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Sunday
Jul192009

Can breastfeeding promotion learn something from drunk-driving ads?

Please note that I am not comparing formula feeding to drunk driving. Let me be 100% clear about that before anyone gets their nose out of joint.

A new study conducted by Magdalena Cismaru, Anne M. Lavack, and Evan Markewich at the University of Regina found that Canadian drunk-driving ads are more effective than those in other countries:
Of five countries studied, Canada has the most number of different anti-drinking and driving campaigns. The country also has a lower fatality rate than its neighbours to the south. Canada's annual drunk driving death toll is about 2.61 per 100,000 population, compared to the U.S., which is 4.54.

"In Canada, we're very good at giving people some courses of action and giving them encouragement that they can actually carry that out," said Anne Lavack, dean of the faculty of business at the U of R. "We found that in other countries, like Australia for example, they're very good at arousing fear and telling people how serious it is, but they don't focus on giving them alternatives for action." (source)

The important thing to take away from this is that scaring people only works if you offer them an alternative. Telling someone not to drive drunk only works if you remind them to take a taxi, have a designated driver, or use programs like Opération Nez Rouge (Operation Red Nose). You would think it is common sense, but I guess not.  Mothers Against Drunk Driving (MADD) Canada is known for some pretty sobering ads about the risks of drunk driving, but they also focus on reinforcing this message:
Don’t drive while impaired. Don’t get into a vehicle with someone who is impaired. Don’t let your family and friends drive after consuming alcohol. If you drink, arrange a ride, take a taxi, stay over.

One example of a message sent to party hosts is this Ontario advertisement:



Now consider the recent National Breastfeeding Campaign in the United States. There were ads showing pregnant women riding bulls or participating in log rolling events and saying:
You wouldn't take risks before your baby's born. Why start after. Breastfeed exclusively for 6 months. Recent studies show babies who are breastfed are less likely to develop ear infections, respiratory illnesses and diarrhea. Babies were born to be breastfed.

Or there are the print ads that were initially sending a very strong message and later softened to this:

dandelions



These campaigns are intended to scare, but do they offer alternatives to women that might be struggling with breastfeeding? Do they send any messages to their friends and family about how to support them? Not really.

What if we consider the findings from the drinking and driving study and apply it to breastfeeding promotion campaigns? We could conclude that telling people about the dangers of formula feeding would be more effective if:

  • women were told where they could turn for breastfeeding support

  • access to lactation consultants was easy and affordable

  • workplaces were friendly to pumping moms and maternity leaves were extended to support full term breastfeeding

  • reducing exposure to harmful chemicals was made a priority as this could have an impact on milk supply

  • friends, health professionals, and family are willing and able to provide support to a breastfeeding mom rather than sabotaging her

  • more resources were put towards human milk banks to increase access to breast milk for those that cannot breastfeed or do not make enough milk


Aiming breastfeeding promotion ads at the five to ten percent of the population that do not want to breastfeed may make a small dent in breastfeeding rates, but figuring out how to battle the systemic barriers to successful breastfeeding is more important, more difficult and more likely to make a real difference.
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Reader Comments (31)

"Please note that I am not comparing formula feeding to drunk driving. Let me be 100% clear about that before anyone gets their nose out of joint."

Oh Annie, it's such a shame that you have to start off you post like this!

Great post, as usual. Getting to the root of the problem is much more difficult but in the end is the only way.

July 19, 2009 | Unregistered CommenterFamilyNature

Really great post. I am nearing my 6th month of exclusive breastfeeding and am so proud of myself. I struggled in the beginning with a wicked case of thrush for months and every time I went to the La Leche League site, I was told, "See a lactation consultant." They don't tell you this costs money. The lactation consultant then gave me bad advice (to use Lansinoh on my cracks, which makes thrush worse). It took a dozen trips to three different doctors before I found one who put me on Diflucan for a month, which cured the thrush. The cracks didn't go away for 3 months. I stuck with it because I am stubborn, but I now have ABSOLUTE sympathy for women who use formula. Breastfeeding CAN be hell. People need to recognize that and create better support systems.

July 20, 2009 | Unregistered CommenterSandy

agreed........ :)

July 20, 2009 | Unregistered CommenterNaomi

Well-put! (Including the disclaimer, which I must admit, made me chuckle.)

