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?

"What about the women who would like to breastfeed but simply can't?"

There are already schemes in place for these women.

In our area we have a breastfeeding clinic every single day of the week somewhere in the borough.

There are also three national helplines, and volunteer peer supporters and breastfeeding counsellors in most areas.

You'd be amazed at the number of mothers who struggle with breastfeeding who for some reason choose not to access ANY of this help, despite saying they have really struggled with breastfeeding.

I'd hope that in the areas where this scheme is being launched, there is also in place other support for breastfeeding mothers.

biryani - glad to see that tiktok has replied to you - great post tiktok
Glad to see this thread getting the facts out there to those who've perhaps not seen them plainly put before.
There's obviously lots more work to be done in this country to make sure that all women know the facts about the benefits of breast-feeding - and therefore the comparative risks of FF. Then women can make truly informed choices about what is best for them and their babies.

Mumraa - are there? Studies showing that formula feeding is better than breastfeeding? Where?

I can only think of the studies into HIV, and even then more recent work shows that truly exclusive breastfeeding gives the best outcomes.

Unless there is a medical reason, I can't understand why breastfeeding is being described as hard.

It can be tiring in the early days but unless you are unwell, have been unwell and are recovering, or there is a physical disability with you and/or the baby that prevents breastfeeding or makes it very difficult to do, then breastfeeding is not had. I do take on board their may be certain mental health issues that could also make it difficult to breastfeed.

I don't think anyone should be paid to do it. People should be encouraged to do it by making more facilities available for those that are not comfortable in breastfeeding in public.

Personally, I discreetly fed everywhere and anywhere but understand that some women don't want to feed in front of others and that may be a reason not to breast feed.

More education in schools and at hospital check ups is where I would rather see money spent, than on paying people to breastfeed which cannot actually be proven!

DaddyThunder - 'booby pump'????

Choice of vocab. aside, if people are uncomfortable with the idea of women being incentivised to bf, how much more are they going to react to being incentivised to pump???

If women are made to feel bad because their babies cannot latch on, then you are describing poor maternity care - hope you complained if it happened to you/your DW.

It's aimed at the mothers who wouldn't contemplate breastfeeding.. that's all. All I'm reading is waaaa I couldn't/wouldnt/didn't want to what about meeee I want mine it's not fair.. its discrimination.

If they were rolling out free formula for all.. There wouldn't be half as much outrage and the insults that breastfeed mothers have to put up with would have one more thing to be at the with.

I don't agree with any voucher scheme.. support should come first and foremost to help the ones who want to breastfeed but are finding it hard going. When that's established then maybe.

"Tiktok there are many studies stating that breastfeeding isn't always best too."

That's what 'reviews of the evidence' are for though.

They look at a range of studies - how they're constructed, numbers involved, how funded etc. And they look at where the weight of the evidence falls. In the case of infant feeding the weight of the evidence falls very heavily on the side of breastfeeding as being the healthiest way of feeding a baby.

"but there's not much saying "if you can't breastfeed, here are some other options".

Given that the majority of babies over 2 weeks old in the UK are having formula milk, and given that a mother will have seen much more bottle feeding and formula than she's ever likely to have seen breastfeeding, I think it's fair to say that most people know that if you can't breastfeed you can feed your baby formula.

I tried to breast feed but due to cists around my nipples (sorry if TMI!) I just couldn't, it was incredibly painful and my DS wasn't getting a sufficient feed. My HV told me to stop after 10 days. I was in a real state, felt so much pressure to breast feed despite the extreme pain and getting so wound up about it. I felt like a failure of a mother.
Luckily I had a wonderful HV who just said the possible detrimental impact of me continuing- given how it was making me feel, and ending up struggling to bond with DS or with PND- just was not worth the risk.

With DD I was then pressured once again despite telling them what had happened previously and the issues with my breasts. I was told told I 'didn't stick with it long enough' and 'must be very sensitive to pain and need to just bear it'.
I did it, lasted about 7 days and then stopped as it really was horrendous and making me absolutely miserable and it was affecting my bond with DD.
This was all 20+ years ago, and pressure has been hyped up even more since then.
I find this scheme absolutely ludicrous and disgusting. Yes breast feeding is best, BUT for some it just isn't possible and pressuring mothers into it can lead to far worse consequences of PND. Bottle feeding isn't harmful for the baby, and shouldn't be dressed up that way. Mothers have a right to free choice and no stigma should be attached to either breast or bottle feeding.

