Support to woman/nourisher in the advertising pieces of the World Breastfeeding Week

ABSTRACT

Objective:

to unveil the support to woman/nourisher in the advertisements of the World Breastfeeding Week.

Method:

This is a descriptive, exploratory, documentary, qualitative study. Since the collection until the analyses of these advertisements, we adopted the methodological steps of Gemma Penn, based on the semiology of Roland Barthes. The results were interpreted by the theory of Social Network of Sanícola and of the five types of support: companionship, emotional, instrumental, informational, and self-supportive.

Results:

we identified actors of the social network of the woman/nourisher in nine advertisements of the 22 world breastfeeding weeks. In five of them, partner, grandmother, and brother showed emotional and companionship support to breastfeeding. We observed self-support in three posters; instrumental support in one; and informational support in none.

Conclusion:

the support unraveled in only five advertisements included: emotional, companionship, instrumental, and self-supportive. In the others, there was no support. The set of supports was not revealed in any of them.

Descriptors:
Breastfeeding; Social Network; Advertising as Topic; Women; Nursing

RESUMO

Objetivo:

desvendar os apoios da rede social da mulher/nutriz nas peças publicitárias da Semana Mundial da Amamentação.

Método:

estudo descritivo, exploratório, documental, qualitativo. Desde a coleta até a análise dessas peças, foram adotados os passos metodológicos de Gemma Penn, fundamentados na semiologia de Roland Barthes. Os resultados foram interpretados pela teoria da Rede Social de Sanícola e dos cinco tipos de apoio: presencial, emocional, instrumental, informativo e autoapoio.

Resultados:

em nove peças publicitárias das 22 semanas mundiais da amamentação, identificou-se/identificaram-se ator(es) da rede social da mulher/nutriz. Em cinco delas, companheiro, avó e irmão demonstraram apoio emocional e presencial à amamentação. Percebeu-se o autoapoio em três cartazes; o apoio instrumental, em um cartaz; e o apoio informativo, em cartaz algum.

Conclusão:

os apoios desvendados em apenas cinco peças publicitárias incluíram: emocional, presencial, instrumental e autoapoio. Nas demais, não havia apoio. Em nenhuma delas, o conjunto dos apoios foi revelado.

Descritores:
Aleitamento Materno; Rede Social; Publicidade como Assunto; Mulheres; Enfermagem

RESUMEN

Objetivo:

desvelar los apoyos de la red social de la mujer/nutriz en las piezas publicitarias de la Semana Mundial da Lactancia Materna.

Método:

estudio descriptivo, exploratorio, documental, cualitativo. Desde la reunión hasta el análisis de esas piezas, se adoptaron los pasos metodológicos de Gemma Penn, fundamentados en la semiología de Roland Barthes. Los resultados fueron interpretados por la teoría de la Red Social de Sanícola y de los cinco tipos de apoyo: presencial, emocional, instrumental, informativo y auto-apoyo.

Resultados:

en nueve piezas publicitarias de las 22 semanas mundiales de la lactancia materna, seidentificó/se identificaron actor(es) de la rede social de la mujer/nutriz. En cinco de ellas, compañero, abuelo y hermano demostraron apoyo emocional y presencial a la lactancia materna. El auto-apoyo se vio en tres carteles; el apoyo instrumental, en un cartel; y el apoyo informativo, en ningún cartel.

Conclusión:

los apoyos desvelados en solo cinco piezas publicitarias incluyeron: emocional, presencial, instrumental y auto-apoyo. En las demás, no había apoyo. El conjunto de los apoyos no se reveló en ninguna de ellas.

Descriptores:
Lactancia Materna; Red Social; Publicidad como Tema; Mujeres; Enfermería

INTRODUCTION

Breastfeeding and the complementary healthy feeding offered to children may contribute, along with other interventions, to achieve the eight Millennium Development Goals established by the United Nations⁽¹⁾. For that, Brazil develops policies for promoting, protecting, and supporting breastfeeding, such as: Baby Friendly Hospital Initiative, Brazilian Network of Human Milk Banks, Legal Protection to Breastfeeding, Social Mobilization, Monitoring of Breastfeeding Indicators, and the Breastfeed and Feed Strategy Brazil⁽²⁾.