I was just talking yesterday with a friend of mine whose wife had such trouble breastfeeding that she quit trying at 3 weeks and they formula fed from that point on. No one had told her that having a (elective, in her case) c-section might very well complicate things and cause supply issues without additional support (fenugreek, domperidone, pumping, etc.) She had no idea - she'd blamed herself for years. She'd seen a couple of doctors about it (her OB, and their family doctor) and no one had told her the link between c-sections and early supply issues, and no one told her how to help it either - they just said 'keep trying, and supplement with formula'!! In her case - an effective ad campaign might have saved their family thousands of dollars (formula for 1 year x 2 children!) and a lot of personal suffering as well. Had she known what to expect, and how to access *real* help...
Anyhow - I think you've hit the nail right on the head: the message that women (and men! who are often even quicker to want to give up and move to formula!) are being sent is more of a 'if you don't breastfeed you're a bad parent', than 'if you are having trouble breastfeeding, please try *this* before resorting to formula, because breastmilk really is the best thing for your child.'

July 20, 2009 | Unregistered CommenterSarah (solemom)

Good call. It's not like women don't try. It's a rare woman who doesn't want to at ALL. So yes, they need to be supported with the best information about how to get over the barriers, such as the ones Sandy mentioned. A friend of mine had mastitis so bad that she had to get part of her breast removed and had a hole there! The lactation consultant was like, "Keep BFing with it or just the other one." I think when women are given bad advice, the lact. consultants lose credibility as a whole. (Similar to people giving birth horror stories so no one thinks it can be done or you're crazy to try.)
I wrote a blog on Nature's Child today about NY state passing the BFing Mothers' Bill of Rights. It's a good first step. Now, for actual implementation.
http://blog.thenatureschild.com/2009/07/breastfeeding-gets-nys-support.html

July 20, 2009 | Unregistered CommenterCate

This is a great article. Thank you for pointing out that sometimes women don't continue to breastfeed because it is difficult for them. I had a very hard time breastfeeding my son and gave up after just 4 weeks. When I had my daughter I had supportive friends, moms who had been through the same things, and a great doctor that helped me out and I was able to feed (directly from the breast) for 4 months! I then continued to pump and also supplemented with formula when I was working.

July 20, 2009 | Unregistered CommenterRaj Thandhi

Most of the friends I know who stopped early did so because they were surrounded by people who told them to stop if it was too hard/painful/difficult since formula was just as good and they just had no idea that breastfeeding isn't always easy. Educating everyone, just not nursing mothers, has to happen for us to get our breastfeeding rates higher. It's a big job.

"figuring out how to battle the systemic barriers to successful breastfeeding is more important, more difficult and more likely to make a real difference."

Amen, amen, amen! I believe this wholeheartedly. Most women, at least here in Canada, initiate breastfeeding. They want to breastfeed, they really do, but they encounter so many barriers. There is really such a lack of support and good information for moms who struggle with breastfeeding.

We really need to step that up. Your suggestions are great, and I agree wholeheartedly. Putting the support systems in place and letting moms know where to find them is really the key. Let's back up our words with real action, and then I think we can make a difference.

July 20, 2009 | Unregistered CommenterAmber

This is a stroke of brilliance, and it needs to happen. How do we set this in motion? Anyone?

July 20, 2009 | Unregistered CommenterDou-la-la

Thats a really interesting idea, and the disclaimer made me lol! hehehe :D nice post :)

July 20, 2009 | Unregistered CommenterJude

Bravo Annie! Your ideas are fantastic. Not hard to do either. Hope someone in the know gets wind of this one.

July 20, 2009 | Unregistered CommenterMelodie

Very true. Women know that breastfeeding is best (although some try to rationalize their decision to formula feed) but don't realize how hard it can be. Women do feel guilty if they don't breastfeed but they need to be shown how to breastfeed properly and alternatives such as pumping.

The previous poster Sarah had a good point too. Many women don't realize that having a c-section can hinder breastfeeding. I'd love to see a public education campaign on the risks of c-sections too

Totally agree. I once contacted the people in charge of roads to suggest that instead of saying "Drunk drivers die" or "Every K over is a killer" (K for kilometer), they should put "Thank you for driving safely" and "Have a safe trip home".

They didn't.

It's a good thing your blog is here for these women, which is why everyone should stumble it and digg it and tweet it to their friends and relatives.

July 21, 2009 | Unregistered CommenterFamily Matters

@Family Matters: Thank you so much for the lovely compliment.

