Five Questions to Build Your Message

Free-Range Thinking | October 2001

A campaign that successfully promoted breastfeeding demonstrates how answering five questions can help any public interest group craft the most persuasive message.

Few things seem as instinctive and natural as breastfeeding, and its advantages over formula appear overwhelming. For babies, mother’s milk can decrease the incidence of allergies, respiratory problems, ear infections, sudden infant death syndrome and diabetes. For nursing mothers, breastfeeding can reduce the risk of breast and uterine cancer, improve bone density, and speed weight-loss after pregnancy. Little wonder, then, that the American Pediatric Association recommends breastfeeding exclusively for the first six months of a baby’s life and as part of the diet for at least a full year.

Nevertheless, only about six in ten American mothers breastfeed their children immediately after delivery, and by six months that number drops to roughly two in ten. Infant formula, with its promise of greater freedom and flexibility (not to mention corporate marketing muscle), continues to be a powerful competitor, and it now requires millions of dollars to convince new mothers to breastfeed. One such campaign, the USDA National Breastfeeding Promotion Project, launched by Best Start Social Marketing, a Tampa-based nonprofit, is noteworthy for two reasons. While the campaign successfully increased breastfeeding rates, it also demonstrates how answering five questions can help you craft the most persuasive message:

1. Who is your target audience?
With a sizable grant from the US Department of Agriculture, Best Start was able to develop a campaign for ten states. The group did not want to waste any dollars, however, talking to mothers who were already planning to breastfeed. For the targeted areas in which the campaign would run, this meant keeping the focus on at-risk mothers and economically-disadvantaged single mothers primarily from Latino, Haitian, and Native American communities.

2. What does the target audience believe that supports your objectives?
Focus groups revealed several positive attitudes about breastfeeding upon which a message could be built. The women interviewed were well aware of the health benefits for mother and child, they enjoyed the physical experience, felt it was an important part of the bonding process with their babies, and also reported that breastfeeding distinguished them from other caregivers. The importance they attached to each of these factors, however, was what mattered most to Best Start. “As we were teasing out the proper way to reach these women,” said Best Start’s Director, Jim Lindenberger, “it became evident that health messages weren’t going to do it. Number one: they already knew it, and number two, that’s not why they were having babies.” The bonding aspects of breastfeeding, in contrast, were emerging as extremely persuasive.

3. What does the target audience believe that creates barriers for your objectives?
Audience research also uncovered attitudes so strongly negative that overcoming them became as important (if not more important) than building on the positive. “It’s like showing your body in public,” said one mother who had already decided against breastfeeding. “The life of a breastfeeder revolves around the baby. You have no life,” said another. There were also numerous complaints about hospitals, friends, and especially family members who made the process more difficult. Among all these “costs” of breastfeeding, lack of support was clearly another major factor.

4. Where does the target audience get information about your issue?
If you’re going to change the way people think and behave, you have to know where they turn first for information and advice. In Best Start’s focus groups, the answer came back loud and clear: the mother’s own mother was the primary source. Ann Altman, a principal in the advertising agency that developed the campaign’s message, recognized this as another critical piece of the message puzzle. “We saw that the target was incredibly influenced by their mothers, husbands or boyfriends,” Altman said. “The challenge would be to encourage all these people to provide the support necessary for women to breastfeed.”

5. Which spokesperson(s) will the target audience most readily believe?
Even the most finely crafted message may fall on deaf ears if it comes out of the wrong mouth. (Picture George W. explaining why “reading is fundamental.”) Once again, Best Start turned to focus group participants to learn whom they trusted most. Predictably, the women said they would trust people like themselves: working women from a range of racial and ethnic backgrounds. Consequently, the ads Altman’s team developed prominently featured a rainbow of nursing moms and, of course, their co-starring babies.


With answers to these five questions in hand, Altman’s agency developed a campaign around the theme, “Loving support makes breastfeeding work.” Posters and brochures in public health centers, carefully selected billboards (like the one pictured), and broadcast ads featured nursing moms bonding with their babies while explicitly encouraging the people around them to support breastfeeding. As the research predicted, the campaign struck a chord. Breastfeeding rates increased in the targeted states and today, according to Lindenberger, “every state in the country uses this program in some form or another.”

Lindenberger is quick to add that communications was only one contributor to an effort that also relied on heavy doses of community relations, in-hospital programs and other forms of outreach. There can be no doubt, though, that starting with the right message was critically important. So even if someone on your team thinks he has all the answers, take a moment to work through these five questions. It’s one formula even Jim Lindenberger will endorse.

 free-range follow-up

It’s not easy being greener.

Environmental groups tend to avoid open competition, but behind-the-scenes elbowing for recognition as “most environmental” is not uncommon. The problem of labeling one group as “greener” than another, however, is that this term also connotes inexperience. It also fails to adequately convey the self-righteousness that usually accompanies this claim. So, in the interest of precise communication, may I humbly submit granolier-than-thou, as in, “Everyone from Greenpeace biked to the meeting, so they entered the conference room with granolier-than-thou attitude.”


The Visual Battle Over Abortion.

Did Life Magazine Play a Pivotal Role?

If you are personally or professionally interested in the abortion issue, Maud Lavin’s new book, Clean New World: Culture, Politics, and Graphic Design (MIT Press 2001), has one chapter which you’ll probably find fascinating. In “A Baby and a Coat Hanger: Visual Propaganda in the U.S. Abortion Debate,” Lavin describes how pro-life advocates have used images more effectively than their pro-choice counterparts:

“Using new technologies in fetal imagery like ultra-sound sonograms, the right-to-life movement has expanded its propaganda, emphasizing design and photographs. The pro-choice movement has produced generally less dramatic and less effective images of pregnant women, happy planned families, and that icon of desperation, the coat-hanger.”

Lavin points to 1965 as a watershed year in this ongoing visual battle due to Life magazine’s memorable photo essay of a living embryo inside its mother’s womb. “When viewers become familiar with seeing the fetus independent of the mother,” Lavin writes, “they can more easily begin to consider fetal rights as if separable from maternal ones.” For pro-choice advocates, says Lavin, the visual battle has been uphill ever since