The policy for social mobilization, whose goal is the success of breastfeeding, celebrates annually, in the first week of August, the World Breastfeeding Week (WBW). At that moment, advertising pieces are released, with a theme chosen by the World Alliance for Breastfeeding Action (WABA)⁽³⁾. These pieces, produced for a campaign of propaganda or advertising, consist of images and texts⁽⁴⁾, distributed in health institutions and transmitted in the media.

Despite the benefits of breastfeeding, only 37% of children are exclusively breastfed in the world⁽⁵⁾. In Brazil, due to the advances of those policies, the duration of this practice has improved, as the following indexes show: from 3.1% of exclusive breastfeeding in 1980 to 38.6% in 2006; and from 9.9 months to 11.3 in the period from 1999 to 2008, with an increase of just over a month in the median duration of breastfeeding. Nevertheless, early weaning is still a reality⁽²⁾. This is because the success of breastfeeding is also linked to the support of the social network, which cooperates in meeting the physical, emotional, social, cultural, intellectual, and professional needs of women⁽⁶⁾.

This network is formed from social relations and can be classified into primary (mother, partner, and family) and secondary (health professionals)^(7-8). These actors, during the process of breastfeeding, can offer five types of support: a) emotional, which refers to the expression of empathy, kindness, and concern for the person, positive appreciation, encouragement, agreement with ideas and feelings; b) instrumental, by which the person receives practical help; c) informational, concerning advices, directions, suggestions, or feedback on how the person is doing; d) companionship, being the availability to spend time with the person; e) self-supportive, when the one supports oneself⁽⁹⁾.

These actors of the woman's social network are indispensable to the establishment and maintenance of breastfeeding with tranquillity and pleasure for the whole family. Thus, there is a need for broad public disclosure about the involvement of these actors in supporting the woman/nourisher, so that they become aware of the co-responsibility of this practice in the construction of a new culture which, today, focuses only on the responsibility of the woman. Therefore, this study aimed to unveil the supports of the woman/nourisher's social network in the advertisements of the World Breastfeeding Week.

METHOD

Ethical aspects

The research did not require approval of the Research Ethics Committee, since this documentary study was about the advertisements of WBW in Brazil - public domain documents - and we did not carry out interviews.

Type of study and theoretical-methodological framework

This was a descriptive, exploratory, qualitative, documentary study of the advertisements of WBW. We used, as theoretical-methodological framework, the steps proposed by Gemma Penn⁽¹⁰⁾, based on the semiology of Roland Barthes⁽¹¹⁾.

Barthes (1915-1980), French semiologist, contributed to the analysis of advertising images, considering Semiology as "that part [of language] that encompasses the large meaning units of discourse"⁽¹¹⁾. According to him, there would be three "layers" in the message conveyed by advertisements: the literal iconic, which consists in the recognition of the elements present on the scene; the symbolic iconic, represented by the association between the iconic signs selected according to the context in which the scene is inserted; and the linguistic, whose job is to guide the understanding of the image, which is polysemic and has multiple meanings⁽¹¹⁾.

Gemma Penn⁽¹⁰⁾ presents a method that directs this understanding of the image and complements the analysis proposed by Barthes. For the author, the image is always polysemic, and the textual component helps elucidating the discourse's meaning. While the signs appear sequentially in the written language, they appear simultaneously in the image. Therefore, it is suggested that the semiotic analysis have first to identify the denotative inventory to only after establish higher levels of signification, in order to better seize the imagetic signs.

In the context of breastfeeding, the methodological steps of Gemma Penn⁽¹⁰⁾ and the semiology of Barthes⁽¹¹⁾ allow us to analyze the visual and textual messages transmitted in the advertisements of WBW.

Methodological procedures

Study background

The advertisements of WBW in Brazil, released by the Ministry of Health (MS) and Brazilian Society of Pediatrics (SBP), were chosen as background for data collection.

Data source

The sample consisted of nine posters of WBW of Brazil (2005, 2006, 2007, 2008, 2010, 2012, 2013, and 2014 [two posters]) that have been selected for bringing, in the visual and/or textual messages, actors from the woman/nourisher's primary and secondary social network. These established inclusion criteria enabled the identification of the supports given by the actors of the social network to the woman during the process of breastfeeding.

