Unintended Consequences of "Breast Is Best" Messaging on Mothers: An Autoethnography

Purpose: To describe the breastfeeding experiences of a dietitian and mother so as to expose dominant discourses reinforcing expert-driven imperatives to breastfeed. Methods: Professional experiences and personal challenges related to breastfeeding promotion are described, analyzed, and interpreted using autoethnography. The social ecological model (SEM) is used as a sensitizing concept to guide the organization, presentation, and analysis of experiences. Results: Data were organized into two discussion themes: breastfeeding promotion practices and "failure" to breastfeed. Dominant discourses reinforcing expert-driven imperatives to breastfeed are revealed, including health as a duty, intensive motherhood, and mother blame. Discourses promoting or reinforcing breastfeeding simultaneously judge and denormalize formula-feeding. Conclusions: Contemporary breastfeeding promotion messages and strategies are quiet coercions used to influence infant-feeding decisions and do not support the principles of evidence-based practice, person-centred care, and informed choice.