title: Breast pumps as an incentive for breastfeeding: a mixed methods study of acceptability.
abstract: Increasing breastfeeding rates would improve maternal and child health, but multiple barriers to breastfeeding persist. Breast pump provision has been used as an incentive for breastfeeding, although effectiveness is unclear. Women's use of breast pumps is increasing and a high proportion of mothers express breastmilk. No research has yet reported women's and health professionals' perspectives on breast pumps as an incentive for breastfeeding. In the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study, mixed methods research explored women's and professionals' views of breast pumps as an incentive for breastfeeding. A survey of health professionals across Scotland and North West England measured agreement with 'a breast pump costing around £40 provided for free on the NHS' as an incentive strategy. Qualitative interviews and focus groups were conducted in two UK regions with a total of 68 participants (pregnant women, new mothers, and their significant others and health professionals) and thematic analysis undertaken. The survey of 497 health professionals found net agreement of 67.8% (337/497) with the breast pump incentive strategy, with no predictors of agreement shown by a multiple ordered logistic regression model. Qualitative research found interrelated themes of the 'appeal and value of breast pumps', 'sharing the load', 'perceived benefits', 'perceived risks' and issues related to 'timing'. Qualitative participants expressed mixed views on the acceptability of breast pumps as an incentive for breastfeeding. Understanding the mechanisms of action for pump type, timing and additional support required for effectiveness is required to underpin trials of breast pump provision as an incentive for improving breastfeeding outcomes. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.
authors: Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom. ncrossland@uclan.ac.uk.
authors: Nicola
authors: N
authors: Crossland
authors: Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom.
authors: Gill
authors: G
authors: Thomson
authors: Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom.
authors: Heather
authors: H
authors: Morgan
authors: Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom.
authors: Graeme
authors: G
authors: MacLennan
authors: Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom.
authors: Marion
authors: M
authors: Campbell
authors: Maternal and Infant Nutrition & Nurture Unit (MAINN), School of Community Health and Midwifery, University of Central Lancashire, Preston, United Kingdom.
authors: Fiona
authors: F
authors: Dykes
authors: Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, United Kingdom.
authors: Pat
authors: P
authors: Hoddinott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001942:Breast Feeding / Q000523:psychology*; D061186:Breast Milk Expression / Q000523:psychology*; D004739:England; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009035:Mothers; D009042:Motivation; D036301:Qualitative Research; D012606:Scotland; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Incentives; acceptability; breast milk expression; breast pump; breastfeeding