Data collection and organization

Data collection started with the choice of material, according to the first methodological step of Gemma Penn⁽¹⁰⁾, based on the semiology of Barthes⁽¹¹⁾. The choice of material, the advertisements of WBW of Brazil, followed certain inclusion criteria and was held at the website of the Ministry of Health (MS) and Brazilian Society of Pediatrics (SBP). After selection, these pieces were acquired in a Baby Friendly Hospital and in the Health Secretariat of Pernambuco, in the form of printed posters, original size.

Data analysis

The data analysis, composed by the identification of the denotative inventory and establishment of higher levels of signification, was also guided by the methodological steps of Gemma Penn⁽¹⁰⁾, based on the constructs of Barthes⁽¹¹⁾.

After the selection of the nine advertisements of WBW and before starting the denotative inventory, we did a descriptive analysis of all the posters together, exploring information, abstracting similarities and differences about size, shape, environment, characters, and sponsors. Based on these descriptive information about the set of selected advertisements, we proceeded to identify the denotative inventory by individual analysis of each poster in its original size.

For this, we undertook a detailed and meticulous description in the physical medium - visual and textual component - separately. Regarding the visual component, we registered the size and orientation of the poster (portrait/landscape), the setting, the characters (quantity, their location on the poster, specification of race/skin color, hair, eyes, direction of gaze, position, breasts, clothes, use of ornaments), the logos designs, and the existence of objects in the posters. The textual component was read from left to right, top to bottom, traversing a "visual" path in the form of the letter Z⁽¹²⁾, transcribed in full, analyzing how the typography - color, layout on the page, and size of the characters - contributed to the meaning of the visual message. In this detailed description, we also identified the existing characters in the visual and textual component of the poster, verifying their belonging to the type of network, primary and secondary, and to the possible social relations with the woman/nourisher, according to the theory of Social Network⁽⁷⁾.

At the end of the reading of the textual and visual component, we sought to identify the relationship between the text and image of the advertising piece, to understand the anchorage in which the text suppresses the ambiguity of the image or the relay, when text and image, together, produce the full meaning. The advertisements of WBW were understood by signs, which defined various interpretations. The visual image was anchored by the accompanying text, articulating its signifier (in the form of nomenclature or expression plan) and its signified (in the form of use/reasons or content plan) by the mechanism of denotation and connotation. Denotation refers to the literal message of the component, and connotation, to the symbolic message (extension of denotation), which requires cultural knowledge⁽¹¹⁾.

After anchoring and/or relay, we established the higher levels of signification, defined by the association between signifier (or image), signified (or concept or idea)⁽¹¹⁾, made from the denotative inventory, and syntagma, in which we collected the aspects needed for the construction of the connotation, the symbolic message, anchored by the cultural knowledge and the identification of types of support.

Continuing the data analysis procedures, the syntagmatic relationship was formulated from the understanding that syntagma is a spoken sentence defined by the combination of signs, since speech goes beyond the extent of phonation⁽¹¹⁾. These signs, side by side, create a specific utterance, commonly understood as a sentence.

After the syntagma production, we analyzed the development of the connotation, which consisted in the interpretation of the relationship that the actors in the social network had with the woman/nourisher and the expression of breastfeeding presented in the images.

To better understand the connotation, some questions were made: What did each element connote? What was implicit in each image and text identified? How was the relationship between the elements? Which social network was identified according to Sanícola's theory? What kind of support to breastfeeding was given by the member of the social network? What cultural, historical, political knowledge of women and child health were found in the scientific discourses? What facts related to breastfeeding and social network were identified in the literature? To complete the analysis, the denotative inventory and the highest levels of signification of each poster were re-read several times, to verify if the associations had been designed.

The results of this study will be presented in frame, in line with each advertising piece selected, whose image depicts in itself the visual aspect of the denotative inventory and the results of the analysis process that referred to the connotation. The interpretation of results was grounded by the Theory of the Social Network⁽⁷⁾ and by the five types of support - companionship, emotional, instrumental, informational, and self-supportive⁽⁹⁾ - appearing in the posters, given by actors of the woman/nourisher's primary and secondary network.

The Theory of the Social Network allows us to understand that, from the construction of these networks, people and family are inserted in the social relations. There is, as already described, the primary and secondary network, and, in each one of them, different subtypes and modalities.

