Warning: Public health officials have determined that not breast-feeding may be hazardous to your baby's health.
There is no such label affixed to cans of infant formula or tucked into advertisements, but that is the unambiguous message of a government public health campaign encouraging new mothers to breast-feed for six months to protect their babies from colds, flu, ear infections, diarrhea and obesity.
In April, the World Health Organization, setting new international benchmarks for children's growth, for the first time referred to breastfeeding as the biological norm.
"Just like it's risky to smoke during pregnancy, it's risky not to breastfeed after," said Suzanne Haynes, senior scientific adviser to the Office on Women's Health in the U.S. Department of Health and Human Services.
"The whole notion of talking about risk is new in this field, but it's the only field of public health, except perhaps physical activity, where there is never talk about the risk."
A two-year national breast-feeding awareness campaign that ended this spring ran television announcements showing a pregnant woman clutching her belly as she was thrown off a mechanical bull during ladies' night at a bar and compared her behavior to failing to breast-feed.
"You wouldn't take risks before your baby's born," the advertisement says. "Why start after?"
Sen. Tom Harkin, an Iowa Democrat, has proposed requiring warning labels, similar to those on cigarette packages, on cans of infant formula and in advertisements, They would say that the Department of Health and Human Services has determined that "breast-feeding is the ideal method of feeding and nurturing infants" or that "breast milk is more beneficial to infants than infant formula."
Child-rearing experts have long pointed to the benefits of breast-feeding. Critics say the new campaign has gone too far and will make mothers who cannot breast-feed or choose not to feel guilty and inadequate.
"I desperately wanted to breast-feed," said Karen Petrone, an associate professor of history at the University of Kentucky in Lexington. When her two babies failed to gain weight and her pediatrician insisted that she supplement her breast milk with formula, she said, "I felt so guilty."
"I thought I was doing something wrong," she said. "Nobody ever told me that some women just can't produce enough milk."
Moreover, urging women to breast-feed exclusively is a tall order in a country where more than 60 percent of mothers of very young children work, federal law requires large companies to provide only 12 weeks' unpaid maternity leave and lactation leave is unheard of.
A third of large companies provide private areas where women can express breast milk during the workday, and 7 percent offer child care on-site or nearby, according to a 2005 national study by the nonprofit Families and Work Institute.
"I'm concerned about the guilt that mothers will feel," said Ellen Galinsky, president of the center. "It's hard enough going back to work."
Public health leaders say the scientific evidence for breast-feeding has grown so overwhelming that it is appropriate to recast their message to make it clear that it is risky not to breast-feed.
That evidence supports the contention that breast-fed babies are less vulnerable to acute infectious diseases, including respiratory and gastrointestinal infections, experts say.
Some studies also suggest that breast-fed babies have a lower risk of sudden infant death syndrome and serious chronic diseases later in life, including asthma, diabetes, leukemia and some forms of lymphoma, according to the American Academy of Pediatrics.
Research on premature babies has found that those given breast milk scored higher on IQ tests than those who were bottle-fed.
The goal of a government health initiative called Healthy People 2010 is to get half of mothers to continue at least some breast-feeding until their babies are 6 months old.
About 70 percent of new mothers start breast-feeding right after childbirth, a little more than a third are breast-feeding at 6 months, and fewer than 20 percent are exclusively breast-feeding by that time, according to the 2004 National Immunization Survey.
Breast-feeding is more prevalent among mothers who are older and have more education and income. Black women are less likely to breast-feed, and Hispanics are more likely.
For women, breast-feeding can be an emotionally charged issue. Even its most ardent supporters acknowledge that they have made sacrifices.
"It's a whole lifestyle," said Kymberlie Stefanski, a 34-year-old mother of three from Villa Park, Ill., who has not been apart from her children except for one night when she gave birth. Stefanski quit working when her first child was born almost six years ago, nursed that child until she was 4 years old and is nursing an infant now.
She said she wanted to reduce the risk of breast cancer for herself and her three daughters, referring to research indicating that extended breastfeeding may reduce the risk for both mother and daughters.
Scientists who study breast milk almost all speak of it in superlatives. Even the International Formula Council, a trade association, acknowledges that breast-feeding "offers specific child and maternal health benefits" and is the "preferred" method of infant feeding.
The American Academy of Pediatrics states in its breast-feeding policy that human breast milk is "uniquely superior for infant feeding."