I have been following with interest the varying views on the direction that the ad campaign should take.  It occurs to me that each point of view has validity. A theory of health behavior called the Health Belief Model states that for a person to engage in a health behavior regularly, five constructs must be met.  These are: perceived susceptibility to an illness, perceived severity of the illness, perceived benefits of engaging in a health behavior, perceived barriers to engaging in a health behavior, and self-efficacy. Lack of self-efficacy is an additional barrier to action.  If breastfeeding is perceived as a healthcare behavior, which the ad campaign purports that it is, then all of these criteria must be met for a person to continue to engage in the behavior.   

But breastfeeding promotional campaigns in the United States, including this newest incarnation, are almost always focused on the nutritional and immunological benefits. The assumption is that every mother would choose breastfeeding if only she were convinced of its superiority over formula.   However, breastfeeding is a highly culturized activity, therefore, efforts to convince mothers to breastfeed their children through promises of improved health alone may not be adequate. Transformation of the cultural norm from formula-feeding to breastfeeding requires changes in the way the activity of breastfeeding is perceived: 
  a.. The notion that breastfeeding is a private activity and incompatible with life outside the home. 
  b.. Sources which purport to promote breastfeeding perpetuating the perception that breastfeeding is difficult, sometimes painful, and a lifestyle sacrifice.
  c.. Adherence to the spirit of the WHO code on the marketing of breastmilk substitutes.
  d.. And finally, teaching our children about the female breast and its functions that challenge the view that its primary purpose is of a sexual nature. 
Stacy Miller-Leonard RN,MS,IBCLC
Chicago suburbs
(climbing off my soapbox and putting away my Kathryn Dettwyler)

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