Abstract
BackgroundDespite a gradual increase in breastfeeding rates, overall in the UK there are wide variations, with a trend towards breastfeeding rates at 6–8 weeks remaining below 40% in less affluent areas. While financial incentives have been used with varying success to encourage positive health related behaviour change, there is little research on their use in encouraging breastfeeding. In this paper, we report on healthcare providers’ views around whether using financial incentives in areas with low breastfeeding rates would be acceptable in principle. This research was part of a larger project looking at the development and feasibility testing of a financial incentive scheme for breastfeeding in preparation for a cluster randomised controlled trial.MethodsFifty–three healthcare providers were interviewed about their views on financial incentives for breastfeeding. Participants were purposively sampled to include a wide range of experience and roles associated with supporting mothers with infant feeding. Semi-structured individual and group interviews were conducted. Data were analysed thematically drawing on the principles of Framework Analysis.ResultsThe key theme emerging from healthcare providers’ views on the acceptability of financial incentives for breastfeeding was their possible impact on ‘facilitating or impeding relationships’. Within this theme several additional aspects were discussed: the mother’s relationship with her healthcare provider and services, with her baby and her family, and with the wider community. In addition, a key priority for healthcare providers was that an incentive scheme should not impact negatively on their professional integrity and responsibility towards women.ConclusionHealthcare providers believe that financial incentives could have both positive and negative impacts on a mother’s relationship with her family, baby and healthcare provider. When designing a financial incentive scheme we must take care to minimise the potential negative impacts that have been highlighted, while at the same time recognising the potential positive impacts for women in areas where breastfeeding rates are low.
Highlights
Despite a gradual increase in breastfeeding rates, overall in the UK there are wide variations, with a trend towards breastfeeding rates at 6–8 weeks remaining below 40% in less affluent areas
Some healthcare providers viewed financial incentives as a potential ‘connector’ providing an opportunity for them to engage with women about breastfeeding or for women to engage with support services, in children’s centres
Relationships between mother, baby and family and those between mother and healthcare providers lie at the heart of breastfeeding support theory and practice
Summary
Despite a gradual increase in breastfeeding rates, overall in the UK there are wide variations, with a trend towards breastfeeding rates at 6–8 weeks remaining below 40% in less affluent areas. While financial incentives have been used with varying success to encourage positive health related behaviour change, there is little research on their use in encouraging breastfeeding. In recent years rates of breastfeeding initiation in the UK overall have increased to over 80% Despite this positive change, this increase is not reflected to the same extent in breastfeeding duration or exclusivity rates, with only 55% of women breastfeeding at six weeks and only 1% exclusively breastfeeding at six months [1]. This increase is not reflected to the same extent in breastfeeding duration or exclusivity rates, with only 55% of women breastfeeding at six weeks and only 1% exclusively breastfeeding at six months [1] They found that this was more acceptable to those of childbearing age, of non-White ethnicity and to those who had breastfed a previous baby
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