‘Off to the best start’?

A multimodal critique of breast and formula feeding health promotional discourse


  • Gavin Brookes University of Nottingham
  • Kevin Harvey University of Nottingham
  • Louise Mullany University of Nottingham




infant nutrition, breastfeeding, motherhood, neoliberalism, health promotion, multimodal critical discourse analysis


This study critically examines the multimodal discourses of baby-feeding practices in contemporary health promotion in the UK. Comparing two parallel texts from the ongoing Start4life campaign (one dedicated to breastfeeding, the other to bottle/formula feeding), our multimodal critical discourse analysis identifies a series of recurring, multisemiotic strategies through which these texts aim to promote breastfeeding as the most desirable, natural and even morally responsible method of infant nutrition. These discursive strategies, we argue, are underpinned and driven by neoliberal assumptions about infant feeding, health and risk, which fail to take into account the structural constraints that affect the take-up of the ‘ideal’ of breastfeeding, all the while propagating unobtainable and often contradictory notions of total motherhood and familial relations - discursive moves that can have negative consequences for the health and wellbeing of new mothers and their infants.

Author Biographies

  • Gavin Brookes, University of Nottingham

    Gavin Brookes is research fellow in the Centre for Research in Applied Linguistics (CRAL) in the School of English, University of Nottingham, UK. His research interests include corpus linguistics, discourse analysis, multimodality and health communication.

  • Kevin Harvey, University of Nottingham

    Kevin Harvey is lecturer in sociolinguistics in the School of English, University of Nottingham, UK. His specific research interest is in the area of discourse-based health communication, which includes corpus linguistic and multimodal approaches to health-related discourse.

  • Louise Mullany, University of Nottingham

    Louise Mullany is professor of sociolinguistics in the School of English, University of Nottingham, UK. She has published widely in the area of language and gender research and recent book publications include Language, Gender and Feminism: Theory, Methodology and Practice, with Sara Mills (Routledge). She specialises in sociolinguistic investigations of gender and language in professional settings including healthcare, businesses and organisations.


Alvin, L. P. (2016) The thematic structure of homepages: an exploratory systemic functional account. Semiotica 210: 105–127. http://dx.doi.org/10.1515/sem-2016-0048

Arora, S., McJunkin, C., Wehrer, J. and Kuhn, P. (2000) Major factors influencing breastfeeding rates: mother’s perception of father’s attitude and milk supply. Pediatrics 106: e67. http://dx.doi.org/10.1542/peds.106.5.e67

Barthes, R. (1977) Image, Music, Text. New York: Hill & Wang.

Berry, N. J. and Gribble, K. D. (2008) Breast is no longer best: promoting normal infant feeding. Maternal and Child Nutrition 4: 74–79. http://dx.doi.org/10.1111/j.1740-8709.2007.00100.x

Blum, L. M. (1993) Mothers, babies, and breastfeeding in late capitalist America: the shifting contexts of feminist theory. Feminist Studies 19: 291. http://dx.doi.org/10.2307/3178367

Borra, C., Iacovou, M. and Sevilla, A. (2015) New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Journal of Maternal and Child Health 19: 897–907. http://dx.doi.org/10.1007/s10995-014-1591-z

Brookes, G. and Harvey, K. (2015) Peddling a semiotics of fear: a critical examination of scare tactics and commercial strategies in public health promotion. Social Semiotics 25: 57–80. http://dx.doi.org/10.1080/10350330.2014.988920

Brown, B. J. and Baker, S. (2012) Responsible Citizens: Individuals, Health and Policy under Neoliberalism. London: Anthem Press. http://dx.doi.org/10.7135/UPO9780857289131

Bucholtz, M. (1999) ‘Why be normal?’ Language and identity practices in a community of nerd girls. Language in Society 28: 203–23. http://dx.doi.org/10.1017/S0047404599002043

Burchell, G. (1996) Liberal government and techniques of the self. In A. Barry, T. Osborne and N. Rose (eds) Foucault and Political Reason: Liberalism, Neo-Liberalism and Rationalities of Government 19–36. London: UCL Press.

