Tuesday, 12 November 2013

£200 to breastfeed a baby?

A new scheme is being rolled out to incentivise new mothers to breastfeed their babies, rather than giving them formula. According to the BBC, mothers in selected areas of Sheffield can earn £200 by breastfeeding their newborns for six months -read the story here.

This raises several questions in my mind.  
1) Who, if anyone, will be susceptible to such an incentive?  2) What sort of cost analysis has been carried out,  to enable the NHS to decide that £200 was an effective amount to pay - are they thinking it will save them money? 3) How on earth are they going to verify which mothers have fed in the right way for the right amount of time? And finally, 4) how come noone wants to hit me with two hundred big ones?

1) On the first question, I guess the targets are not women who already badly want to be able to breastfeed but fail, and feel desperately guilty about it. It must be women for whom £200 is a sufficiently large pay off to justify weeks and months of potential pain, frustration and embarrassment. It will be very interesting to see what the results of the trial are. I assume that the targets are women who might have an easy time breastfeeding, but who for whatever reason have never really thought about giving it a go before. It is hard to believe that many such women exist, given the very visible efforts that midwives have made in recent years to advertise and advocate breastfeeding already.

One thing that I haven't heard many people talking about is that breastfeeding is massively a class issue, in this country at least. There must be an interesting historical explanation that I'm not aware of, but my extensive and very official research* has shown that middle class mummies are much more keen on wearing slings and shoving their nipples into little one's mouth, while working class ladies work their prams and think bottles are best. Is this a correlate of my other experimentally-observed "fact", which is that those who are without money tend to assume that things that cost money are better than things that do not? Interestingly, my research suggests that things may be reversed in South Africa, where the whipping-out of boobies is something more done by the poor**. Interestingly, mr interweb also tells me that rates of breastfeeding are much lower among african american mothers than in other american racial groups (wait I actually have things i can cite for that bit here and here). Anyway the £200 prize must be aimed at poorer mothers, if only because that isn't much money to most people, not for something you'll do 5-8 times a day for 27 weeks.

*Lies, lies, she's making it up, she only spent ten minutes looking round a children's centre.
**This claim has been inducted from one ambiguous comment made by one south african person and ought not to be trusted any more than the rest of them.

2) So how was the princely sum of two hundred squids arrived at? Breastfeeding already saves a family money. Mr interweb says it costs about £240 to buy formula for six months worth of feeds. That doesn't include bottles, sterilisers etc either. However, child benefit at £80 per month covers this, and probably nappies too. So low income mothers may not think of these costs as really coming out of their pocket.
In any case, supposing that £200 is sufficient to persuade a reasonable number of women to put down the scoop, someone presumably thinks that all of this will save the NHS money too. Given that science seems to be rather reluctant to come up with hard evidence of clear medical benefits of breastfeeding (although maybe the formula industry has just been very effective at constructing counter-evidence), what is this based on?

3) How will mothers be required to prove that they have breastfed for six months? Will they be expected to perform in front of an audience? Are there any tests, of mother and/or baby, which can determine the lactational history?Must it have been exclusive breastfeeding, or just the odd suck here and there?

4) I hit the six month mark a few days ago. I must say, even though I had a fairly easy time of it (give or take the odd bout of mastitis), the main reason I kept it up was convenience. Who wants to go downstairs on a cold autumn night and mess about with bottles and microwaves? Who is organised enough to manage to take the right amount of milk at the right temperature etc when they head out the door for trips of unknown duration? Thats, like, magic! At this stage I thought i'd be really happy to say goodbye to the nipple torment, to wear normal clothes again and most importantly to surrender permanent personal responsibility for my boy's good mood. But now we've come this far I can't imagine switching the ease of lifting my top up for fiddling about with cartons or measuring out powder. I might permit Ors the odd glug of formula here and there, to facilitate some fridge-less daddy time. In fact, I'm quite amenable to the idea that there might be some ingredients in formula (DHA and ARA) that i'd quite like included in the chunkster's diet on occasion. Nonetheless, i've been a dutiful and exclusive milk cow for six whole months now, with the sore nipples, baggy tops and addiction to candy crush to prove it, and if anyone would like to pay me £200 right now I will happily say HELL YEAH : )

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