See Alison Thewliss Scottish National Party, MP for Glasgow Central (above) leading the debate in the debate on Breastfeeding that took place yesterday – 24th June 2015WEBCAST (the final item for the day, starts at 4:30 PM)
HANSARD (Column 319WH)Do watch/ listen/read and tell your MP about it.MPs who spoke:Peter Bone (Chair)Alison Thewliss, Scottish National Party, MP for Glasgow CentralKirsty Blackman, SNP MP for AberdeenHelen Hayes, Labour MP for Dulwich and West NorwoodSharon Hodgson. Labour MP for Washington and Sunderland WestGeorge Freeman, Parliamentary Under-Secretary of State for Life SciencesAlison Thewliss’ four “asks” to develop a road map to1. Fund the National Infant Feeding Network – 600 infant feeding specialists – got only £30,000 last year and none this year2. Support roll-out of Baby Friendly Standards BFI3. Reinstate the Infant Feeding Survey4. Enact the Code fully in UK law supporting Baby Milk Action’s call prior to the Election)CLICK HERE for the SNP response to our callClick HERE for my Blog explaining where we are with the campaign to bring the UK and EU regulations into line with the International Code and Resolutions.Among the issues raised by MPs in the Debate yesterday was the advertising of Follow-on milk, an issue that we are campaigning on in the EU.Other things discussed yesterday:breastfeeding breaks at work, popular awareness of WHO guidelines BF “2 years and beyond,” protecting breastfeeding in public, role models and normalising breastfeeding in non-breastfeeding communities, support local breastfeeding cafes, access to skilled breastfeeding support (more than BFI 3 day course), integrate support from breastfeeding voluntary organisations.Alison Thewliss quoted James Grant, UNICEF Executive Director 1980 to 1995,“Breastfeeding is a natural safety net against the worst effects of poverty…exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence. It is almost as if breastfeeding takes the infant out of poverty for those few vital months in order to give the child a fairer start in life and compensate for the injustices of the world into which it was born.”
Motion lapsed (Standing Order No. 10(6)).
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National Breastfeeding Week
That this House has considered National Breastfeeding Week.
It is a pleasure to serve under your chairmanship, Mr Bone, and to be lucky enough to have secured this debate during National Breastfeeding Week. I welcome Members in the Chamber and those who are breastfeeding as they watch our proceedings online.
Alison Thewliss: As I was saying before the Division, celebrating breastfeeding is the theme of this National Breastfeeding Week, and there is much to celebrate about that remarkable human act. Although completely natural, breastfeeding is also a skill that mothers and babies must learn together, and is not without its difficulties. I acknowledge that some women cannot breastfeed and others choose not to, and in holding this debate I do not seek in any way to judge them—those bottle feeding also require assistance and advice.
I will talk briefly about my experience of breastfeeding and why I am so committed to promoting it, before touching on its health and societal benefits. The UK has one of the lowest breastfeeding rates in the world, and lags far behind comparable nations in the OECD. There is a lot we can do to improve the experience of families in our constituencies.
I have breastfed both of my children, and despite being in this place from Monday to Thursday have managed to persevere in feeding my one-and-a-half-year-old daughter, Kirsty. She is not here today as a visual aid but in fact is in nursery in Glasgow, so my determination has been at some personal discomfort. When I had my son I was a local councillor in Glasgow and took the view that I could not take the time off work for maternity leave, so I combined my role with being a mum. During the past five years I have fed my children while fully participating in meetings of Glasgow City Council, and have been made very welcome in doing so by my colleagues. That the right to feed is enshrined in law in Scotland has been a real reassurance to me, and whether I have been feeding in a café, waiting for a bus, or in the stand at Hampden—I have been lucky in securing the backing of the tartan army for giving the wee man his tea at the game—I have been made welcome.
My colleague and good friend Aileen Campbell MSP, Scotland’s Minister for Children and Young People, has taken her own children, Angus and Crawford, into the Scottish Parliament Chamber; her youngest was with her during a stage 3 debate just the other week. Aileen and I are lucky, as not many mothers can do that at their work. I understand from speaking to colleagues that doing something similar in this place would be frowned upon. I seek to gently challenge that. We should take a lead and seek to be creative in how we support women to continue breastfeeding in all workplaces once they return from maternity leave.
