Yesterday, when the breastfeeding vouchers story hit the headlines, I reacted – like many others – with sheer outrage. Being paid to breastfeed? Nuts! How on earth would that help you get through the pain, the tears, the blood and sweat and sheer agony at 3am in the morning? According to research the UK has one of the lowest rates of breastfeeding by 6months despite an initially high take up straight after birth. Due to the many proven benefits for both mum, baby – and the NHS – there is a desire to encourage breastfeeding and try to halt the rapid drop off . Apparently only 1% of babies are exclusively breastfed at 6months. I would be interested to know the figures at 12mo.
From speaking to other mums – both yesterday and previously – it was clear that where they’d benefited (or not, as was the case) was from excellent local support and advice. Whether through midwives, Health Visitors, GP, peer supporters, lactation consultants or local groups. However funding for this sort of support and advice is often threatened and there does not seem to be enough to go round. Therefore my logic was simple – instead of “paying” women to breastfeed, why not put that funding into support and advice?
That’s where I went wrong with my thinking! The media had us so hepped up with outrage that I missed a crucial piece of information. This is a scientific study to look into the benefits of financial incentives to increase breastfeeding rates. It is NOT government policy – they are not taking money from funding to support this. In fact, it shows some forward thinking on the behalf of the NHS to test out a potential plan before then rolling it out willy nilly – so that it doesn’t waste time and money. After a lengthy debate on twitter and reading this well written piece, the following question really had me thinking:
If it does increase rates, will I still disagree with it?
Well no, obviously not – that would be rather shortsighted of me! However this is where my thinking is going about all of this.
- Raising awareness of breastfeeding in the media and generally – this can be no bad thing. Breastfeeding – and extended breastfeeding seems to have an extremely negative perception in this country. Why, I’m not sure, but it seems slightly crazy given the access to bare breasts in traditional media (Nuts, Zoo and Page 3 – yes, I’m looking at you). Ah yes, because breastfeeding is not sexy, it’s not a way of selling something. They’re being used for something other than titillation (!)
- More motivation to breastfeed – the money – £200 in vouchers is not given in a lump sum. It’s weighted – an initial £120 amount and then smaller amounts of £40. That’s a decent amount to some people – and something I can’t relate to because I’m in the fortunate position of not being reliant on £40 to pay for crucial food, bills, medication, nappies, childcare, rent etc. So instead of sneering at this amount, I actually feel a bit ashamed – although I do think the amount seems paltry given how much breastfeeding does. So anyway, it will encourage people to feed for longer to get that extra money to pay for much needed things. (I am sorry if this sounds hideously patronising, I don’t mean it to be, it’s tricky to write without sounding like a hideously middle class guardianista)
- More demand for support as a result – if people are wanting to BF for longer, they are also going to requite some more support. This will place demand on already over-stretched local services. Hopefully if the scheme is rolled out nationally they will be forward thinking enough to look at this issue and put in place more funding for specialist midwives, consultants and training peer supporters etc.
- Placing a visible value on breastfeeding – logically, something that you have to pay for always seems to have more value than something that is free. Which is slightly bonkers when it comes to breastfeeding, but does make sense. For example, the purchasing value of breastmilk – for milk banks etc within hospitals (unless they receive donations of milk – which I encourage anyone to do) is around £1 /ml. I used to pump for Baby Thor for nursery – approx 300ml a day. Thats £300. I have pumped upto a litre a day. That’s a lot of money and a lot of milk. Perhaps this will contribute to changing perceptions also.
- Will it really result in sustained breastfeeding rates? I am uncertain about this. I can see an increase in initial take up of breastfeeding, particular in areas where breastfeeding may not be the norm. But, to be blunt, breastfeeding can be really bloody demanding and exhausting. I don’t think people continue with it because of the savings on formula or whatever. Will money be enough without the support alongside to encourage people. This leads me on to….
- Further demand on overstretched resources… The mums on the scheme will not have to “prove” that they are breastfeeding, they will simply be asked by the midwife or health visitor. However if the mums are determined to continue breastfeeding, they may well need local support to check latch or positioning, to diagnose what can be very complex tongue and lip ties, to advise on thrush or mastitis or blocked nipples, to help with advice on feeding public, being bitten and anything and everything in between. If this support is not there, will the money be enough to help mums persevere through difficult times?
- Guilt…Failure…Giving Up. Words I have heard from so many friends and other mums who have not achieved their breastfeeding aims. It saddens me so much. How will this scheme combat this and not end up putting even more pressure on mums during a difficult and sensitive time? Breastfeeding is hard. If I was struggling and having various issues, wouldn’t the pressure of knowing we were reliant on the money make me feel even worse. And if I gave up and we lost the money? What message does that send to women – to other mothers and mothers to be? Its leading to a sort of not only have you “failed” (and I don’t agree with that term but it’s one that is used) your child but you’ve also lost out on money. I have many concerns about this.
In summary, this is just a study – and with a very small number of mums – 130. I would like to hope that we’ve slightly got the wrong end of the stick about this study. That alongside the financial incentives there will be decent, specialised, local support from appropriate people who can help these mums. In my opinion, on the whole, breastfeeding support very much needs a holistic approach. A mum may have a very obvious physical problem but helping and encouraging her with whatever she wants to do needs a much broader approach – often psychological and supportive – nurturing even. Information and guidance is one thing but sometimes a friendly face and a cup of tea is another to support her on her breastfeeding journey.
I hope one day that breastfeeding won’t be a point of discussion. People either do or don’t – it’s their choice but there is support and help if needed.
Just my thoughts, let me know yours.