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Acceptability of financial incentives for breastfeeding: thematic analysis of readers' comments to UK online news reports

Lookup NU author(s): Matthew Holmes, Emerita Professor Elaine McCollORCiD, Professor Falko Sniehotta, Dr Jean Adams



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Whilst it is recommended that babies are breastfed exclusively for the first six months, many mothers do not maintain breastfeeding for this length of time. Previous research confirms that women and midwives value financial incentives for breastfeeding, but limited research has explored the wider acceptability of these interventions to the general public. This paper examines opinion towards financial incentives for breastfeeding using reader responses to UK on-line media coverage of a study undertaken in this area.Methods: This study used netnography to undertake a thematic analysis of 3,373 reader comments posted in response to thirteen articles, published in November 2013, which reported findings from a feasibility study of financial incentives for breastfeeding. All articles were published on one of six UK news websites that achieved a monthly audience of at least five million viewers across laptop and desktop computers and mobile devices during April-May 2013.Results: Nine analytical themes were identified, with a majority view that financial incentives for breastfeeding are unacceptable. These themes cover a range of opinions: from negligent parents unable to take responsibility for their own actions; through to psychologically vulnerable members of society who should be protected from coercion and manipulation; to capable and responsible women who can, and should be allowed to, make their own decisions. Many views focused on the immediate costs of the intervention, concluding that this was something that was currently unaffordable to fund (e.g. by the NHS). Others contrasted the value of the incentive against other 'costs' of breastfeeding. There was some consideration of the issue of cost-effectiveness and cost-saving, where the potential future benefit from initial investment was identified. Many commenters identified that financial incentives do not address the many structural and cultural barriers to breastfeeding.Conclusions: Overall, those commenting on the on-line UK news articles viewed financial incentives for breastfeeding as unacceptable and that alternative, structural, interventions were likely to be more effective. Further consideration of how best to conduct internet-based qualitative research to elicit opinion towards public health issues is required.

Publication metadata

Author(s): McColl E; Adams JM; Sniehotta FF; Holmes M; Giles EL

Publication type: Article

Publication status: Published

Journal: BMC Pregnancy and Childbirth

Year: 2015

Volume: 15

Online publication date: 16/05/2015

Acceptance date: 05/05/2015

Date deposited: 18/08/2015

ISSN (electronic): 1471-2393

Publisher: BioMed Central Ltd


DOI: 10.1186/s12884-015-0549-5


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Funder referenceFunder name
British Heart Foundation
Cancer Research UK
Centre for Translational Research in Public Health
Medical Research Council
National Institute for Health Research, under UK Clinical Research Collaboration
Centre for Diet and Activity Research (CEDAR)
Economic and Social Research Council