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“An Act of the Scottish Parliament to make it an offence to prevent or stop a person in charge of a child who is otherwise permitted to be in a public place or licensed premises from feeding milk to that child in that place or on those premises; to make provision in relation to the promotion of breastfeeding; and for connected purposes.”
That important piece of legislation was a Member’s Bill proposed by the Labour MSP Elaine Smith. I pay tribute to her today for the work she did to make it possible for so many women in Scotland to breastfeed secure in the knowledge that no one has the right to stop them.
There are now greater rights in England and Wales, afforded by the Equality Act 2010, under which discriminating against a woman because she was feeding a child became unlawful. That is significant, and I commend all who made it happen. We far too often see tabloid tales of mothers being shamed for the simple act of feeding a hungry child. That is completely unacceptable, and every such story destroys women’s confidence; they need to hear from their elected representatives that breastfeeding is welcomed and that they are supported.
Getting the right support is absolutely crucial. Without that and without information, establishing breastfeeding can be incredibly difficult. As I said, breastfeeding is natural, but it is not easy. Without the assistance of the breastfeeding counsellors at the Princess Royal maternity hospital in Glasgow, who sat with me through the tears and the pain, I may have given up myself. Not all women will have experience of breastfeeding within their families or peer groups. Good public health information must be there to counter the ever-present adverts for bottles and formula milk, as well as perceptions and prejudices.
I recall that, at an event in Glasgow, Councillor Jim Coleman told me how women in some parts of the city were made to feel that breastfeeding was evidence that someone could not afford to buy formula. We know that runs absolutely counter to all wisdom on the benefits of breastfeeding, but those kinds of old wives’ tales persist and must be challenged by people in those communities.
Since this debate was announced, I have been contacted by various individuals and by organisations including the Royal College of Paediatrics and Child Health, the Royal College of Midwives, the Breastfeeding Network, the World Breastfeeding Trends Initiative, the UNICEF “Baby Friendly” initiative and the National Infant Feeding Network. I am grateful for the extensive briefings they have provided.
The organisations all reinforced the need for support. Their evidence demonstrates that women start breastfeeding, and initiation rates have risen from 62% in 1990 to 81% in 2010. But the drop-off rates are staggering: only 17% are still exclusively breastfeeding at three months, 12% at four months and 1% at six months. There are also huge variations across social class; other factors include deprivation, maternal education, age and ethnicity.
Scotland is lagging behind, and the Scottish Government are putting strategies in place to tackle that; they also held a summit on breastfeeding in February. Recent figures from the “Growing Up in Scotland” cohort survey found that breastfeeding was strongly associated with multiple socioeconomic factors. For example, 60% of degree-educated mothers exclusively breastfed to six weeks or more, compared with 18% of those with standard grades;
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53% of mothers living in the least deprived areas breastfed exclusively to six weeks, compared with only 21% in the most deprived areas; and 45% of mothers in their 30s and 41% of those aged 40 or older at their child’s birth exclusively breastfed to six weeks or more, compared with 35% of mothers in their 20s and only 12% of teenage mothers.
Members will be aware that breastfeeding is good for maternal and infant health. Benefits to children from breastfeeding include reduced gastrointestinal, respiratory, urinary tract and ear infections, lower incidence of allergies and a reduced likelihood of developing obesity. For women who choose to breastfeed there are lower risks associated with breast and ovarian cancer, less chance of hip fractures and osteoporosis in later life, and the added benefit that it helps with getting back to their pre-baby weight.
UNICEF has done excellent work in documenting the savings that could be made to public health services through breastfeeding and its benefits, and I commend its document “Preventing disease and saving resources” to the House. “The 1001 Critical Days” is a manifesto that is also well worth a read.
“Breastfeeding is a natural safety net against the worst effects of poverty…exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence. It is almost as if breastfeeding takes the infant out of poverty for those few vital months in order to give the child a fairer start in life and compensate for the injustices of the world into which it was born.”
Those are striking words, and it is to areas of multiple deprivation that I believe resources should be targeted, but most certainly not in a heavy-handed way. Instead, local networks, existing organisations and women themselves need to be given the skills and knowledge to spread the word among their peers and to challenge the old wives’ tales I spoke about. They must work across the whole experience of pregnancy and parenthood. Public Health England found in March 2015 that the most effective strategies for promoting breastfeeding were among smaller local peer support groups. There is a lot of excellent information online, from KellyMom to Mumsnet, but there remains a digital divide, and at times of crisis having a local network to fall back on is hugely valuable.