The primary consists of family, kinship, neighbors, coworkers, and friends, who develop specific skills, such as proximity and preference. The secondary can be divided into formal and informal. The informal are the ties established between individuals with the aim of supplying an immediate need, in which the bond is based on solidarity. The formal is represented by institutions (health institutions, schools, and social services), non-profit third sector organizations, and market organizations that are included in the economic sphere⁽⁷⁾.

RESULTS

Of the 22 WBWs, between the years of 1992 and 2014, only nine advertisements showed in their visual and/or textual component some of the actors of the woman/nourisher's social network. Most of these actors, represented by partner (2007, 2013, 2014 of SBP), grandmother (2008, 2014 of SBP), and brother (2014 of MS), belongs to the primary social network. The secondary social network was only observed in two advertisements, one by the visual component (2013) and the other by the textual component (2006), because of the theme of the WBW "Breastfeeding. Ensuring this right is everyone's responsibility", in which the health-care professional did not offer any type of support to the woman/nourisher (Chart 1).

Chart 1
Denotative inventory, connotation/myth of the World Breastfeeding Weeks of Brazil, types of support, and woman/nourisher’s social network

Advertising Piece/Synthesis of the Denotative Inventory	Connotation/Myth	Networks and supports identified
WBW 2005 of MS Smiling actresses, frontal look, upright position, sitting, supported laterally on each other, breastfeeding children, without maintaining visual contact with each other.	Although the young actresses are breastfeeding without help from people of the social network to which they belong, they show self-confidence, independence, calm, pleasure, and happiness, because the voluminous breasts produce and excrete the liquid that gives life, the breast milk. This dialogue with the audience recovers the myth that the woman is always able to breastfeed and that this practice occurs easily, even when the position is not comfortable. What proves this is that both are at the center of the poster, looking forward, showing how they are empowered to breastfeed, regardless of the presence of others around them and even without the maintenance of visual affective bond with the children, who seem to suck smoothly most of the areola and appear to be healthy because of breast milk. Therefore, the interlocutor infers that every child is able to only breastfeed for six months and, after that period, keeps sucking, even with the introduction of other foods. Thus, every woman should breastfeed her child. Reinforcing this myth, the advertising piece shows that women and children are able to practice breastfeeding without the support of the actors of the social network, since only the woman is responsible for breastfeeding her child.	Primary No support
WBW 2006 of MS Actress sketches a smile, has frontal look, is in upright position and sitting. She breastfeeds a child, but does not establish visual contact with him/her.	Although the theme of WBW, featured in the center of the poster, says that the right to breastfeed is everyone’s responsibility, this advertising piece features a public woman, alone experienced, breastfeeding her child. There is no support from her social network. The woman expresses self-confidence, independence, peace, pleasure, and happiness. This dialogue with the audience emphasizes that a woman in advanced age is able to breastfeed easily, for a longer period of time, even in non-comfortable position. This perception, coming from the communication of the poster, is reinforced by the white of her clothes, color that symbolizes peace and tranquility and by the forward direction of her gaze, which signals that the woman has power to breastfeed with no one around to support her and without maintaining affective visual bond with her child. The child is peaceful, sucking the breast of his mother, and looks healthy due to the properties of breast milk. One infers, therefore, that every child is able to breastfeed exclusively for six months and, after this period, keep sucking, even with the introduction of other foods, and that every woman should breastfeed her child for the maximum time, without support of the actors of her social network. This is a myth refreshed by this advertising piece: that the woman is the only responsible for breastfeeding her child.	Primary and Secondary No support
WBW 2007 of MS The actors are next to each other. They smile and look at the child. Both are sitting. He is with the left hand on the shoulder of the nourisher and the right over her leg. She breastfeeds a small child.	The social network was not included in the theme of WBW, but the advertising piece features an actress breastfeeding her child in a comfortable position, in the presence of one of the members of her primary social network, her partner, which shows a feeling of intimacy, complicity, and protection. He, for being a famous actor, can communicate to the public the idea of perfect and model husband, and that it is possible for the father to participate in the child feeding, staying close and involved since the earliest hours of the child’s life. This involvement is signaled by the way he embraces his partner, by his look and smile toward the newborn that breastfeeds. The child, in turn, is sucking most of the areola of the breast exposed, in which one sees the blue venous plexus (Haller’s plexus). However, we can see the lower lip of the child inward, sign of incorrect sucking that has not been corrected in time — before the process of photographing — neither by mother nor father. The predominance of white in the clothes suggests cleaning, peace, calm, and tranquility in the act of breastfeeding. However, this feeling is not always perceived during breastfeeding. This advertising piece does not refer to “breastfeeding in the first hour”. Signs of this are the facial and body appearance of the actress, as well as the complete cleaning of the newborn. On the other hand, the piece reinforces the idea that the father can support the child’s breastfeeding and that he needs support and guidance to be able to help the woman, even when the sucking is incorrect.	Primary Emotional and companionship support of partner. Self-support of the nourisher.
