Dear Lactnetters:

In 1991 or 1992, the USDA supported a number of demonstration projects
to specifically test whether providing incentives (material goods)
increased the initiation and/or duration of breastfeeding.  I believe 6
or 7 projects were funded (one in Northern Kentucky).  Of these
projects, only one found a positive impact.  This project had already
been providing incentive items to moms for different parenting
behaviours, and it was easy for them to incorporate breastfeeding into
their services/incentives.

In all of the other projects, incentives did not make a difference.  In
chatting with my friends who coordinated the project in Northern
Kentucky (greater Cincinnati area), they said there were several
problems:

1)  There were lots of reasons moms chose their infant feeding method.
For most of them, getting stuff was not a big incentive.  One mom noted
that she was not going to be 'bribed' to breastfeed.

2)  Getting the items themselves were very difficult and time consuming.
In order to get something 'big' that would be an incentive (like a crib
or a tv), they either had to be purchased or donated.  Then, they got
into lots of problems with conflict of interest, businesses not willing
to donate on a REGULAR basis, etc.  (they would give one item one time,
but not every month!).

3)  Lots of the target clients actually had a lot of small material
items and didn't need any more.  Instead of material goods, what clients
really needed was help in learning breastfeeding and support for
continuing.

4)  The material items that clients really wanted/needed were things
they needed for breastfeeding right away (nursing bras, breast
pumps)--such items don't work well to reward duration.

I believe that the final report of the USDA project is available from
the National Maternal and Child Health Clearinghouse:
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IMHO, we do better increasing WIC breastfeeding rates when:

1)  We get all of our health care providers updated and supportive with
breastfeeding (WIC, Maternity, Home Visiting, Hospitals, pediatrics,
etc.);

2)  We have a home visit within 2-3 days of birth or hospital discharge;

3)  We get the bf message out to the community -- perinatal drug
recovery programs, pregnant girls homes, halfway houses for pregnant
women, churches, community centers, etc. where our clients hang out.
Businesses, too -- Walmart, corner grocery, thrift stores, medical
clinics, etc.

We have had a lot of success with "rock and relax" areas at county
festivals and the Kentucky State Fair.  Events like Breastfeeding Baby
Showers etc. help moms feel good about what they have accomplished, and
gives them a party, a celebration, without the sense of a "bribe".

So, IMHO, have your friends write a grant to put on staff/community
education, throw a party, put out a newsletter, purchase client-targeted
educational materials, etc.

Good Luck!!!

--Doraine Bailey
Lexington-Fayette Co (KY-USA) Heath Department
(still promoting breastfeeding in WIC after 10 years!!)

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