That kind of work is often facilitated by the voluntary sector, and we need to ensure that that is maintained even in these straitened financial times. I understand that the hon. Member for Dulwich and West Norwood (Helen Hayes) will refer to a local case, and I have I have been contacted by mothers in Lambeth and Southwark who discovered that funding for their work would be cut. They have been hugely successful in increasing breastfeeding rates in their area. Such projects should be treated as exemplars, and their good practice should be taken on board.
In my contact with several organisations, there have been a couple of broader asks that it would be neglectful of me not to mention. The first is that there should be financial support for the National Infant Feeding Network, which I understand had its funding cut in 2014. The funding
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that was cut was a meagre £30,000, which went a very long way to organising and supporting a network of 600 infant feeding specialists. They are responsible in turn for the education and support of some 70,000 health professionals across England who reach 650,000 mothers and babies every year. That is crucial, for the reasons I mentioned. Breastfeeding mothers really need support, especially in the early days.
Secondly, the Department of Health should continue to strive for the implementation of UNICEF “Baby Friendly” standards in maternity, community and neonatal services. In the UK the percentage of services with full “Baby Friendly” accreditation are 49% of maternity services; 51% of health visiting services; 37% of university midwifery courses; and 9% of health visiting courses. It is important that those professionals should all have the skills to enable them to pass on information to the women they help.
The percentage of births taking place in fully “Baby Friendly”-accredited hospitals stands at 44% in England, a wonderful 84% in Scotland, an even better 92% in Northern Ireland, and 60% in Wales. The impact of services being “Baby Friendly”-accredited is that mothers get consistent advice and support throughout their pregnancy and in the early months after the birth. It is not just about hospitals, but about embedding good practice across the range of provision. That means that there should not be any kind of postcode lottery, so that women and families can feel confident about breastfeeding.
Thirdly, I implore the UK Government to reinstate the national infant feeing survey across the UK. The main basis for the statistics I have given to demonstrate the need for more support today is that five-yearly study, which I understand has been on the go since 1970. It fits into the World Health Organisation’s global strategy for infant and young child feeding, which recommends that Governments carry out a survey to track rates and target support effectively. Without the data, we lose touch of where we stand in the world and what work we need to do. The Scottish, Welsh and Northern Irish Governments have all committed to keep it going, and I urge the Minister also to commit to it, to complete the statistics for the whole UK.
Fourthly, I seek the Minister’s advice on where the UK currently sits with regard to full implementation of the international code of marketing of breast milk substitutes, which was adopted by the World Health Assembly in 1981. I support calls by groups such as Baby Milk Action for the UK Government to play their part in protecting the public from aggressive and damaging marketing by the formula industry.
My final plea is a personal one. I have come into this place as a breastfeeding mother, which has been hard for me, even in this position of relative privilege. I ask for the consideration of all parents in this place—Members, staff and visitors—and of how we can make it easier for them. I ask colleagues to consider what they can do in their own constituencies to celebrate and support breastfeeding in this and every week of the year. Could our local cafés be more welcoming? Are our own offices a safe space for nursing mothers? Could we encourage investment in support services in our areas, and do we know where they are so that we can send them recommendations? We all have a role to play in encouraging the uptake of this most basic human need.
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I breastfed my two children, who are now aged nine and six. I was fortunate because that experience was relatively straightforward, but it was not without issues or a need for support. A few days after having my first baby, I remember experiencing toothache and wondering, in my slightly dazed state as a new mother, how toothache could possibly be a post-natal complication. I then realised that I had given myself toothache from clamping my teeth so hard because of the pain every time my baby fed. Those first few days were difficult and painful, and there were tears, but once I had mastered it, it was a hugely rewarding experience. My second baby could not tolerate cow’s milk, which made the transition to any type of formula very difficult, but I was glad to continue breastfeeding her for much longer because it benefited her health enormously. The health benefits of breastfeeding for mothers and babies are well established and proven, as rehearsed by the hon. Lady.
