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Postnatal care, not vouchers, will increase breastfeeding rates

02 December 2014
Volume 22 · Issue 12

It is well known that in the UK, despite initial breastfeeding rates being relatively high, maintining these rates are a problem; the amount of women continuing to exclusively breastfeed past 6 weeks is dramatically low. In 2010, the Infant Feeding Survey found that the initial breastfeeding rate was highest in England at 83% (compared with 74% in Scotland, 71% in Wales, and 64% in Northern Ireland). However, exclusive breastfeeding at 6 weeks dropped to 24% in England and 22% in Scotland, compared to 17% in Wales and 13% in Northern Ireland (Health and Social Care Information Centre (HSCIC), 2012). There is a strong correlation between age, socioeconomic status and breastfeeding, with younger women in deprived areas being less likely to breastfeed than women in areas of low deprivation (HSCIC, 2012; Relton et al, 2014). The benefits of breastfeeding to the health and wellbeing of the mother and baby and to the NHS are well established; therefore, it is important that midwives and health professionals alike find ways to help increase these figures.

A study published in the Lancet this week, detailed a controversial scheme in which financial support was offered to new mothers to incentivise them to breastfeed (Relton et al, 2014). The support, in the form of vouchers for supermarkets and high street shops, was offered to new mothers in a few areas in South Yorkshire and Derbyshire, which have low 6–8 week breastfeeding rates. It was hoped that offering vouchers to mothers will increase the prevalence and duration of breastfeeding (Relton et al, 2014). Preliminary results were encouraging and found that of the 108 women eligible for the scheme, 58 (53·7%) joined. Of which, 48 (44·4%) claimed 2-day vouchers, 45 (41·7%) claimed 10-day vouchers, and 37 (34·3%) claimed 6–8 week vouchers. Data for 3- and 6-month rates are still accruing. Both the health professionals and the mothers participating in the scheme were very satisfied (Relton et al, 2014).

While the preliminary results were positive, it is unclear whether this is due to the financial incentives or the additional support the women received. One of the statements that came out of an interview with a mother who participated in the scheme was: ‘It's that support network, not the money, that spurs you on to continue’ (Dreaper, 2014). With midwifery services so underfunded and under-resourced, surely the money would be better spent on postnatal care so midwives can dedicate more of their time providing these essential ‘support networks’.

There is evidence to suggest that support from a skilled health professional can have a positive effect on women's initiation, duration and experiences of breastfeeding (Spilby et al, 2009). From personal experience, I know how invaluable one-on-one breastfeeding support is—I was one of the lucky ones, I left hospital (armed with some scribbled notes from my midwife that I could refer to when I got home—I still have them) having had fantastic care and support with breastfeeding and I went on to feed my little girl exclusively for 5 months. However, not everyone is so fortunate. The Royal College of Midwives is concerned that due to staff shortages women may not be getting the postnatal support they need from midwives while they establish breastfeeding in the early days after birth. So maybe we need to be more innovative in our approach to breastfeeding support and remember it's the little things that make the difference to mothers.