In Massachusetts, we have learned a lot about using the most effective language to get policy-makers to support breastfeeding, after then-Governor Mitt Romney quashed the nation’s first statewide ban on the hospital marketing of baby formula. The lessons we have learned can be applied to other aspects of breastfeeding advocacy and make breastfeeding messages more convincing.


  1. Reframe, don’t react.

    When you reframe the argument, you are in control of the message you give; when you respond directly to their argument/charges, they are in control of the message.

For example, countering “freedom of choice” with assurances about supporting choice only deflates your message by turning it into part of your opponent’s message.

  1. Be cautious when debating “feeding choice.”

    Politicians and proponents of baby formula often talk about “freedom to choose” how to feed a baby. Freedom of choice is a concept frequently raised by makers of other unhealthy products, like junk food and tobacco. These corporations say that healthy choices are the individual’s personal responsibility. They minimize the effect their marketing has on consumer behavior. “Choice” is the language of breastfeeding opponents. When they talk “choice,” it’s best to respond using entirely different language, like “marketing” or “profits.” Avoid the word “choice” altogether.

  2. Do not identify yourself as a “lactivist.”

    Do identify yourself as a concerned citizen, parent, or health care provider. You may be the most passionate breastfeeding advocate on the planet, but if your audience sees you as such, you risk becoming marginalized and losing credibility. Policy makers need to recognize breastfeeding as a mainstream health and family issue. Use calm and measured language and always sound professional.

  3. Present breastfeeding as normal.

    Avoid describing breastfeeding as “ideal,” “perfect,” “optimal” or “special.” Formula companies use these words make breastfeeding sound unattainable. They know most people are content with just “regular.”

  4. Talk about risks.

    Instead of talking about the “benefits of breastfeeding,” talk about the risks of not breastfeeding. Instead of breastfeeding “preventing” breast cancer or obesity, we should note that breast cancer risk increases with shorter durations of breastfeeding.

  5. Describe breastfeeding barriers as a public health issue.

    Breastfeeding is a public health issue just like smoking, safe sex, and seatbelts. This message removes the baggage of your audience’s personal breastfeeding issues, and is an effective antidote to the language of “choice” so popular with our opponents. Cite the risks of not breastfeeding, both to mothers and to children, both for acute and chronic illnesses.

  6. Include specific statistics.

    rather than just general language about risk. By itself, saying “there are risks to not breastfeeding” may be interpreted as a value judgment. By contrast, saying “babies who are formula-fed have double the risk of diarrhea” sounds informative and scientific.

  7. Frame breastfeeding as a systems issue.

    rather than an individual issue. Explain how policies impact breastfeeding success and duration. Yes, a woman may see her breastfeeding difficulties as a personal failure, rather than the result of the many roadblocks that undermine nursing mothers. But once a woman recognizes how others have failed her and her baby, she doesn’t feel “guilty” she feels angry. Help women transform their frustrations into voices for change. Reframe “guilt” as anger or grief

  8. Present standing up for mothers and children.

    It’s hard to argue with that. When you phrase breastfeeding support this way, you are also acknowledging that breastfeeding is a normal part of family life. You can remind people that most mothers actually do breastfeed initially, but poor support results in short duration.

  9. Promote the medical recommendations.

    When you say, “We need to help women follow medical recommendations,” you remind people that breastfeeding is the medical recommendation, after all.

  10. Use the ego.

    When referencing influence of formula companies etc. state “do you want to be used?” Nobody wants to be “sold and serviced.” Another approach: “You went to nursing school (or medical school) to take care of patients, not to peddle baby formula.”

In Summary:

Reframe the argument instead of just answering your opponent’s charges. Identify yourself as a voice from the mainstream. Remind people that exclusive breastfeeding for six months is the medical recommendation. Hammer home that breastfeeding is a serious public health challenge, worthy of funding and legislation. Include numbers when you can, and always remember to talk about the risks of not breastfeeding, rather than the “benefits of breastfeeding.” Discuss “marketing” and “profits,” not “choice.”

With carefully chosen words, your voice can lead to change.


  1. Adapted from piece by Melissa Bartick, MD, MS, March, 2007



1.Wiessinger D. Watch your language! J Hum Lact 1996;12(1):1-4.

2.Donnelly A, Snowden H, Renfrew M, Woolridge M. Commercial hospital discharge packs for breastfeeding women. Cochrane Data Base Systematic Review 2000;2(CD002075).

3.Howard C, Howard F, Lawrence R, al. e. Office prenatal formula advertising and its effect on breastfeeding patterns. Obstet Gyencol 2000;95(2):296-03.

4.Shealy K, Li R, Benton-Davis S, Grummer-Strawn L. The CDC Guide to Breastfeeding Interventions. Atlanta: US Department of Health and Human Services, Center for Disease Control and Prevention; 2005.


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