I want to highlight a pressing issue in my constituency: the potential loss of the breastfeeding cafés that operate in Sure Start centres in my constituency, in Streatham and in Camberwell and Peckham. Those cafés, which are resourced by experienced midwives from King’s College hospital, are a vital resource for new nursing mothers. They are under threat because the support from King’s College hospital is going to be withdrawn, due to the midwives who staff the cafés being needed on the labour wards. The hospital is otherwise unable to recruit to a series of vacancies in its midwifery department.
This is a grave situation. The breastfeeding cafés operate in Sure Start centre locations where many mothers are deprived, successfully extending the reach to those areas and increasing breastfeeding rates there. The benefits of addressing nutritional disadvantages, helping those babies to be healthier and getting them off to a good start in life are vital. I am concerned that a shortage of midwives elsewhere in the health service is putting those breastfeeding cafés at risk. I will certainly raise the issue with King’s College hospital when I meet staff there on Friday, and I will talk to the local authorities in Lambeth and Southwark about whether there is any way that those vital services could be continued.
I call on the Minister to help us in that endeavour and to help make additional resources available, so that experienced midwives can continue to staff breastfeeding cafés in my constituency and beyond. Extending breast- feeding to deprived communities in particular will save the health service money in the long term, so resourcing this service is money spent positively and spent well.
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lucky to be able to go back to work so quickly and to take my children with me. That worked well for us in terms of breastfeeding.
My second child was an absolute dream to feed. She was wonderful and knew what she was doing from day one. She was just a dream come true. However, it was still painful at times. Even in the most ideal circumstances, breastfeeding is not plain sailing all the way. My first child was a nightmare to feed. We had a horrendous time. Nearly all the things that can go wrong with breastfeeding went wrong. My son was re-admitted to hospital at five days because he was not gaining weight, so for a while we had to pump exclusively and then he was weaned back on to breastfeeding.
The support networks and breastfeeding cafés, which hon. Members have mentioned, are so important. There are proven statistical outcomes from breastfeeding cafés and people having physical support. I am not sure whether hon. Members are clear about how the outcomes are achieved. My hon. Friend mentioned the huge online support network, including Mumsnet and Facebook groups. Those places are good and people can get a huge amount of information from others there, but that does not compare with having somebody physically present who knows what they are talking about. In those early days, when people do not know what they are doing, and when their baby does not know what they are doing, they need somebody there to help and show them what they are doing wrong, or what they are doing right, and to explain it. It is not something that can be learned from a video on the internet, because every mum and every baby is a different shape and every baby reacts differently. Somebody must be physically there, and they must have huge experience and know what they are talking about.
A three-day training session on breastfeeding does not, in many cases, equip a midwife or health visitor with adequate means to provide mums with all the support they need. Those people also need experience behind them: they need to see many babies breastfeeding and speak to lots of people before advising in all cases.
In terms of the support available, the Government in Scotland and the Government here—Governments all over the place—need to think about the voluntary organisations providing support. People who have been through breastfeeding and experienced the problems—and those seeking support—are getting involved in the La Leche League and with NCT breastfeeding support, for example, to help people. When I was being shown what I was doing wrong, those were the people I found most helpful, because they knew what they were talking about. Training systems are a great idea, but we need to make sure that voluntary groups and breastfeeding cafés, which have experienced staff, are kept going. If we lose that experience, we cannot get it back. We need to keep these groups going to keep up the breastfeeding rates.
The World Health Organisation guidelines suggest breastfeeding exclusively up to six months and that breastfeeding onwards to two years or beyond is desirable, advised and good for children and mothers. This is not widely known in the UK: people even get funny looks
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when breastfeeding a child over six months. People do not understand that that is actually good and has health benefits.
I breastfed my children for a total of three years—adding them both together—so I had that experience of breastfeeding a child who is running around. That is totally shocking for so many people and it should not be, because World Health Organisation guidelines and statistics suggest that there are health benefits from breastfeeding. There is a job of work for all of us to normalise breastfeeding and to explain it to people. If people say, “What are you doing?”, we should explain to them, “This is right. This is not in any way unnatural. This is totally the right thing to do and has benefits for everybody.”
