In regions where breastfeeding is infrequent, financial incentives may increase breastfeeding rates in mothers at 6 to 8 weeks, according to the results of a randomized trial published in JAMA Pediatrics.

Researchers included 92 electoral ward regions in England with breastfeeding prevalence <40% at 6 to 8 weeks’ postpartum in this analysis to determine the effect of financial incentives in addition to usual care (n=46) vs usual care only (n=46) on the prevalence of breastfeeding.

A total of 5398 mother-infant dyads were included in the intervention group vs 4612 mother-infant dyads in the group receiving usual care alone. The financial incentive intervention involved the distribution of £40 (US $50) shopping vouchers to mothers at 5 time points based on the age of the infant (2 days, 10 days, 6 to 8 weeks, 3 months, 6 months).

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Following adjustment for baseline breastfeeding prevalence, researchers found a statistically significant difference in average 6- to 8-week prevalence of breastfeeding between the intervention vs usual care groups (37.9% vs 31.7%, respectively; 95% CI for adjusted difference, 2.7% to 8.6%; P <.001).

The investigators found no difference between the groups with regard to the average prevalence of exclusive breastfeeding at 6 to 8 weeks (27.0% vs 24.1%; adjusted mean difference, 2.3 percentage points; 95% CI, –0.2 to 4.8; P =.07) or average prevalence of breastfeeding initiation (61.9% vs 57.5%; adjusted mean difference, 2.9 percentage points; 95%, CI, –0.4 to 6.2; P =.08).

The investigators in this trial had no feasible method for validating mothers’ claims that their babies were being breastfed, as these data were obtained from incentive-driven reports.

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According to the investigators, offering a financial incentive to encourage breastfeeding may help better “communicate the value of breastfeeding and have a positive influence on those who support women, and thus address some of the complex, financial, organizational, and cultural barriers that limit breastfeeding.”


Relton C, Strong M, Thomas KJ, et al. Effect of financial incentives on breastfeeding: a luster randomized clinical trial.  JAMA Pediatr. 2017:e174523. doi:10.1001/jamapediatrics.2017.4523