July 21, 2009 | Unregistered Commenterphdinparenting

Great post. Our ad campaign, which was donated pro-bono by a top ad agency, was intended to capture attention and urge women to find out if their hospital, physicians, employers, and healthcare were truly supporting them to succeed at breastfeeding, so it was a start. But ad campaigns are extremely expensive to run . . . even at a non-profit rate, a full page ad in a pregnancy magazine can run $10,000 or more. So it becomes a fundraising issue. Here's our ad and press release:
http://www.bestforbabes.org/help-moms-beat-the-booby-traps/

July 23, 2009 | Unregistered CommenterBettina

Annie, this is a great post. Women need to know that breast feeding is really important for babies and what resources are available to help make it work. We all also need to know that for many women breast feeding is a real struggle. It is not as natural for some of us as the advertisements would have us believe. My daughter was committed to breastfeeding for at least nine months with each of her two children. She found it difficult, even in Germany where home visits from midwives including help with breastfeeding were a regular part of postpartum care. She was able to get the support she needed, including acupuncture after her second child, which helped considerably. She did everything suggested to increase milk supply. She succeeded in breastfeeding for the required time, but it took a long time to really get going. She considers it the most difficult part of the whole pregnancy and birth experience, but feels really good that she was able to carry through for her children. Education, family support, and easily accessible resources are essential.

July 23, 2009 | Unregistered CommenterAnne

My mom had home visits in Jamaica -- from Mead Johnson, or whoever the formula maker was in those days!! Marketing is key, but there's no money to be made by selling something that's free (which should be a key part of the pro-bf message, by the way!). Even I, who sell nursing clothes, tell everyone that they are completely unneccessary.
The best support came from my pediatrician -- but I'm lucky enough to have Dr. Paul Fleiss. Think about it, who does the nw mom see most? His office will totally help you with breastfeeding issues and you see other mothers nursing in the waiting room all the time.
Without a huge ad budget, the very best thing we can do to increase breastfeeding rates and support is to nurse in public -- without a goofy cover. No need to haul out your entire boobie, but seeing a mother calm and nurture a baby in person will have an impact. That's something we all can do! (I went a little further and crazily signed up for the Bringing Home Baby show when I had twins because I was so sick of the birth-intervention-baby-needs-a-bottle storyline of all those shows. I birthed my girls drug free, used cotton diapers and nursed them on camera. To this day, I get emails from people thanking me for letting them know that this was possible with twins. If you want to share the madness, the videos are on the about us page of our site.)
But we have the power to affect mothers to be! :)

July 24, 2009 | Unregistered CommenterRoxanne Beckford Hoge

Such a good article. It's so true that most women don't know where to turn for help and when help is needed it's at a time that women are in such an emotional non logical state of mind.

We had tons of trouble for the first two weeks. Luckily, I had a lactation consultant assigned to me by the hospital, a supportive pediatrician, a doula, and my mom who breastfed me - not to mention LLL. Otherwise we would never have succeeded.

July 26, 2009 | Unregistered CommenterJessica

Very true. Love the parallel.
One of my cousin recently gave birth, and was debating whether to breastfeed or formula feed. She decided, before going into labour, that she would formula feed after all. I don't know all the details behind that decision, but I think it's unfortunate. My mom felt obliged to defend her in her choice when I mentioned it, to which I reply: "I'm not judging her. She was probably misinformed. We need to change society's perception of breastfeeding, and explain that there ARE resources around if you need them. Only then will women be able to make informed choices."

Obviously, easier said than done.

July 31, 2009 | Unregistered CommenterJohanne

[...] their breastfeeding goals. The Best for Babes Foundation recognizes, as I explained in my post Can breastfeeding promotion learn something from drunk driving ads? , that scaring women into breastfeeding isn’t the right approach. Best for Babes Co-Founders [...]

I'd like to clarify that the Party Smart ad above is part of a campaign run by Arrive Alive Drive Sober. We are an Ontario based charity focused on spreading awareness about the dangers of impaired driving. Check us out at arrivealive.org and thank you for helping spread the message. =D

August 6, 2009 | Unregistered CommenterArrive Alive Ontario

[...] Can breastfeeding promotion learn something from drunk-driving ads ... [...]

This is really the germ of it and well said:

Aiming breastfeeding promotion ads at the five to ten percent of the population that do not want to breastfeed may make a small dent in breastfeeding rates, but figuring out how to battle the systemic barriers to successful breastfeeding is more important, more difficult and more likely to make a real difference.

Keep up the powerful thinking...

December 1, 2009 | Unregistered Commenterjulia

This is an excellent post. FYI, there is a new PSA coming out for drunk driving using positivity (I recently auditioned for it; that's the only reason I know - hope I'm not releasing anything top secret!!) to enforce the message. The script was hilarious and hopefully will be effective.

