Should Money Be Used To Encourage Breastfeeding? Interview with:
“Breastfeeding welcome here” by Newtown grafitti is licensed under CC BY 2.0
Clare Relton, PhD
School of Health and Related Research
University of Sheffield, Sheffield, England What are the key findings of your report?

Response: Our five year research project explored whether offering financial incentives (shopping vouchers) for breastfeeding increased breastfeeding. We studied what happened to breastfeeding rates at 6 to 8 weeks post-partum in areas in England with low (<40%) breastfeeding prevalence. Our cluster randomized clinical trial (which included 10 010 mother-infant dyads) showed that areas with the financial incentive had significantly higher rates of breastfeeding at 6 to 8 weeks (37.9% vs 31.7%) compared to usual care.

The financial incentive scheme was widely acceptable to healthcare providers (midwives, health visitors, doctors) and mothers. The financial incentives made it easier for everyone to discuss breastfeeding and mothers reported feeling valued (supported and rewarded) for breastfeeding. What should readers take away from your report?

Response: The results show that ‘valuing’ breastfeeding, i.e. attaching a monetary value to breastfeeding, can improve breastfeeding in areas where breastfeeding is not the norm. What recommendations do you have for future research as a result of this study?

Response: We would like to discuss how valuing breastfeeding in this way can become part of public health policy and help achieve WHO recommendations that all babies are exclusively breastfed up to 6 months of age and partially breastfed to at least 2 years of age. Is there anything else you would like to add?

  • Given that the effect increased over the four quarters of the trial, what would be the long term impact of offering financial incentives?
  • Can financial incentives significantly increase exclusive as well as any breastfeeding rates?
  • How to integrate/synergise financial incentives with existing behaviour change cash transfer schemes (e.g. Healthy Start, WIC)?
  • Should financial incentives be universal or targeted?
  • What would be the full long term impact of offering financial incentives on population health?
  • How to provide objective confirmation of breastfeeding (particularly at 3 and 6 months) when it is required? Thank you for your contribution to the community.


Clare Relton, Mark Strong, Kate J. Thomas, Barbara Whelan, Stephen J. Walters, Julia Burrows, Elaine Scott, Petter Viksveen, Maxine Johnson, Helen Baston, Julia Fox-Rushby, Nana Anokye, Darren Umney, Mary J. Renfrew. Effect of Financial Incentives on BreastfeedingA Cluster Randomized Clinical Trial. JAMA Pediatr.Published online December 11, 2017. doi:10.1001/jamapediatrics.2017.4523

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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