Trial reportArchives of disease in childhood2020
Cost-effectiveness of offering an area-level financial incentive on breast feeding: a within-cluster randomised controlled trial analysis.
Trial report in Archives of disease in childhood, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Evidence for incentive-based strategies to promote breastfeeding: a systematic literature review of randomised controlled trials.BMC pregnancy and childbirth · 2025Pooled it
- Methods of assessing value for money of UK-based early childhood public health interventions: a systematic literature review.British medical bulletin · 2023Pooled it
- Support for healthy breastfeeding mothers with healthy term babies.The Cochrane database of systematic reviews · 2022Pooled it
- Trial
- Levelling up health in the early years: A cost-analysis of infant feeding and healthcare.PloS one · 2024Article
- Promoting Healthy Childhood Behaviors With Financial Incentives: A Narrative Review of Key Considerations and Design Features for Future Research.Academic pediatrics · 2022Review
- The cost-effectiveness of antenatal and postnatal education and support interventions for women aimed at promoting breastfeeding in the UK.BMC public health · 2022Article
- The financing need of equitable provision of paid maternal leave in the informal sector in Indonesia: a comparison of estimation methods.International journal for equity in health · 2021Article
- The yearly financing need of providing paid maternity leave in the informal sector in Indonesia.International breastfeeding journal · 2021Article
- Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units.Pediatric research · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveTo provide the first estimate of the cost-effectiveness of financial incentive for breastfeeding intervention compared with usual care.
designWithin-cluster ('ward'-level) randomised controlled trial cost-effectiveness analysis (trial registration number ISRCTN44898617).
settingFive local authority districts in the North of England.
participants5398 mother-infant dyads (intervention arm), 4612 mother-infant dyads (control arm).
interventionsOffering a financial incentive (over a 6-month period) on breast feeding to women living in areas with low breastfeeding prevalence (<40% at 6-8 weeks).
main outcome measuresBabies breast fed (receiving breastmilk) at 6-8 weeks, and cost per additional baby breast fed.
methodsCosts were compared with differences in area-level data on babies' breast fed in order to estimate a cost per additional baby breast fed and the quality-adjusted life year (QALY) gains required over the lifetime of babies to justify intervention cost.
resultsIn the trial, the total cost of providing the intervention in 46 wards was £462 600, with an average cost per ward of £9989 and per baby of £91. At follow-up, area-level breastfeeding prevalence at 6-8 weeks was 31.7% (95% CI 29.4 to 34.0) in control areas and 37.9% (95% CI 35.0 to 40.8) in intervention areas. The adjusted difference between intervention and control was 5.7 percentage points (95% CI 2.7 to 8.6; p<0.001), resulting in 10 (95% CI 6 to 14) more additional babies breast fed in the intervention wards (39 vs 29). The cost per additional baby breast fed at 6-8 weeks was £974. At a cost per QALY threshold of £20 000 (recommended in England), an additional breastfed baby would need to show a QALY gain of 0.05 over their lifetime to justify the intervention cost. If decision makers are willing to pay £974 (or more) per additional baby breast fed at a QALY gain of 0.05, then this intervention could be cost-effective. Results were robust to sensitivity analyses.
conclusionThis study provides information to help inform public health guidance on breast feeding. To make the economic case unequivocal, evidence on the varied and long-term health benefits of breast feeding to both the baby and mother and the effectiveness of financial incentives for breastfeeding beyond 6-8 weeks is required.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.