Caldas-Coulthard, C. R. (2005) Personal web pages and the semiotic construction of academic identities. In C. R. Caldas-Coulthard and M. Toolan (eds) The Writer’s Craft, the Culture’s Technology 23–46. Amsterdam and New York: Rodopi.

Carter, P. and Campling, J. (1995) Feminism, Breasts and Breastfeeding. New York: St Martin’s Press. http://dx.doi.org/10.1057/9780230389533

Cook, G. and O’Halloran, K. A. (1999) Label literacy: factors affecting the understanding and assessment of baby food labels. In T. O’Brien (ed.) Language and Literacies: British Studies in Applied Linguistics 14 145–56. Bristol: Multilingual Matters.

Duvall, S.-S. (2015) Not ‘simply the breast’: media discourses of celebrity breastfeeding, and normalcy. Feminist Media Studies 15: 324–40. http://dx.doi.org/10.1080/14680777.2014.919334

Edwards, D. (2000) Extreme case formulations: softeners, investment, and doing nonliteral. Research on Language and Social Interaction 33: 347–73. http://dx.doi.org/10.1207/S15327973RLSI3304_01

Fairclough, N. (1995) Critical Discourse Analysis: The Critical Study of Language. London: Longman.

Fairclough, N. (2003) Analysing Discourse: Textual Analysis for Social Research. London: Routledge.

Grant, A. (2016) ‘#discrimination’: the online response to a case of a breastfeeding mother being ejected from a UK retail premises. Journal of Human Lactation 32: 141–51. http://dx.doi.org/10.1177/0890334415592403

Hays, S. (1996) The Cultural Contradictions of Motherhood. New Haven, CT: Yale University Press.

Hodge, B. and Kress, G. (1988) Social Semiotics. Cambridge: Polity.

Jeffries, L. (2007) Textual Construction of the Female Body: A Critical Discourse Approach. Basingstoke: Palgrave Macmillan. http://dx.doi.org/10.1057/9780230593626

Knaak, S. J. (2006) The problem with breastfeeding discourse. Canadian Journal of Public Health 97: 412–14.

Kress, G. (1993) Against arbitrariness: the social production of the sign as a foundational issue in critical discourse analysis. Discourse and Society 4: 169–91. http://dx.doi.org/10.1177/0957926593004002003

Kress, G. and van Leeuwen, T. J. (2002) Colour as a semiotic mode: notes for a grammar of colour. Visual Communication 1: 343–68.

Kress, G. and van Leeuwen, T. J. (2006) Reading Images: The Grammar of Visual Design (2nd edn). New York: Routledge. http://dx.doi.org/10.1177/147035720200100306

Lazar, M. M. (2000) Gender, discourse and semiotics: the politics of parenthood representations. Discourse and Society 11: 373–400. http://dx.doi.org/10.1177/0957926500011003005

Ledin, P. and Machin, D. (2015) How lists, bullet points and tables recontextualize social practice: a multimodal study of management language in Swedish universities. Critical Discourse Studies 12: 463–81. http://dx.doi.org/10.1080/17405904.2015.1039556

Lupton, D. (1993) Risk as moral danger: the social and political functions of risk discourse in public health. International Journal of Health Services 23: 425–35. http://dx.doi.org/10.2190/16AY-E2GC-DFLD-51X2

Lupton, D. (1995) The Imperative of Health: Public Health and the Regulated Body. London: Sage.

Lupton, D. (1996) Food, the Body and the Self. London: Sage.

Machin, D. (2013) What is multimodal critical discourse studies? Critical Discourse Studies 10: 347–55. http://dx.doi.org/10.1080/17405904.2013.813770

Machin, D. and Mayr, A. (2012) How to Do Critical Discourse Analysis. London: Sage.