My hon. Friend the Member for Glasgow Central mentioned formula milk and the way it is advertised and classified. I spoke to some of my online friends who have been involved in supporting people with breastfeeding, and one of their biggest concerns, and one of the things that makes them most angry, is the advertising of follow-on milk. Follow-on milk is allowed to be advertised because it is not aimed at mothers with babies, and the adverts for follow-on milk have very small babies who are obviously just six months old. That is the way that the companies can get round the rules, because they are not advertising to mothers with a baby who is under six months; they are advertising to mothers with babies who are older than six months. Before the ban on advertising baby milk was introduced, there was no such thing as follow-on milk; the companies have just invented it so that they can still advertise. That is a concern.
We should have formula, and women who choose to formula-feed—or women who end up formula-feeding not by choice—need to have options in terms of formula. But formula should not be pushed at every opportunity by the companies, and we should not allow them to do so. We should try to avoid that situation.
The last thing I wanted to mention was the pressure to breastfeed. It is very positive that we are promoting and encouraging breastfeeding, but there is a fine line; some women feel that they cannot give up breastfeeding in the very early days without experiencing a huge amount of negativity. Breastfeeding is hard for some women at the moment, particularly when the support is not there nationally.
I have heard of women who have said that not being able to breastfeed caused them to have post-natal depression. The issue was the expectation—that they felt they had to breastfeed, but nobody was there to support them. What they wanted was somebody to show them what to do and to help them, and not having that help is costing the Government and the devolved Administrations through the outcomes for those babies, as they are more likely to cost the NHS more in later life; through the outcomes for the mothers; and through the outcomes for some mothers who really struggle with having to give up breastfeeding, and end up in the mental health system as a result. That really concerns some of my friends and some of the other people I have spoken to about the issue.
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for Glasgow Central (Alison Thewliss) for securing this important debate, and other Members for their excellent contributions.
We need to keep our focus on this issue, and I am very pleased that all the Members who have spoken so far share my passion for extolling the virtues of breastfeeding. I am also pleased to note that the Minister present today is the Under-Secretary of State for Life Sciences, who I respect hugely. Although at first I thought it was rather strange that breastfeeding came under his brief, I am now sure that it is simply the case that the issue is so important to the Government, and crosses so many departmental boundaries, that they settled on him, and it was not just a case of Ministers perhaps playing “pass the parcel” with this important debate. As I say, I am very pleased to see that he is here to respond to it.
I will start my remarks by putting my cards firmly on the table—for me, wherever possible breast is best. I breastfed both my children, as all the Members who have spoken so far breastfed their children, and I am evangelical about the merits of breastfeeding.
As other Members have said, and shared, breastfeeding sometimes hurts at first—although not for everyone—and that is why the right support is vital, to help women and encourage them to carry on breastfeeding. Having someone physically there really makes the difference, especially when a woman has a baby like my son, who did not like to open his mouth very wide when latching on. If he could get away with it, he would just suck on the nipple until it was red raw, and obviously he then got no milk. If nobody had told me that that is not how it is supposed to happen, I would have given up immediately. Support is vital. As with my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), my second child—my daughter—could not tolerate cows’ milk. Fortunately, I was able to carry on feeding her to about 16 months, but feeding a toddler in public draws lots of frowns, and eventually I succumbed. We went on to soya milk, and even now she does not really like milk.
We have a fabulous support network in the north-east called Bosom Buddies, which helps, supports and encourages new mums as they get to grips with breastfeeding during the early days. The network provides much-needed guidance and advice for mothers who may otherwise be unsure about even starting to breastfeed. Those services are replicated in various parts of the country, and many are in Sure Start centres. I have had the great pleasure of visiting many breastfeeding support groups in those centres, and I have seen their great work. I would love every new mother across the UK to have access to such services, because that support makes a huge difference, as we have all attested today. Sadly, as we have seen across the country in recent years, Sure Start centres are closing. More than 700 have closed since 2010, which limits the amount of support that mothers can get. What assessment have the Government made of the number of support services that have been lost as a result of the closure of more than 700 Sure Start centres?
National Breastfeeding Week is a brilliant idea, and over the years it has successfully highlighted, across the world, the importance of breastfeeding. I fully endorse and support the campaign, and I hope this debate will go some way towards making even more people aware of the virtues of breastfeeding. As we have heard, numerous studies have shown breastfeeding to be the healthiest way to feed a baby. Not only does breastfeeding
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provide essential nutrients and sustenance, it also greatly reduces the risk of a baby developing health problems such as gastroenteritis, asthma, diabetes and obesity. Furthermore, breastfeeding helps to protect women from breast and ovarian cancer. The World Health Organisation is unequivocal that, if possible, babies should be totally breastfed until they are at least six months old. On top of all that, there is the additional bonus that breast milk from source is always at the right temperature for babies, with no bottles needing to be sterilised. Best of all, it is 100% free. Breastfeeding is cheap; it is good for babies; it comes highly recommended; and, by preventing illnesses, it keeps babies safe while saving millions of pounds from stretched NHS budgets. Put simply, what is not to like?
