Pediatricians recommend that mothers exclusively breastfeed infants
until at least six months of age because it can reduce babies’ risk
of ear and respiratory infections, sudden infant death syndrome,
allergies, childhood obesity and diabetes.
Mothers can benefit too, with longer periods of breastfeeding linked
to lower risks of depression, bone deterioration and certain
For the current experiment, researchers randomly chose 18 low-income
Puerto Rican mothers to receive monthly cash incentives totaling up
to $270 to breastfeed infants, and compared their feeding habits to
another 18 similar mothers who were not offered cash.
When the babies were six months old, 72 percent of the mothers
eligible for cash rewards were breastfeeding but none of the other
mothers were, researchers report in Pediatrics.
“It has been challenging to help mothers maintain breastfeeding
especially among those who are socioeconomically disadvantaged and
belong to racial or ethnic groups who do not commonly promote
breastfeeding among their members,” said lead study author Dr.
Yukiko Washio, of Christiana Care Health System and the University
of Delaware in Newark.
“Although the study sample was very small, the study provides an
insight on a potential way to motivate mothers to continue
breastfeeding,” Washio said.
Women in the study received services through the Supplemental
Nutrition Program for Women, Infants and Children, or WIC, a
government program that gives healthcare and nutrition support to
pregnant and breastfeeding women and their young kids.
After initial evaluations, researchers assessed whether women were
still breastfeeding by watching mothers nurse babies during
evaluations at one, three and six months postpartum. If mothers
pumped milk for babies, staff observed this and watched mothers feed
expressed milk to their babies.
All of the participants were paid $25 for each assessment, with the
potential to earn up to $100 for completing the study.
Mothers in the cash incentive group could also earn $20 for the
first month of breastfeeding, then payments increased by $10 each
month after that.
At one month, 89 percent of women eligible for cash were still
breastfeeding, compared with 44 percent of mothers who didn’t get
payments. By three months, the same proportion of mothers in the
cash group still breastfed their babies, but this declined to 17
percent of women who didn’t get payments.
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Still, many women supplemented breast milk with formula, and there
wasn’t a meaningful difference in the proportion of women who
exclusively breastfed babies.
One limitation of the study is that it’s too small to detect factors
in addition to cash incentives that might influence whether women
continued with breastfeeding, the authors note.
One concern with payments is that they might coerce low-income women
into breastfeeding when that isn’t the choice they want to make, Dr.
Lydia Furman of Case Western Reserve University and Rainbow Babies
and Children's Hospital in Cleveland, Ohio, writes in an
Women may also need additional support to succeed with
breastfeeding, Furman said by email. Particularly when they return
to work, women need support from home, Furman added.
In addition, the La Leche League, an international organization that
helps women to breastfeed, notes on its website that working mothers
may encounter resistance from their employers when requesting time
and a private space for pumping.
Among other things, women may do better with expressing milk if they
can call the caregiver during the day to speak to their baby or go
down to the daycare and nurse the baby, Furman said. Nursing at
night can also help.
“I personally believe that cash incentives paid to WIC recipients
for breastfeeding can ‘level the playing field’ with respect to
money spent by WIC on the mother-child couple and that they are
ethically defensible and socially responsible,” Furman writes in the
SOURCE: http://bit.ly/2lhnVdY and http://bit.ly/2kk3kHB Pediatrics,
online February 6, 2017.
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