SMAM 2008 do MS Atriz, vestida de branco, amamenta o filho ao lado de sua mãe, que a envolve com os braços e mãos, cujas peles são enrugadas. Ambas esboçam um sorriso e se olham.	The theme of this WBW stresses the importance of the support of the woman’s social network during breastfeeding. This advertising piece, in keeping with the theme, features a public woman breastfeeding her child in a comfortable position, with help from her mother, a member of the primary social network, which becomes publicly known. Both, by their tender look, and the grandmother, by hugging her daughter and grandson, communicate a feeling of complicity and acceptance. The presence of Dona Flor suggests an environment of tranquility, because her experience makes her daughter confident, happy, and safe. However, the tranquility of the act of breastfeeding, reinforced by the white clothes of the nourisher, not always takes place. This practice occurs in a quiet way when the baby is well positioned, aligned to the mother’s body, making the correct sucking— upper and lower lip facing out, chin and nose against the breast —, and when there is support by the actors of the woman’s social network. The image of a healthy baby highlights the benefits of breastfeeding for the child. The advertising emphasizes the need to feed the child with breast milk, but draws attention to the fact that the breastfeeding success depends on the support of people from the woman’s primary social network.	Primary Emotional and companionship support of maternal grandmother
SMAM 2010 do MS Veem-se na peça três mulheres: uma negra, segurando uma criança, e duas brancas, sendo uma gestante. Uma ao lado da outra, têm olhar frontal e sorriem. Vestem roupas em que predomina a cor branca. Não há entre elas contato visual com a criança, que não está mamando. Todas estão em pé, em um ambiente bucólico de estúdio fotográfico.	In the textual component of this advertising piece, we read that breastfeeding brings benefits to the child, but neither the practice of breastfeeding nor the support of the woman’s social network is shown. Although there are three young women, of different skin color and fertile periods, with predominance of white clothes, standing, with frontal look, happy, in a bucolic environment assembled in a photographic studio, one does not see a supportive relationship between them. The child, who looks healthy, sleeps peacefully in the arms of the black woman. Possibly, he/she only breastfed until six months and keeps sucking, even with the introduction of other foods, because of the benefit of breast milk.	Primary No support.
WBW 2012 of MS Young women, sitting on a river bank, smile when breastfeeding the children. The actress has a frontal look and is distant from the others who look at the children in their laps. The older child looks smiling at a baby that breastfeeds.	Breastfeeding is seen in this poster as a lonely event between mother and child, because the women do not show bonds between themselves. Therefore, there is no supportive social network between them. The two women who breastfeed, in a public place (park), without embarrassment, show bonds only with their children and satisfaction with the very practice of breastfeeding. The actress who breastfeed her child is not inserted in this scenario, nor keeps a bond with it: she expresses self-confidence, independence, tranquillity, and pleasure to offer breast milk to her child, considered the best food for the reduction of child mortality. The only character who seems to be an actor in a primary social network to support breastfeeding is an older child, by the look and smile. This child, in the future, may be a great encourager of breastfeeding, for experiencing this practice closely.	Primary No support from the actress. Self-support from the women in the park. Emotional and companionship support of the child.
A couple, in a children’s office, wears colorful clothes, is sitting and smiling. One look at the other and each hold a child. The baby, in the mother’s lap, is breastfeeding. The health professional wears a white coat, glasses, is sitting and smiling. She does not look the at the couple nor the kids, but to the front.	In the textual component of the WBW theme, one can see the importance of the support of the primary social network, by the father figure, and of the secondary, by the presence of the health professional. In the visual component, we observe a couple in a child’s office. The mother breastfeeds one of them and the father holds the other. Both exchange glances of complicity and happiness. Together, in the consultation, they are interested in listening to what the professional has to say. The attitude of the couple shows the support needed for the success of the practice of breastfeeding. However, the health-care professional remains distant, without showing support, because she not even look at the couple, which shows the little importance given to the primary social network. She, with frontal look, wearing glasses and coat, expresses grandiosity and expertise, and suggests that the success of breastfeeding depends mainly on her performance.	Primary and Secondary Emotional, instrumental, and companionship support of partner
WBW 2014 of SBP Father, grandmother, and mother, close to each other, wear colorful clothes and are smiling. They look at the child who is breastfeeding. The aunt also smiles and has frontal look; thus, she does not maintain eye contact with the other characters.	The focus of the theme of WBW is not centered in the supports that the social network can offer the woman/nourisher, but the advertising piece features a supporter family, with physical characteristics similar to those of the Brazilian people. They are not known public figures and seem to be members of a popular family, whose skin color shows the Brazilian miscegenation. The clothing and accessories are more accessible, except the production in makeup and hair. This family, close and happy, characterizes the support of the primary social network, highlighted by the look of mother, father, and grandmother, directed to the child breastfeeding, which involves everyone in this practice. The presence of these actors contributes to the self-esteem, confidence, and safety of the woman/nourisher. The colorful clothes, acnes on face of aunt and father, and flaccid breasts of the mother reflect the everyday reality with less staging, though the scenario is a photographic studio. The teenager is not looking at the child being breastfed, but her smiling attitude shows pride to be present in this context. The child apparently is healthy due to the benefits of breastfeeding. The comfortable posture of mother and baby, well positioned, shows the proper way to breastfeed a child.	Primary Emotional and companionship support of grandmother and partner. Self-support of the nourisher. No support from the aunt.
WBW 2014 of MS An actress dressed in white breastfeeds her daughter alongside her son, in the room, sitting in a comfortable chair. Both smile and look forward; thus, not maintaining eye contact with the baby. On top of their heads, there is a mobile that brings pictures of the girl dressed in different ways.	The WBW presented by this advertising piece emphasizes the benefits of exclusive and supplemented breastfeeding for a promising future to the children. However, it was not emphasized that the woman needs support from the actors of her social network to the beginning and continuation of exclusive breastfeeding for six months and permanence of this practice with the introduction of other foods for a period of two years or more. The woman and child look forward, showing joy, autonomy, confidence, and empowerment. Once again they reinforce that breastfeeding is a calm practice, happening easily, and that every woman who wants to breastfeed can do this, even without support.	Primary No support.