*be beaten with

minifingers I haven't looked at this myself, but an article along these lines won an award from the Royal Statistical Society for excellence in statistical journalism so I place some weight on this.

Link to the article is here but behind a pay wall unfortunately:

www.rss.org.uk/site/cms/contentviewarticle.asp?article=592

I don't think it's anything to get angry about. For one, its just a pilot testing out the efficacy of this isn't it? If it works, that's great. If not, move onto something else.

It's true that more support is also needed for new mothers who want to breastfeed.

However I think there's a significant number of mothers who simply choose not to for cultural reasons, not because breastfeeding can be hard. If you want higher breastfeeding rates, it's finding a way to tackle that cultural change that's important. IMHO.

I have to say I'm not sure how they're going to measure/test this though. Will be interested to see!

No no no. Terrible idea.

The money should be spent on better access to qualified lactation consultants (especially people trained to spot tongue tie). This might mean more women who actually want to BF are able to do so for more than a few days.

I realise the idea of the vouchers is to get breastfeeding up amongst mothers who have never even intended to try it. However I think those mothers will not be persuaded by vouchers either. At best they will give it a token go in hospital, grab the vouchers and then revert to bottle ASAP.

Whereas, if we give better support to women who actually want to BF, so that they can and do carry on BFing, then longer term and public BFing would become much more common. This might have a positive influence on the women who currently don't even consider BF, as it would mean it is more common to see a woman BFing and there is less of a "yuk" reaction. It would also mean there are fewer tales of bleeding nipples, constant feeds and weight loss to scare women away from the idea of BF. So IMO supporting women who want to BF may actually help get BF rates up among those who currently don't even try it.

Free chocolate hob nobs for breastfeeding mothers would be a good idea though

This would have been great for me! Especially if there had been an hourly rate, or a long service bonus. Ended up BFing dc1 for 2.6 yrs, dc2 for 13m and dc3 for 4yrs .

No axe to grind at all, just appealed to my lazy side (couldn't be arsed with all that formula and sterilising) and didn't really know (with 1 and 3) how to extricate myself without upsetting dc. (Dc2 started biting me, so BFing swiftly terminated by mutual agreement ).

Sunday you're really lucky that you didn't find it hard. I think the reality is that this is the minority situation. Whatever the NHS' line is, most people I know have found breastfeeding excruciatingly painful at some point in the first few weeks. This time round it was not just my nipples that were sore but my uterus contracting each time I fed that made the first fortnight a total misery.
gamerchick if you read the whole thread, I think there's little of that at all - both from those people well off enough to admit that £200 wouldn't make much difference to their household budget over 6 months, and from those saying that they would have found the money useful - the general view isn't that 'it's not fair' because they as individuals didn't receive the money.

Lackingideas, you have linked to a newspaper article not a study.

The article assessed the statistics - I know the article and the journalist was correct in her point that evidence 'for' breastfeeding is sometimes overstated mostly because too many people don't understand statistics. The other aspect is that sometimes 'benefits' are impossible to quantify in individuals, but only show up across populations.

I don't know of any studies that show formula feeding is 'better than' breastfeeding - do you?

1. It encourages people to lie in order to get the money.
2. Women often feel guilty about not BFing, now they can feel like they are letting their families down financially too.
3. There are too many grey areas in infant feeding - the rules are going to be very complex about who is entitled to the money and who is not - let alone proving what someone feeds their own child in the privacy of their home.

"There's obviously lots more work to be done in this country to make sure that all women know the facts about the benefits of breast-feeding - and therefore the comparative risks of FF."

I think it's going to be very, very hard to do this. Maybe impossible, especially while we have a huge, flourishing and expensively and widely marketed infant formula industry.

People are very, very resistant to the idea that formula feeding may put babies at risk of ill health. Resistant to the point where the very mention of it on this board within the context of a sensible and sedate discussion of infant feeding issues, can result in an outbreak of hysteria on the boards. And if you referred to this issue on Bounty, Netmums, or iVillage, or most of the other boards, no matter how politely or how relevant the context, you'd be banned very quickly. I got banned from Bounty about 7 years ago for putting a link to a leaflet, produced by the midwives information service, MIDIRS, that says this: "Formula milks and bottle feeding equipment are not only an added expense but are known to carry increased risk for infections and other illnesses, and in rare cases, even mortality." leafletsummary

My DC were born in a 'deprived' area. I was treated like an oddity for breast-feeding.

