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Study predicts when breastfeeding financial incentive schemes will succeed


Should mothers be given vouchers to encourage them to breastfeed? Public opinion is divided as to whether such financial incentive schemes should exist, but a health economics study has explored when they would be effective.

Breastfeeding rates in the UK lag behind those of similar countries. This worries healthcare professionals because breastfeeding promotes the health and prevention of disease in both infant and mother in the short and long term. So lower rates mean an increase in preventable illnesses – such as chest and ear infections in babies, and breast cancer among mothers – and in associated costs.

Researchers from Brunel University London, together with collaborators at the Universities of Oxford and Sheffield and in the Netherlands, are the first to apply a technique called discrete choice experiments to the topic of financial incentives for breastfeeding. They explored the preferences of 562 women from South Yorkshire, who chose between various scenarios carefully designed to expose how much they liked or disliked various possible attributes of a financial incentive scheme.

This way, the researchers tested preferences for duration of breastfeeding, the maximum amount of a financial incentive, the type of financial incentive, and who would need to provide a signed statement to verify the breastfeeding had taken place. Responders were also provided with scenarios that included an option of no breastfeeding.

“Previous research led by Brunel showed that breastfeeding for longer could save the NHS £11 million a year,” said Dr Nana Anokye, from Brunel University London's Health Economics Research Group (HERG), “so we needed to explore ways to encourage mothers to continue breastfeeding.

“Our new study controlled for various characteristics about the individuals we studied, including their socioeconomic background. When we did this, we found that financial incentives could be an acceptable and effective way to improve breastfeeding.”

The study discovered that individual characteristics can influence women's preferences for a financial incentive scheme, so there are predictors that can help healthcare organisations decide how to design future programmes – and types of incentive that are more likely to work.

Dr Frauke Becker, from the University of Oxford, commented: “If women were living with their partner, had breastfed before or intended to breastfeed for longer than 6 weeks, and from lower socioeconomic groups, they preferred the incentive scheme to the option of no breastfeeding.”

Additional findings include:

  • Overall, participants preferred a longer breastfeeding duration of 6 weeks.
  • Participants preferred gift packs in comparison to cash transfers or high-street vouchers, and vouchers for local shops the least.
  • There was a strong positive preference for higher values paid as an incentive, including the highest two choices of £240 and £600.
  • Decisions to participate in the scheme aren't affected by the choice of who signs to verify breastfeeding has happened.

“Financial incentives are an effective approach for helping women continue breastfeeding in areas with low breastfeeding rates,” said the University of Sheffield’s Dr Clare Relton. “However, many factors need to be taken into consideration in their design.”

'Women's preferences for alternative financial incentive schemes for breastfeeding: A discrete choice experiment', by Frauke Becker, Nana Anokye, Esther W de Bekker-Grob, Ailish Higgins, Clare Relton, Mark Strong and Julia Fox-Rushby, is published in PLOS One.

(Image: CC by flickr/archangeldeb)

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Joe Buchanunn, Media Relations
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