• Note: WBW: World Breastfeeding Week of Brazil; MS: Ministry of Health.

Of the five types of support, the emotional and companionship were found in five ads (2007, 2008, 2012, 2013, and 2014 of SBP); the self-supportive, in three (2007, 2012, and 2014 of SBP); the instrumental, in one (2013); and the informational did not appear in any advertising piece. In four posters (2005, 2006, 2010, and 2014 of MS), no support was observed. We highlight that the set of five kinds of support - emotional, companionship, informational, instrumental, and self-supportive- was not present in any advertising piece (Chart 1).

In the synthesis of the denotative inventory (Chart 1), we observed that the advertisements feature soft colors, mostly white, including the skin color of the characters, except in the posters of 2010 and 2014 of SBP. Most characters (2005, 2006, 2007, 2008, 2012, 2013, 2014 of SBP) is a public figure, is in a sitting position, have a frontal look and, therefore, does not maintain eye contact with the child being breastfed. Calls attention the fact that, in the only advertising piece (2013) in which the health professional is visually present, there is no interaction with the couple and children; unlike the actors of posters of 2007, 2008, and 2014 of SBP, which interact with the woman/nourisher by physical proximity and look.

DISCUSSION

In the 22 WBWs, represented by nine posters, we identified, only in eight weeks, in the textual and visual component, members of the woman/nourisher's social network. However, the posters that showed public personalities (artists) did not signaled, in their entirety, the support that the woman/nourisher needs to breastfeed, considering that the woman has been identified as the only responsible for breastfeeding her child.