The so-called breast-feeding mafia haven't extended their reach throughout the country.

In many areas, 'bottle is best' is the over-riding message from family and peers. The midwives and HV I met didn't mention breast-feeding to me and expressed surprise when I stated I would be EBF.

"You'd be amazed at the number of mothers who struggle with breastfeeding who for some reason choose not to access ANY of this help, despite saying they have really struggled with breastfeeding."

I was one of those mothers with my first 2 children. I can only speak for myself, but it was down to my emotional state at the time, I felt inadequate, embarrassed and I didn't want to take up somebody's time if I wasn't going to succeed but rather than just switch over to FF I felt obliged to continue struggling with BF until I found it unbearable. I struggled on for a good 6 weeks with both of them feeling quite desperate until I finally hit the wall and FF. With DS3 I just was so much better emotionally even though the birth was by far the worst and he had tongue-tie, I was readmitted for a blood transfusion etc etc. I still gave some formula but rather than ending BF it enabled me to carry on longer. He is mostly FF now at 7 months but does still have 3 or 4 BFs a day.

I am really unsure about this scheme, I can't really see how it can be properly administrated and if the baby has 1 bottle of FF and is then deemed mixed fed with that "disqualify" them? If it does mean there is better access in the area for BF as a result of the scheme (more drop-in clinics etc) I can see how that would be a positive, although it wouldn't have made any difference to me to is very apparent from this thread that there is a real shortage of accessible bf support.

Ridiculous idea bribing people into it! Spend the money on more available support for people who need it; I'm still BF my DD who's 15 weeks, I've found it really difficult at times & to be honest it's only the support of family & friends who got me through. I'm 19 & every time I go to the HV they ask what formula I'm using & assume I'm FF, IMO there needs to be tailored information for younger people, the amount of my friends who have had babies & not even tried to BF amazes me sometimes, instead of drumming in breast is best, information & guidance needs to be there for people to encourage them to at least try it for the first few days, if it doesn't work out, fair enough but I set myself the target of if I could do it for 3 days I'd be happy, I loved it & am still BF now, but I'm glad I found the support of a lactation consultant in hospital because the first day I was struggling with getting my DD to latch.

this will be impossible to monitor. We don't have enough well trained health visitors and midwives. Also - many women already have their supply mucked up by the time they leave hospital because so many health practitioners in hospital offer new mums a bottle when they are having difficulty rather than getting them help from a trained lactation consultant. All hospitals need better breastfeeding help in the wards.

Put the money into training midwives and health visitors on dealing with problems that can booby trap your supply and your breastfeeding experience.

Put all formula on free prescription and ban follow on and hungry baby milks. Have tighter controls on advertising and promotion of breast milk, make society aware that breastfeeding is a natural and normal thing and give women the confidence to feed in public.

Most of all stop treating formula like a normal part of baby feeding. Change the way people think about it and start promoting the idea that feeding beyond a year, beyond 2 years is actually normal and that formula is not the answer to all sleep problems.

Absolutely, bleedingheart. There are areas in the UK where the number of women who even start breastfeeding is under 20 per cent. The women who manage this, in the face of often massive hostility, may not breastfeed for long.

MrsCakes - I assume in setting up this scheme (which will be a very small scale and limited to particular areas) they have had detailed discussion of how it can be checked if a mother has continued to breastfeed. My understanding is that health visitors will play a big role in this.

mini: did anyone suggest that the research is worthless?

Most people have a basic grasp, I think, of why breastfeeding is considered better in the first six months or so. You don't need to read the Express or Google to find that out.

But there is a message that breastfed babies somehow "do better" than others. And if this is the message, then it needs to be backed up by properly conducted research that is in the public domai, easily accessible and easily digested by women so that they can make informed, rational choices.

We also need to know what the definition of "better" is. Does it mean that breastfed babies do better in school? Do they get fewer colds? Are they fitter? Do they get better jobs? Apologies for sounding flippant, but we need something a bit more credible than a throwaway statement to h..lp us make informed decisions.

Also - I haven't seen a midwife since DS was 12 days old and my health visitor only came once every week then every two then I saw her at the clinic for developmental check-ups. Are they suggesting a midwife or health visitor call round every couple of weeks to see how it's all going? What help will be offered to people having problems?