) that I think addressing the matter in that way would cause so much resentment that it would outweigh any benefit.

And this is why I think it should be talked about. This is why I think we should have a culture that actively works on equality for couples when bfing beyond newborns; a culture that works out how it could be done for the mid - to long-term without making women drudges. Otherwise you put the burden of standing up for themselves on individual women and that burden is too great - the cost / benefit analysis of whether to stand up for yourself or not in a relationship so often comes out as "don't bother".

So I think one of the responsibilities of bf-ing advocates is to acknowledge that it happens and do something about it.

The Principal Investigator has written an article about this in the Guardian.

gu.com/p/3kh7q

I agreed with a lot of this

www.theguardian.com/commentisfree/2013/nov/12/worst-breastfeeding-initiative-shopping-vouchers

I see that the investigator refers to schemes in other parts of the world like "free food to bf-ing mothers in India". Completely different! I have no idea how that actually works but I think that, in some forms (not humiliating traipsing around with welfare vouchers for instance) it would be a great idea. If bf-ing cafes actually put full meals on for free - how great would that be! Turn up, see a bf-ing counsellor, stuff you face with good food you did not have to cook, the rest of the day is going to seem a lot easier. Maybe a doggy bag for your toddler's tea. Or would that be over-generous?