Ethically spending a million pounds on useful research

Does offering financial incentives encourage mothers of newborns to breastfeed? While this may seem incredulous, a study actually was implemented in parts of England to see if this would be the case.

More than 10,000 mothers across regions such as South Yorkshire, Derbyshire and north Nottinghamshire took part in the trial, where mothers were given a hundred and twenty pounds if they breastfed their babies, and a further eighty pounds if they continued up to the point the babies were six months old. That is to say mothers received two hundred pounds if their babies were breastfed up to the age of six months.

But why was this implemented in the first place? One of the reasons the study was done was to see if financial incentives would help raise the rate of breastfeeding in the UK. In some parts of the UK, only one in eight babies are breastfed past eight weeks. The early suspension of breastfeeding causes later problems in life for babies, and this was a study to see if it would be possible to save a reported seventeen million pounds in annual hospital admissions or GP visits.

How were these women chosen? They were picked from areas which were reportedly low-income ones. There was a suggestion that in low-income areas, mothers feel obliged to return to work quickly and breastfeeding is inconvenient and a reason why mothers stop it.

The financial incentive did result in a rise of six percentage points, from 32% to 38%. This meant that over six hundred more mothers in the ten thousand breastfed their babies for up to six months instead of the hypothetical eight week line.

Should we get excited about these results? Caution is to be exercised.

As a few leading academics noted, there was no way to monitor a reported increase. The mother’s word was taken at face value but there was no way to monitor that a prolonged breastfeeding period actually took place. It would not be inaccurate to say that of these six hundred mothers, some merely reported they had breastfed for longer but without actually doing it. If you live in an income-deprived area, and were offered two hundred pounds of shopping at a time when you needed it, without having to do much apart from saying “Yes, I breastfed”, wouldn’t you take the easy money?

It was mentioned that if the results did have a high percentage of trustworthiness to them, in other words, if mothers breastfed as they said they had done, it would help normalise breastfeeding in regions where it might cause embarrassment to the mother. Why might breastfeeding cause embarrassment? For example, in some social situations it might be slightly awkward to reveal normally covered parts of the body in public.

How much did the scheme cost? If we assume that 38% of 10000 mothers breastfed and claimed these financial vouchers, that’s around 4000 mothers each claiming two hundred pounds, at a cost of eight hundred thousand pounds.

Wow. Eight hundred thousand pounds of free shopping for which an outcome cannot be undisputably proven. Where does all the money come from?

The Medical Research Council was funded to the tune of up to seven hundred and fifty-five million pounds in 2016/17, or which nearly half was provided as grants to researchers. But while all that may sound as a lot of money, surely there should be more accountability in how the money is used. Using up nearly a million pounds of that money for a trial whose results cannot be justified is not a good use of money.

But perhaps the babies’ height, weight and other factors pertaining to breastfeeding could have been taken? For example, if we know that breastfeeding has benefits in certain areas, such as in growth charts, perhaps the babies that were breastfed in that study could have been measured against babies who had not been breastfed to see if there had been any positive gain, and something that could correlate to breastfeeding over the six month period?

Imagine if this had been a study about literacy. Imagine that mothers who read two stories to their child up to the age of four years would receive two hundred pounds. Surely, at the end of the period, the research scientists would not merely be going to the mothers and saying “Did you read to your child? Yes? Here’s two hundred pounds.” They would try to assess the child, perhaps by means of a literacy test of some form, to see if any reading had actually taken place.

Otherwise it is just money down the drain for results which cannot be proven and cannot be relied on. In that case, what is the purpose of spending money on hearsay?

Did giving eight hundred thousand pounds encourage mothers in income-deprived areas to breastfeed for longer periods? Who knows? The only thing we can be sure of is that eight hundred thousand pounds made them say they did it.