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Study analyses financial burden contributing to low rates of breastfeeding

Assessing the financial incentive for higher numbers of breastfeeding, in a bid to improve mother and baby health

Assessing the financial incentive for higher numbers of breastfeeding, in a bid to improve mother and baby health

Breastfeeding has positive effects for infants’ and mothers’ health. Despite decades of public health policy initiatives breast feeding rates remain low in many communities in the UK.


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This randomised controlled study investigated the effect of financial incentives on breast feeding rates at six-eight weeks post-partum.

Ninety two electoral ward areas with rates of below 40% were randomised to be areas in which mothers were offered financial incentives plus usual care (5,398 mother-infant dyads) or just usual care (4,612 mother-infant dyads). Usual care was primarily delivered by midwives and health visitors.

Shopping vouchers worth £40 were offered to mothers in the intervention areas at two days, ten days, six to eight weeks, three months and six months. Mothers were required to sign confirming that the infant had breast milk, which was countersigned by a professional agreeing that they had discussed breastfeeding. Professionals could contact the research team separately without jeopardising the payment if they thought the infant was not receiving breast milk.

Breastfeeding was assessed and recorded by clinicians at the routine six- to eight-week postnatal check visit. There was a statistically significant increase in breastfeeding in the intervention group (37.9%) compared to the usual care group (31.7%) although no difference in breastfeeding initiation or rates of exclusive breastfeeding at six to eight weeks. Financial incentives offered a modest benefit in areas with breast feeding rates below 40%.


Relton C, Strong M, Thomas KJ et al (2018) Effect of financial incentives on breastfeeding: A cluster randomized clinical trial. JAMA Pediatrics. 172, 2, e174523.

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