Research type 
Desk research
Year of report 

Summary of findings


Understanding the need for a social marketing campaign

National data suggests that the group least likely to breastfeed nationally are British white women, aged 25 years old or under, living in deprived areas. This pattern is repeated in York and North Yorkshire. Research suggests that young women view breastfeeding as old-fashioned, and many do not even consider it.

This research suggest that within this proposed segment of the population there is a strong culture of bottle feeding, despite high recall of campaigns such as ‘breast is best.’ Breastfeeding is seen as the preserve of the middle-classes who are perceived to have better support networks. The main challenge in developing a social marketing campaign is to challenge the power of these social norms which mean that feeding decisions are often taken subconsciously very early in pregnancy.

Current use of services

Awareness of services was mixed, and levels of engagement low. Engagement typically involved national organisations such as the NCT and NBH. (The exception to this was the services offered by Sure Start.) Informal influencers had a much greater influence upon the feeding decision of the young women than healthcare professionals.

Developing the social marketing campaign

It is important that materials designed for grandmothers and dads are carefully designed in order to incorporate their existing ‘first hand’ knowledge, whilst encouraging them to think differently. Relevant imagery should be used to minimise the benefits of bottle feeding and maximise the benefits of breast feeding. The Be A Star materials which were pre-tested performed very positively in this regard. Strengths related not only to its potential to raise awareness of why a young woman would want to breastfeed, but also that it contained practical information about how to do it.

Interventions received most positively were the face-to-face methods of breastfeeding support groups and in-home and in-hospital peer-to-peer support.

Research objectives


The main objective for this research was to identify the most appropriate target audience for the proposed campaign and to explore the attitudes and behaviours of those least likely to breastfeed.

Specifically the research was designed to:

  • Explore attitudes to and perceptions of breastfeeding and bottle feeding, and barriers and motivations which influence choice of feeding method.
  • Evaluate awareness and usage of breastfeeding support services in North Yorkshire and York;
  • Explore levels of awareness of national breastfeeding campaigns;
  • Undertake pre-testing of the Be A Star campaign – message, visuals and textual detail;
  • Evaluate the appeal and perceived effectiveness of intervention ideas.



Breastfeeding has a major role to play in public health, as it promotes health and prevents disease in both the short and long term for both infant and mother. It is widely accepted as the best form of nutrition for infants to ensure a good start in life. Whilst overall rates of breastfeeding have increased since the last 1990s, percentages remain low versus other developed countries, and contain significant differences between different social grades. Recent national and local campaigns are perceived to have failed.

The health inequalities which result from low breastfeeding rates are well-documented and understood from an international to an individual perspective. Therefore this project aims to investigate how best NHS North Yorkshire and York can address low breastfeeding initiation and duration rates through a targeted social marketing campaign.

Quick summary


This research was designed to identify the most appropriate target audience for the proposed social marketing campaign and then to use a range of techniques to explore the attitudes and behaviours of those least likely to breastfeed.

Audience Summary



Not specified


  • Mums and mums-to-be aged 25 and under.
  • Ages of the ‘key influencers’ not specified.

Social Class


Not specified



  • Analysis of data gathered by NHS North Yorkshire and York (maternity rates, breastfeeding initiation rates, etc.
  • Some consultation with healthcare professionals (at the inception meeting)
  • Qualitative methods:
  1. 3x focus groups with: i) 4 new mums aged between 16 and 20 years old, ii) 5 mums-to-be aged between 15 and 19 years old and 4 partners. Iii) 3 mums-to-be aged 17.
  2. 39x ‘street intercepts’ (short qualitative interviews) with new mums, mums-to-be, grandparents, partners.
  • Quantitative self-completion questionnaires (x71 in all), circulated via health visitors, children’s centres, midwives and community midwives. Three questionnaires were used, one each for new mums (aged  < 25), mums-to-be (aged < 25), and partners / parents / friends.

Data collection methodology

Depth interviews
Focus groups
Textual/documentary analysis

Other data collection methodology


Self-completion quantitative questionnaires

Sample size

  • 3x focus groups comprising a total of 16 people
  • 39x short qualitative interviews (i.e. 39 people)
  • 71x self completion questionnaires (i.e. 71 people)

Detailed region


Qualitative research undertaken in York and Scarborough.
Distribution of self-completion questionnaires not specified; possibly across York and North Yorkshire.

Fieldwork dates


June and July 2009

Agree to publish



Research agency

The hub