Machin, D. and Thornborrow, J. (2003) Branding and discourse: the case of Cosmopolitan. Discourse and Society 14: 453–71. http://dx.doi.org/10.1177/0957926503014004003

Marantz, P. R. (1990) Blaming the victim: the negative consequence of preventive medicine. American Journal of Public Health 80: 1186–7. http://dx.doi.org/10.2105/AJPH.80.10.1186

Meah, A. (2014) Reconceptualizing power and gendered subjectivities in domestic cooking spaces. Progress in Human Geography 38: 671–90. http://dx.doi.org/10.1177/0309132513501404

Mullany, L., Smith, C., Harvey, K. and Adolphs, S. (2015) ‘Am I anorexic?’ Weight, eating and discourses of the body in online adolescent health communication. Communication and Medicine 12(2–3): 211–223.

Page, R. (2002) Evaluation in childbirth narratives told by women and men. Discourse Studies 4: 99–116. http://dx.doi.org/10.1177/14614456020040010501

Pizzini, F. (1991) Communication hierarchies in humour: gender differences in the obstetrical/gynaecological setting. Discourse and Society 2: 477–88. http://dx.doi.org/10.1177/0957926591002004008

Plant, R. J. (2010) Mom: The Transformation of Motherhood in Modern America. Chicago, IL: University of Chicago Press. http://dx.doi.org/10.7208/chicago/9780226670232.001.0001

Public Health England (2015a) Off to the Best Start: Important Information about Feeding Your Baby. London: Public Health England. Retrieved on 15 October 2016 from www.unicef.org.uk/Documents/Baby_Friendly/Leaflets/otbs_leaflet.pdf.

Public Health England (2015b) Guide to Bottle Feeding: How to Prepare Infant Formula and Sterilise Feeding Equipment to Minimise the Risks to Your Baby. London: Public Health England. Retrieved on 15 October 2016 from www.unicef.org.uk/Documents/Baby_Friendly/Leaflets/start4life_guide_to_bottle_%20feeding.pdf.

Rabin, R. (2006) Breast-feed or else. The New York Times (13 June): 1–5.

Shakespeare, J., Blake, F. and Garcia, J. (2004) Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression. Midwifery 20: 251–60. http://dx.doi.org/10.1016/j.midw.2003.12.011

Shuttleworth, S. (1993) A mother’s place is in the wrong. New Scientist 1905: 38–40.

Sunderland, J. (2006) ‘Parenting’ or ‘mothering’: the case of modern childcare magazines. Discourse and Society 17: 503–28. http://dx.doi.org/10.1177/0957926506063126

Van Leeuwen, T. J. (2006) Towards a semiotics of typography. Information Design Journal + Document Design 4: 139–55. http://dx.doi.org/10.1075/idj.14.2.06lee

Van Leeuwen, T. J. (2011) The Language of Colour: An Introduction. New York: Routledge.

Van Leeuwen, T. J. and Wodak, R. (1999) Legitimizing immigration control: a discourse-historical analysis. Discourse Studies 1: 83–119. http://dx.doi.org/10.1177/1461445699001001005

Wall, G. (2001) Moral constructions of motherhood in breastfeeding discourse. Gender and Society 15: 592–610. http://dx.doi.org/10.1177/089124301015004006

WHO (2014) Global nutrition targets 2025: breastfeeding policy brief. Retrieved on 15 October 2016 from www.who.int/nutrition/publications/globaltargets2025_policybrief_breastfeeding/en.

WHO (2016) Infant and young child feeding. Fact sheet no. 342. Retrieved on 15 October 2016 from www.who.int/mediacentre/factsheets/fs342/en.

Wolf, J. B. (2011) Is Breast Best? Taking on the Breastfeeding Experts and the New High Stakes of Motherhood. New York: New York University Press.



How to Cite

Brookes, G., Harvey, K., & Mullany, L. (2016). ‘Off to the best start’? A multimodal critique of breast and formula feeding health promotional discourse. Gender and Language, 10(3), 340-363. https://doi.org/10.1558/genl.v10i3.32035