Milk Money

British women have a poor rate of breastfeeding, one of the lowest in Europe. Breastfeeding is generally a Good Thing, providing total nutrition and some immunity to small babies. However, we now live in a culture where women of reproductive age are often working and pressured by necessity to return to work after giving birth; where breasts are largely seen as obscene sex melons; and where formula feeding is marketed as a magical solution to a happy baby.

Breastfeeding is not easy to establish. Very few women are genuinely physically incapable of breastfeeding. However feeding through the early weeks where it hurts, where your baby may be latching wrong and before milk supply is fully established is bloody hard. And there is shockingly little support available to women who struggle. My sister in law had problems latching her first baby, due to flat nipples and a tiny baby mouth. The midwives could only suggest she continued to express and bottle feed her baby. However, my sister in law didn't give up, and managed (after about five days) to successfully feed her daughter. She has had no problems since, but many women feeling awful after giving birth, with very little support and with the constant Magic Cure of formula on offer would give up.
And who can blame them? Giving birth, especially for the first time, is a huge bodyshock, leaving women feeling vulnerable, sore and disjointed. Breastfeeding publicly can be a matter of some embarrassment, even in front of family members. Facebook deletes photos of breastfeeding mothers as obscene. Women don't remember seeing their own mothers breastfeed. Some women perceive breastfeedng as physically repulsive, and don't want to do it. That is the world we live in.

So, the government has come up with a great idea(!) Why not PAY women to breastfeed? Up to £200 in vouchers are available, if you feed til 6 months, in increments. They can't be used on formula, but other than that there's absolutely no way of checking the women in receipt of it are actually breastfeeding, except trusting to the word of a midwife. Midwives stop seeing most new mothers within two weeks of birth. How many of them are actually going to have time to confirm their client is still breastfeeding?
How about, instead of bribing women to breastfeed (or pretend to breastfeed), the money be invested in better support? The most support I got when establishing feeding with my eldest was a booklet from the NCT, which is a charity. The NHS provided support amounted to having my baby shoved head first onto the boob. It's not the midwives fault - they don't have the staffing to provide the time. Sometimes, all a new mother needs is someone to sit and watch them feed, offering reassurance, for an hour.
How about the money be invested in better education? Women are led to believe that breastfeeding is one constant arc of rainbows. There's no education about how to know whether the baby's getting enough, when latching is wrong, what cluster feeding is and how to work with it, how to ease sore boobs, when how to recognise mastitis. It's currently left to trial and error, or personal research, and not knowing makes a new mother feel abandoned, confused and failing.
How about investing in making breastfeeding culturally normal? No woman should feel like they have to go and hide in a toilet to feed their baby. No woman should panic-wean as returning to work looms around the corner. We see women give birth in screaming agony in soap operas, but there's no follow up of a woman weepily feeding a child in her pajamas three days later (unless she's got postnatal depression, or some other plot device). Feeding babies is culturally invisible, even though all babies need feeding at very frequent intervals, by some means.

A breastfeeding incentive amounts to large amount of spending, for very little reward. The money could be usefully invested in so many other places, with the aim of increasing breastfeeding rates. This is an excellent example of throwing money at a problem rather than treating the root of it. The only positive point I can see is that, if a midwife needs to continue her relationship with the mother for longer than normal to ensure the money is given correctly, women might actually start getting better postnatal support.

PS: This is not an attack on formula feeding, but on the way breastfeeding has become culturally marginalised, or at the extreme, reviled, and how it will take more than a cash incentive to fix that. You feed your baby how you see fit.