It is a mistake to think that pictorial material which has been developed for one culture can simply be transferred and used in another. Nowhere is this more true than with breastfeeding; in Africa, many tribal societies accept women being bare-breasted and suckling their infants at any time, anywhere. In most Asian countries, this is totally unacceptable. Thus, how one portrays breastfeeding in an Asian country will inevitably be markedly different from an African country. An African breastfeeding picture is likely to cause offence to many in Asia while a successful Asian breastfeeding picture may not even be understood in the African context or, at worst, even ridiculed.

In Bangladesh, considerable work was undertaken to try to understand exactly what can (and what cannot) be shown in a breastfeeding scene. There, it was not considered problematic actually to show the breast itself but what troubled many people were the eyes and the expression of the mother when bonding with the suckling infant. Providing the mother’s eyes and expression are entirely neutral, the picture is usually quite acceptable. In some very conservative societies even this may not be enough – but providing there is trust between the agency developing the picture(s) and the technical ministry of the country concerned, what is acceptable can usually be quite quickly established. It should be remembered that both the administration and the consumers have to be satisfied over something as intimate as breastfeeding.

This all said, it is important that breastfeeding be part of the ORT message since the statistics clearly show the huge benefits in terms of survival of infants suffering from diarrhoeal dehydration. In some tribal societies, there is a mistaken belief that fluids (including the breast) should be withheld during diarrhoea because the increase in fluid intake inevitably increases the flow of excreta, temporarily. If this belief is seen in the culture for which this pictorial material is being prepared, perhaps special mention should be made concerning the importance of giving the patient as much fluid as he/she wants – ORT, the breast and even plain, safe water as well.