I've been studying the NHS campaign you speak of, and also a different one used by WIC which focused on how familial support is essential to successful breastfeeding. The WIC campaign portrayed breastfeeding as an empowering, bonding act between mother and baby - and I think this is such a wonderful message to send. Scare tactics have been shown to have a boomerang effect if they come on too strongly - a little fear is good, too much is bad. But women these days are far more media saavy, and I think even subtle fear pisses us off. I believe it would be better for everyone if we stuck to the positive message rather than portraying formula as poison or formula feeders as the devil.

Anyway. Great post!

December 1, 2009 | Unregistered CommenterFearless Formula Feeder

[...] Can breastfeeding promotion learn something from drunk-driving ads? [...]

Great post. The "Why To" is meaningless without the "How To."

In terms of promotion-- I think the most effective approach in general is to get pregnant women into the company of happy nursing mothers and let them see just how much it means to us. Too much emphasis has been placed on the product (the milk) and not enough emphasis has been placed on the process (nursing) and the irreplaceable experience it creates. I wouldn't feel guilty or ashamed if I couldn't breastfeed a future child-- I would feel devastated. I would feel robbed. The loss wouldn't be measured in medical risks. It would be truly incalculable.

July 17, 2010 | Unregistered CommenterArtemnesia

I really love the ads you developed there. I especially like how the text breaks down ways to get support.

November 18, 2011 | Unregistered CommenterGinger Baker

Hey! - weve been saying "thank you for driving sober" for years (cause most people do!) - in several of our PSAs including our most recent and two other released earlier this year -in fact - we consciously avoid saying "don't" and rather use a "how to".. and btw - (in the spirit of participating in the conversation) I successfully breastfed two of my three children and had two "v-backs" and YES! it was lots of work to get thje right diet, sleep patterns, etc. Good luck to everyone working on this...

November 21, 2011 | Unregistered Commenteranne leonard

Sandy,

I wish LCs were free! La Leche leaders are free volunteers, but we are not IBCLCs, which means we can only help so much. As a leader, we are not allowed to give any sort of medical advice; in fact, we are not to give advice at all. Our job is support, encouragement, education, and information. In your case, you did need medical help, which only an MD can provide, not an LC or a LL leader. I wish you had called me though because I would have told you to go see a Dr! :)

Really, I just hear so often how "La Leche didn't help" and I'm on a one-woman campaign to help both breastfeeding moms and La Leche. I think this is exactly what Annie is talking about here - we need better systems to help moms. La Leche is one support system, but we are not lactation consultants, we are not doctors, and I'm not sure that gets out there that much. I *wish* I could help with all latch problems, thrush problems, and breastfeeding problems. Sometimes, all I can offer is a shoulder of support, while one mama cries, when anothers turns to formula, when another struggles with illness. That's what I can be, and that's really what La Leche can be, just that sort of mama-support. I *want* to fix, but I can only support.

(It could be the three calls and over 4 hours I have spent on the phone today - lots of summer babies! And all three moms thought LLL to be something other than we really are. I still hope I helped some.)

July 16, 2012 | Unregistered CommenterScholasticaMama

Agreed! It would be great if breastfeeding ads focused on how to support a breastfeeding mother, at work, at home, in public, rather than putting all of the responsibility on the mother alone to "do the right thing"

September 6, 2013 | Unregistered CommenterRoz

"I'm not judging her. She was probably misinformed. We need to change society's perception of breastfeeding, and explain that there ARE resources around if you need them. Only then will women be able to make informed choices."
Yes you were judging her. Just because she choose to formula feed does not mean that she wasn't informed. An informed choice isn't the choice you would make, it takes in personal circumstances, medical needs and many other factors. That's why it's called a choice.
Great article BTW :) In Australia we are very much moving away from negative advertising. Anit dvd piracy adverts are about people thanking you for buying movies not downloading them, anti smoking campaigns are about saying good on you for visiting the doctor to talk about quitting and even the anti-drink driving campaigns are 'think before you drink, think twice before you drive' with encouragement on what you need to think about before a night out. So obviously advertisers know that guilt trips don't sell. However, smoking, drink driving and dvd piracy is never a good option. Sometimes formula is the best option. While I would much prefer to see 'good on you for breastfeeding and if you are having problems here are suggestions' ads then blatant guilt inducing adverts I think it would have to be done in such a way that encourages mothers who not only want to feed a child who they are struggling with at that time but also mothers who maybe wanted to breastfeed a first child but didn't and would like to give it another go with subsequent children. Any amount of 'you did the wrong thing by your first child' will shut down conversation and put her on the defensive instead of being open to learning different ways she could try (if that is what she wants to do - if she doesn't and she wants to choose formula she should also have support.)

September 7, 2013 | Unregistered CommenterLisa

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