Evaluating Pamphlets, Audio-visuals, Posters, Handouts, and other Media

Any media used to promote or support breastfeeding should include helpful, accurate information and exclude concepts that undermine breastfeeding. Generally, most resources fall into "Why" or "How-To" categories. Effective breastfeeding education includes both “why” and “how-to” concepts.

1. "Why Breastfeed" messages and media help create interest in breastfeeding and motivate people to consider breastfeeding in a positive light. Within the "Why" category, the perspective taken - what is viewed as normal - matters enormously.

"Advantages of Breastfeeding" establishes formula-feeding as the norm. In research conducted for the US National Breastfeeding Campaign, most people are aware of the "benefits" of breastfeeding and consider formula-feeding to be acceptable, with breastfeeding akin to adding vitamins to an already adequate diet. "A is better than B" establishes B as normal.

When breastfeeding is treated as the normative behavior (which is a concept supported by abundant research and prestigious health authorities), any “advantages of breastfeeding” message would become "risks, drawbacks, or consequences of NOT breastfeeding." "B isn't as good as A" establishes A as normal. If breastfeeding is normal, then breastfed babies are not "healthier" - the grammatically correct statement would be "babies who are not breastfed are sicker."

Messages about the feeding decisions are more powerful and effective when breastfeeding is treated as the norm, with "consequences of not breastfeeding" presented clearly.

2. "How to Breastfeed" messages help those who have decided to breastfeed fully implement their decision. Central to this is the concept that the breastfeeding mother-baby dyad is an inseparable unit. UNICEF and the World Health Organization state in the Global Strategy for Infant and Young Child Feeding, "Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other."

Breastfed babies nurse frequently, on cue, around the clock. Breastfeeding should be comfortable and pleasant for the mother. Babies should be exclusively breastfed for six months, and breastfeeding complemented with timely, adequate and safe family foods should continue two years or longer, or as long as mother and baby desire. There is no known age beyond which breastfeeding is detrimental to the infant or mother.

Many mothers benefit from peer, professional and social support in managing the day-to-day realities of parenting and breastfeeding. The US Centers for Disease Control and Prevention (CDC) has compiled a helpful list of support resources on their web site www.CDC.gov/breastfeeding.

BFLRC has many links to breastfeeding support resources.

How to select published materials for breastfeeding education

Linda Smith developed a Score Sheet for Evaluating Breastfeeding Materials which was included in her article “A Score Sheet for Evaluating Breastfeeding Educational Materials” published in the Journal of Human Lactation 1995; 11(4), 3-7-311. This tool has been used by many agencies and professionals to evaluate pamphlets, handouts, videos, posters, and other materials. Its unique features include concepts and ideas that should be included, and concepts that should not be present. It takes only a few negative concepts to quickly undermine or even negate an otherwise good resource.

Click HERE to download the Score Sheet for Evaluating Breastfeeding Materials. This tool can be freely used without further permission under the conditions that (1) it is not sold for a profit, (2) it is not altered in any way, and (3) it is accurately attributed. To contact Linda Smith about the Score Sheet, email Lindaj@bflrc.com.

Guidelines for Evaluating Breastfeeding Educational Materials was developed by the Ohio Department of Health and is a section of Infant Feeding and Breastfeeding Support Policies for the Ohio Department of Health WIC and CFHS Programs, which were implemented in 1995. The Guidelines expand on the Score Sheet and list specific "how to" messages, common causes of breastfeeding problems, and specific errors that should not be present in client / patient education materials.

Click HERE to download the Guidelines for Evaluating Breastfeeding Educational Materials. This document was created with public funds and can be used freely with full attribution to the Ohio Department of Health. For more information about Ohio's Infant Feeding Policies, contact Ann Twiggs, RD, LD, IBCLC; Breastfeeding Coordinator; email ATWIGGS@GW.ODH.State.OH.US.

Finally, review all materials periodically. Breastfeeding materials have a "shelf life" of only a few years because new research is changing our understanding of the physiology of lactation, psychology of breastfeeding, and even the anatomy of the lactating breast. Some agencies schedule a yearly review of educational materials during World Breastfeeding Week (August 1-7). Concepts that were "state of the art" just 5 years ago may have changed, and may no longer be valid or accurate. Be prepared to purchase or create new materials periodically, if for no other reason than changing hairstyles and clothing of the people pictured.