BBC News today includes coverage of a pilot scheme targeting deprived communities in the north of England which aims to better understand the barriers to breast feeding in those communities, and to inform future public health interventions to increase take up rates (http://www.bbc.co.uk/news/health-24900650). The evidence of a link between deprivation and comparatively lower rates of breast feeding is clearly laid out in the article, and the rationale for the pilot study is further developed in the Guardian (http://www.theguardian.com/lifeandstyle/2013/nov/12/researchers-offer-shopping-vouchers-breastfeed). The benefits to both mother and child of breast feeding for at least the first six weeks of a new baby’s life have been established beyond any doubt (you can find a succinct summary of them here : http://www.publish.csiro.au/?act=view_file&file_id=NB05011.pdf). It is beyond reasonable doubt that baby’s who are breastfed for at least this period of time are at a reduced risk of developing a whole raft of childhood complaints including asthma, eczema, chest infections, tummy bugs, and colitis. For mothers, breastfeeding speeds post-natal recovery and reduces the risks of pre-menopausal cancer
The study in the north of England will provide a financial incentive to mothers who breastfeed for 6 months following birth that will amount to shopping vouchers with a total value of £200. These will be released in a staged way, designed to encourage initial take-up and then to incentivise sticking with it for the whole period. The Royal College of Midwives has expressed some reservations about the use of financial incentives to encourage breast feeding, citing the reduction in midwife and health visitor posts within the NHS as a more pressing issue to be addressed if real progress is to be made in improving child and maternal health in deprived communities. That is a good point, well made; but is beyond the scope of a research study to address on its own
What has really struck me about this story is not the validity of the arguments, nor the ethical debate around whether financial incentives in this context are right or not. The thing that I have found most troubling (and which has actually caused me to seriously question the sort of society that we are currently becoming) is the nature and vitriol of the comments below the BBC story. I strongly encourage you to have a look. I used to think that the spoof Message Boards feature in Private Eye was exactly that – a spoof, something so extreme that it couldn’t possibly happen in real life (http://www.private-eye.co.uk/index.php). How wrong was I!
The prejudice, ignorance, and plain mean-spiritedness of the vast majority of the comments is utterly depressing. It’s not an exaggeration to say that a little piece of me died reading them