Recent research by Dr Cecile Morris, Dr Peter Schofield and Dr Craig Hirst of Sheffield Hallam University (SHU) explores how members of the public perceive breastfeeding in public, identifying how different factors are associated with acceptance or opposition. They recommend adopting social marketing and branding as a means to improve the image of breastfeeding and to achieve long term sustainable behaviour of accepting of breastfeeding in public among the members of public.
Building on the above research, SHU doctoral candidate Anuradha Somangurthi aims to critically evaluate the existing UK breastfeeding campaigns and develop a social marketing and branding campaign that will more effectively target those opposed to breastfeeding in public. In this way, the research will contribute to increasing acceptance of public breastfeeding.
Why is it important to support breastfeeding?
Though breastfeeding is a natural process, mothers often require support to get started and sustain breastfeeding. The promotion of breastfeeding is the focus of World Breastfeeding Week, an annual event over the first week of August, and first celebrated in 1992. The theme of Breastfeeding week 2020 was “Support breastfeeding for a healthier planet”.
Malnutrition contributes to one-third of deaths among children under the age of five, often associated with inappropriate feeding practices during the first year of life. As per WHO recommendations, optimal breastfeeding practices include exclusive breastfeeding for first 6 months initiated within one hour of birth and continued for up to 2 years of age and beyond. To achieve global nutrition targets and increase breastfeeding rates, the WHO recommends implementation of campaigns and investing in breastfeeding promotion and support.
There are a range of public health benefits of promoting breastfeeding, especially in reducing mortality and morbidity and improving the wellbeing of mothers and infants. Breastfeeding cuts the incidence of ear, chest and gut infections in children and this helps the NHS save £50 million each year. It also reduces the incidence of breast cancer in women.
Breastfeeding acceptance in public: the situation in the UK
Though the benefits of breastfeeding for improvement of maternal and infant health have been widely acknowledged, the breastfeeding rates in the UK remain suboptimal.
There are multiple factors which affect the mother’s choice to breastfeed or to bottle-feed in public. It is not only a mother’s decision or attitude that matters; a vital role is played by her immediate and social circle. One obstacle to improving UK breastfeeding rates relates to how breastfeeding in public is viewed. Researchers at SHU have found that some mothers in the UK experience embarrassment while breastfeeding in public and hence discontinue breastfeeding. This is echoed by the Infant Feeding Survey of 2010: 47% of mothers in the UK faced difficulty to find a suitable place for breastfeeding and 11% of mothers were stopped or felt uncomfortable feeding in public.
Reducing the embarrassment mothers can experience when breastfeeding in public, and promoting acceptance of breastfeeding in public are thus two ways in which to potentially deliver improved health for infants and mothers, cost savings for the NHS, and reduced environmental impact from the production and use of formula milk.
Why is social marketing useful for promoting breastfeeding acceptance in public?
A range of social marketing campaigns have targeted mothers, their entourage, and health professionals in order to promote breastfeeding in public. Social marketing and branding campaigns have been shown to have some success in changing behaviour and improving public health as can be seen through different campaigns targeting quitting smoking, water quality and use of fertilisers, teen health and use of bicycle. For example, branding strategies have had positive results in reducing teenage smoking. Branding is different from traditional approaches to public health campaign. By building a positive association between the target audience and the campaign, public health branding can encourage individuals to not only adopt, but also sustain positive health behaviours.
Thus, social marketing can be a powerful tool through which to change behaviour of a target audience, provided the health promotion campaign is based on realistic expectations and plans that reinforce the intention.
What does this research explore?
The overall aim of Anuradha Somangurthi’s PhD research is to critically evaluate social marketing breastfeeding campaigns, in order to design more effective social marketing interventions to increase acceptance of breastfeeding in public. The research will explore how to encourage members of the public to empathise with breastfeeding mothers and think about breastfeeding in public from the point of view of mothers, and how to change the image of human milk.
The first step in the research is to critically evaluate social marketing campaigns in relation to theoretical models of behaviour change. On that basis, a social marketing and branding campaign can be developed, which targets members of the public opposed to breastfeeding in public. Pilot testing of that campaign will determine the impact on levels of acceptance towards breastfeeding in public. The information from the pilot testing can then be used to develop, deploy and evaluate a larger scale social marketing campaign aimed at increasing acceptance of breastfeeding in public.
Potential impact of this research
The potential impact of this research would be increased acceptance of breastfeeding in public, which in turn could increase breastfeeding rates. Increasing breastfeeding rates may contribute to improving maternal health by reducing breast cancer incidence, and infant health by reducing infant infections.
The research also seeks to contribute to a more inclusive society, by helping creating an accepting environment for breastfeeding and improving the mental health of mothers who are at risk of isolation or embarrassment when electing to breastfeed their babies in public. Also, supporting breastfeeding helps in building climate resilience and build a healthier planet as breastfeeding has a very low carbon footprint compared to breastmilk substitutes.
About the author:
This blog is based on PhD research (A Critical Application of Branding to Promote Acceptance of Breastfeeding in Public in the UK) by Ms Anuradha Somangurthi, under the supervision of Dr Cecile Morris (Cecile.Morris@shu.ac.uk), Dr Craig Hirst (C.hirst@shu.ac.uk) and Dr Rachel Rundle (R.rundle@shuc.ac.uk), at Sheffield Hallam University.