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J Med Ethics. 2018 Sep;44(9):615-620. doi: 10.1136/medethics-2017-104455. Epub 2018 Apr 21.

Examining the use of 'natural' in breastfeeding promotion: ethical and practical concerns.

Author information

Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA.


References to the 'natural' are common in public health messaging about breastfeeding. For example, the WHO writes that 'Breast milk is the natural first food for babies' and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called 'It's only natural', which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of 'natural' language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as 'natural' is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, 'natural' evokes specific and controversial conceptions of gender and motherhood.


children; ethics; family; newborns and minors; public health ethics

Conflict of interest statement

Competing interests: None declared.

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