This accountability for the act of breastfeeding⁽¹³⁾ can be due to the capacity of the woman to produce breast milk. However, if this biological aspect was crucial to breastfeeding, all women would breastfeed their child. In everyday life, multiple factors from the historical, social, and cultural context influence the onset and establishment of breastfeeding⁽¹⁴⁾.

In addition, this practice is learned by cultural socialization, mainly by comments inside the family⁽¹⁵⁾. In this sense, during the process of breastfeeding, doubts, uncertainties, difficulties, insecurities, and other feelings that do not empower the woman to breastfeed may arise. Therefore, the advertisements on breastfeeding should not communicate only the tranquility, self-confidence, and happiness experienced by the woman/nourisher, since this whirl of positive feelings may be different than those experienced by other women/nourishers.

These advertisements should show the social network supporting the woman/nourisher, since evidence prove that women supported by their network breastfeed longer⁽¹⁶⁾. The support offered by actions, attitudes, and behaviors can be: the emotional support, by the attention, affection, fondness, and joy; the instrumental, participating in prenatal consultations and home visits, helping to position and hold the baby, dividing domestic tasks; the companionship, being close to the woman/nourisher, making her company when breastfeeding; the informational, providing practical help and advice; and the self-supportive, remaining self-confident in the continuity of breastfeeding⁽⁹⁾.

The informative support, not identified in any advertising piece, provides needed guidance to ensure that the process of breastfeeding happens calmly, preventing cracks of nipples, engorged breasts, breast abscesses, among other problems⁽⁹⁾. It should be noted that the textual component of most posters confirms that the practice of breastfeeding is the biological duty of the mother, has advantages for the baby, and imposes only to the woman the responsibility for breastfeeding.

The advertising of 2013 revealed the instrumental support, shown by the practical help from the father when carrying the child on his lap. When the woman/nourisher receives this type of support, she can devote herself to breastfeeding and does not feel so overloaded with the tasks of her daily live.

The father's involvement, since the prenatal period and after the birth, promotes breastfeeding. In women who have had such support, breastfeeding indicators were better⁽¹⁷⁾. However, even so, the father figure was revealed in the breastfeeding campaigns once again showing the hegemonic model based on the view of maternal responsibility⁽¹³⁾.

Most of the members of the social network is present in this period of the woman's life, and many of them do not recognize they are offering support for the practice of breastfeeding. Some health professionals also do not identify these proactive attitudes, because of the frozen view based on maternal responsibility, failing to praise them⁽¹⁸⁾.

The most observed types of support were the emotional and the companionship offered by the child's father and grandmother, who belong to the primary network, the family. This organization represents the supportive social network more close to the woman/nourisher, the father and grandmother being the more present components that influence the process of breastfeeding⁽⁹⁾. This influence can both encourage breastfeeding and lead to early weaning. This interruption was evidenced in a group of women who had the presence of mother or mother-in-law when compared to other women who did not live with them, being justified by the orientation, for their part, in offering other foods, such as tea and water⁽¹⁹⁾.

Women are often supported by the grandmother of the child, whose expertise and experience are valued by the woman/nourisher, who feels confident when receiving from them emotional and companionship support that strengthens the practice of breastfeeding⁽⁹⁾. The grandmothers, who appeared in the advertisements, showed the support a woman needs to breastfeed. Because of this, we can see how much grandmothers should be oriented to participate actively in this accountability. The family participation on breastfeeding is a contextualized topic in researches, since it is an event experienced by the food culture and the context of life^(8-9).

Some advertisements have shown the women's self-support, expressed by the exchange of glances with their child, admiration, approval, and satisfaction in breastfeeding, contributing to their self-esteem and, consequently, providing a more durable breastfeeding. This feeling, when strengthened, promotes breastfeeding and, even before difficulties, weaning does not occur early⁽⁶⁾.

