breastfeeding. This fact, he said, changes the dynamics of the conversation a WIC staff member is likely to have with a WIC participant from one that encourages a mother to breastfeed who has reservations and questions about it to a conversation that supports the mother’s choice to breastfeed. There may not be a huge change in the number of women breastfeeding, Grummer-Strawn said, but the nature of the dialogue has changed. However, he noted that WIC breastfeeding rates, while increasing, still lag behind the national average.

  1. The environment to support breastfeeding has improved considerably. Looking at such factors as state legislation and policies, increases in Baby-Friendly Hospitals and International Board Certified Lactation Consultants (IBCLCs), and other trends, one can see these positive trends as evidence of a far more supportive environment than existed 14 years ago.
  2. The same barriers exist that have existed for the last 25 years. In 1985 recommendations from the Surgeon General’s Workshop on Breastfeeding focused on work, public education, professional education, the healthcare system, support services, and research—issues that are still relevant today. This is because while the trends are positive, as noted above, they remain insufficient. For example, there are just over 100 Baby-Friendly hospitals, and they account for only 4 percent of the births in this country.
  3. Society’s beliefs about breastfeeding have not changed much, at least on such issues as breastfeeding in public and the benefits of breast milk versus formula. Grummer-Strawn shared some data from Porter Novelli’s HealthStyles surveys ( on public attitudes about breastfeeding in 1999, 2003, and 2007. In 2007 respondents actually felt a little less comfortable than those in 1999 when seeing women breastfeed in public. Similarly, Grummer-Strawn noted that the two-year National Breastfeeding Awareness Campaign did not show any significant changes in beliefs about breastfeeding.
  4. How breastfeeding messages are framed is more important than the content of the message. Grummer-Strawn suggested that those designing the new campaign should read a paper by the Berkeley Media Studies Group entitled “Talking about Breastfeeding: Why the Health Argument Isn’t Enough” (Dorfman and Gehlert, 2010). According to the paper, current breastfeeding frames in the media include the beliefs that good mothers breastfed their babies and that breastfeeding is a natural thing to do that has be going on for generations but also that mothers need experts to show them how

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