What do women really want from breastfeeding education and promotion?

Brown, A. (2016). What Do Women Really Want? Lessons for Breastfeeding Promotion and Education. Breastfeeding Medicine, 11(3), 102-110.


Why do the study?   13689467_10210675104260788_327049912_n

Breastfeeding rates in the UK remain low even though we have been trying to promote and encourage breastfeeding. Potentially a new approach was needed and who best to ask but mothers themselves what they feel might work?

Who took part?

Over 1100 mums in the UK with a baby aged 0 – 2 years who had ever breastfed (even if they had stopped now).

What did they do?

They completed an open ended questionnaire asking them about their experiences of breastfeeding, what education and promotion they felt worked, what didn’t work and any ideas they had for changes to education and promotion.

What did it find?

The majority of mothers want breastfeeding education and promotion, but very few believed current messages were useful. Instead, mothers suggested five main ways in which this could be improved

1.Stop referring to breast as ‘best’

‘Breast is best but this puts breastfeeding on an unobtainable pedestal for some people. This then makes infant formula seem to be reachable, normal and something that has all the stuff needed for babies. Instead breastfeeding should be marketed as normal and perfect.’

Mothers felt that the language often used referring to breast as best was divisive and made those who could not breastfeed feel alienated. It could also make breastfeeding feel like the ‘finest’ option when formula is good enough. Using ‘best’ also makes it sound ideal or optional, rather than normal.

2.Don’t just focus on the health benefits of breastfeeding

‘Breastfeeding is about so much more than health. It is about cuddles, and closeness and bonding. It saves time, costs nothing and you can never forget to take it out with you. Why don’t we emphasise these things more?’

Mothers disliked the ‘hard sell’ that breastfeeding was simply only done to prevent illness. Mothers breastfed for all sorts of personal reasons and they wanted these emphasised instead. This would also reduce the backlash that if a baby was breastfed and became ill that ‘breastfeeding wasn’t working’ or the claims that ‘but my baby is formula fed and he’s fine’. More has to be done to recognise that infant feeding isn’t definitive, but about risk and that simply because one breastfed baby is ill, doesn’t mean that they wouldn’t be more ill without breastmilk or that breast milk ‘doesn’t work’.

3.Recognise every feed makes a difference

‘It is overwhelming as a first time mum who is perhaps exhausted by the birth that she must now feed this baby exclusively for the next six months … You might have a mum who baulks at the idea of six months, but six weeks or even 6 days seems achievable for her. That is better than not at all.’

Many mothers wanted to exclusively breastfeed but were worried that because they had used an occasional bottle of formula milk that they had wiped out all the benefits. Mothers also worried that they might not be able to breastfeed for two years or more, and felt like failures if they didn’t meet this. They felt that celebrating every success would actually help to increase breastfeeding rates as mothers didn’t feel so overwhelmed by the duration, but one day woke up realising they had breastfed for six months, a year or more!

4.Educate pregnant women about what breastfeeding is really like e.g. can be challenging

‘It is overwhelming as a first time mum who is perhaps exhausted by the birth that she must now feed this baby exclusively for the next six months … You might have a mum who baulks at the idea of six months, but six weeks or even 6 days seems achievable for her. That is better than not at all.’

A central theme was the idea that mums felt unprepared for breastfeeding. They often hadn’t spent a lot of time on it antenatally, other than being told how to latch a fake baby onto the breast and why breastfeeding was the ideal option. Mothers wanted realistic advice about challenges such as night waking, frequent feeds and engorgement, so they felt normal when it happened and knew where to get help.

5.Target education and promotion to those around the woman

 ‘I know why breastfeeding is important. My partner knows why breastfeeding is important. But it’s very difficult to put up with others’ ignorant views. Educate the general public and it would be a lot easier. Even if this just means more awareness that you’re not allowed to tell a woman to stop!’

Finally, mothers wanted breastfeeding education and promotion but were fed up of it being targeted at just them. They wanted to breastfeed but were affected by the attitudes of those around them, who were often ill informed about how breastfeeding worked and why it was important. Mothers suggested wider promotion, including targeting general society through advertising. They felt that this would create a more supportive environment for breastfeeding.




What do we do now?

The findings really highlight the need to support new mothers with breast-feeding, changing our approach to what information we give pregnant women and the language that we use. We also need to take a societal responsibility for breastfeeding, ensuring that all those around the woman are as informed and supportive as they can be about why breastfeeding matters.

However the government has slowly disinvested in breastfeeding. We need to work together to challenge the government to start investing properly in breastfeeding. By doing so we would reduce illness, save money and protect the environment – what’s not to like?



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what do women really want_ Lessons for breasteeding education and promotion