Of the nine posters analyzed, the 2008 advertising piece, both in the textual and visual component, and that of 2014 (SBP), in the visual, were those that managed to reveal the support of the woman/nourisher's social network. On the poster, the grandmother embraces her daughter and grandson, and they exchange glances, transmitting a feeling of complicity and acceptance. And the 2014 poster managed, among all the posters, to show more than one actor of the primary social network supporting the woman/nourisher on breastfeeding. This family, represented by the partner and grandmother, both close, look happy at the breastfeeding woman. The supports identified in these pieces were the emotional and the companionship of the family, and the self-support of the woman/nourisher. When these actors exert positive influence on the process of breastfeeding and the woman is determined to breastfeed, this process is more durable⁽¹⁶⁾.

In relation to the secondary social network of the woman/nourisher, we identified, in the visual component of an advertising piece (2013), the presence of a health professional, which did not offer any kind of support; she remained distant from the couple, without looking. The posture of frontal look, wearing glasses and coat, expresses grandiosity, competence, and vertical interaction with the woman/nourisher and her partner. In the 2006 poster, the secondary network is implicit in the textual component when referencing that breastfeeding is everyone's responsibility, however, in the image, the figure of the professional does not appear.

The role of health professionals in breastfeeding can be focused, for the most part, on the advantages of breastfeeding for the health of child and woman and on the technique of how to breastfeed a baby. In addition, communication can be verticalized in the transmission of information. Health professionals are essential to encourage breastfeeding, but this only occurs when they are inserted in a relationship of alterity and humanization with the woman/nourisher and her primary network, based on active and sensitive listening⁽²⁰⁾.

The woman and her social network should be encouraged by health professionals, since prenatal care, to discuss about the types of support of this network that can contribute to the success of breastfeeding. In this discussion, it is necessary to include sociocultural and historical aspects, previous experiences, assisted by educational materials (folders and posters of WBW), to explore beliefs, myths, and taboos about breastfeeding, thus preventing early weaning⁽²¹⁾.

The posters of WBW are a means of communication that promote the visibility of breastfeeding to all society⁽²²⁾. It can also be used by health professionals to encourage this practice and/or during the educational activities with the woman and her family⁽²³⁾. This indicates the power of these ads on the dissemination of information, which must express strengthening actions to the woman/nourisher by images close to her sociocultural reality and clear texts that are accessible to the general public. In this women's empowerment in the context of the process of breastfeeding, it is necessary to insert the actors of their social network in these posters, showing the five kinds of support, essential both for the pleasure in breastfeeding and for the co-responsibility of the primary and secondary social network in the promotion of breastfeeding.

Study limitations

The generalization of the results of this study must be conducted with caution, since the research used as data source only the advertising pieces of WBW of Brazil. Other media outlets related to the practice of breastfeeding - such as newspapers, folders, films, chapbooks, among others - were not surveyed. Nevertheless, the results present contributions to the construction of new posters of WBW.

Contributions to the field of nursing, public health, or public policy

This article identifies the actors of the social network and the types of support present in posters of WBW and, thus, makes it possible to direct the preparation of advertisements more consistent with the needs of support to the woman during the process of breastfeeding. The results favor the discussion about the promotion of breastfeeding between managers, health-care professionals, and communication technicians, addressing a more extended look to breastfeeding.

FINAL CONSIDERATIONS

The advertisements published during the WBW in Brazil, among them the posters, throughout their existence, are following the historic discourse of a breastfeeding limited to mother and child and to the advantages of the naturalization of this practice.

As breastfeeding involves several aspects, including the sociocultural ones, the woman/nourisher's social network exerts influence in the process of breastfeeding, but appeared and showed little the many types of support. The actors of this network that supported breastfeeding in the advertisements were the father, grandmother, and brother, considered primary social network. They revealed emotional and companionship support, by proximity, look, and smile toward mother or child. The health professional, member of the secondary social network, appeared in the image only in one poster, and in the textual component in another, but did not show any type of support.

This approach of inclusion of the network in the strategies of promotion, protection, and support to breastfeeding should be built by managers, health professionals, communications technicians, in addition to the participation of women and the network itself, to contribute to the dissemination of the types of support offered by the social network since the beginning and during breastfeeding up to two years or more.

This study offers subsidies for the next advertisements of WBW to address a more extended view of breastfeeding, involving and including the support of the actors of the woman's primary and secondary social network that contribute to the success of this practice.

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Publication Dates

• Publication in this collection
  Jan-Feb 2017

History

• Received
  09 May 2016
• Accepted
  26 Aug 2016