Communicating breastfeeding benefits or formula‐feeding risks? The underlying process explaining the framing effect on infant‐feeding attitudes and intentions

A preregistered experimental study tested the effects of message framing on breastfeeding and formula‐feeding attitudes and intentions. It also examined whether affective reaction and information acceptance mediated these effects, and whether self‐efficacy and perceived behavioral control (PBC) moderated them. Participants (282 pregnant women) were randomly assigned to a gain frame condition (benefits of breastfeeding), a loss frame condition (risks of not breastfeeding), or a control condition. Results showed two opposite indirect effects: the loss frame elicited negative affect, which lowered information acceptance; and conversely, the gain frame induced positive affect, thus increasing acceptance. These affective and cognitive responses differentially affected breastfeeding and formula‐feeding attitudes and intentions, with the loss frame indirectly worsening the former (95% CI [−.24, −.08]) and improving the latter (95% CI [.03, .11]), while the gain frame worsened formula‐feeding attitudes and intentions (95% CI [−.03, −.01]) and improved those related to breastfeeding (95% CI [.01, .08]). Additionally, low levels of breastfeeding self‐efficacy and PBC amplified the negative effects of the loss‐framed message and suppressed the positive effects of the gain‐framed message. These findings highlight the affective and cognitive mechanisms through which risk‐based language can have unintended, counterproductive effects. Breastfeeding promotion should emphasize benefits rather than risks and empower women's self‐efficacy.