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Cultural representation of newborn feeding
  1. S Conti Nibali
  1. Family Pediatrician, Azienda Sanitaria Locale, n.5 Messina, Italy; serconti{at}

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Nicoll and Williams1 suggested that attitudes to breast feeding need to change: “everyone (not just women) needs to see breast feeding as normal and education needs to start early”. In Italy breastfeeding rates are low.2 Numerous training initiatives have been set up to heighten awareness with the aim of promoting breastfeeding. These initiatives have been based on implementation of the Baby Friendly Hospital Initiative;3 three hospitals in the country being nominated “Baby Friendly”.

I was recently invited to discuss the importance of breastfeeding for newborns with two 4th year junior school classes (41 children in total (17 girls and 24 boys), aged between 9 and 10). Before talking to the children, I asked them to draw on a sheet of paper everything they thought was necessary for a baby to grow up healthy. All except four drew a feeding bottle next to a baby; 15 children drew a baby alone with a bottle; only three children drew a baby in his/her mother’s arms, but all these the babies were still holding a bottle. Only two drawings showed the baby with both parents and in without a bottle; the other two drawings without a bottle depicted a scene in the hospital. When I asked how many of them thought that formula milk was the same as mother’s milk, 28 out of 41 raised their hands. I believe this reflects the widespread tendency, also reported in other countries,4 not only to consider breastfeeding the same as artificial feeding, but “artificial” as “natural”.

In an historic and ever pertinent editorial,5 the Lancet hoped a warm chain for breastfeeding could be created, and warned about the ambivalent messages often encouraged by the marketing campaigns of formula manufacturers. I feel that the implementation of interventions aimed at supporting breastfeeding should not be limited to the healthcare system, but should cover a wider range of activities, aimed at changing the cultural representation of newborn feeding and at defending breastfeeding.


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