Unfortunately, despite all of the positives that other Members and I have outlined today, certain obstacles remain for mothers who are looking to breastfeed their children. One such obstacle comes when mothers return to work after maternity leave. Breastfeeding mothers face a heightened sense of anxiety when they return to work from maternity leave, as they have the additional worry of how their baby will be fed in their absence. The hon. Member for Glasgow Central and other hon. Members spoke of their personal experience. Women may have to raise with their employer the issues of expressing and storing breast milk and fitting in feeds around their work and lunch hour. If they harbour fears that their employer lacks an understanding of, or concern about, such accommodations, it may delay their return to work, or stop their return altogether. Alternatively, such fears may make women give up breastfeeding sooner than they had planned.
Maternity discrimination, such as prohibiting mothers from breastfeeding in cafés or restaurants, is now against the law under the Equality Act 2010, but the Act does not apply in the workplace. Mothers can be told not to express milk or be denied breastfeeding breaks. Employers do not have to provide facilities for breast milk to be expressed or stored. Good employers provide such facilities, but they do not have to do so. I can tell hon. Members, as the Health and Safety Executive already has, that toilets are no place for expressing milk or breastfeeding. We all want parents to get back to work if they wish to do so. I hope the Government understand that breastfeeding responsibilities are holding mothers back from returning to work, and I hope the Minister will assure us that he is looking into ways to address that issue.
Over the past few years, we have seen that women in general are finding it harder at work. There were more unemployed women over the past five years than at any time under the previous Labour Government, and real wages for women have fallen year on year since 2010. There has also been a dramatic fall in sexual discrimination and pregnancy discrimination cases made against employers since women were priced out of justice when expensive tribunal fees were introduced. Figures comparing the years before and after the introduction of those fees show a truly staggering 91% fall in sex discrimination cases and a 46% fall in pregnancy discrimination cases. Such dramatic falls are utterly unacceptable in a country that wants to treat women with respect in the workplace. A Labour Government would have scrapped those unfair barriers to justice. I would love to hear the Minister say that his Government will reverse that unfair policy.
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Alongside the structural issues affecting breastfeeding, there is a growing cultural obstacle that prevents new mums from breastfeeding their children. It is particularly striking, as we have heard, in working-class communities. The Department for Health figures show that in Brighton almost 70% of new mothers were partially or totally breastfeeding at six to eight weeks—that is relatively early to be taking a measure, given that the recommendation is that children should be breastfed for up to six months, but we can use it as a comparison—while in Hartlepool and south Tyneside the figure falls to 19.3% and 22.6% respectively.
In some communities today, there seems to be an anti-breastfeeding culture among young mothers, which we need to challenge and reverse. National Breastfeeding Week and this debate are great ways of starting to do that. Breastfeeding must be seen as normal and natural, and new mothers should feel utterly comfortable doing it. We need to focus on the areas and communities in which new mums do not even consider starting to breastfeed because it seems so strange or even repulsive to them. Government support is required. Role models must come forward to extol the virtues of breastfeeding and we need more mums on TV—[Interruption.] Hon. Members may laugh. We need mums in our soaps and even on “The Only Way is Essex”, breastfeeding naturally and happily. We rarely see breastfeeding, and if we do it is usually by mums such as us—middle class, professional, older mums—which reinforces the image in some young mums’ minds that breastfeeding is something for a certain type of people, not for them and their friends.
We need to work to reverse that image and let new mums and young mums know that breastfeeding is not only good for their health and that of their babies, but it has immediate benefits, such as helping them lose their pregnancy weight much faster, as the hon. Member for Glasgow Central said. I was never as slim as when I was breastfeeding my children. If I could have carried on breastfeeding, I would, because the weight really drops off. It also means not having to get cold in the middle of the night making up bottles, and it helps mums to bond in such a special way with their babies, which cannot be imagined until it has been experienced.
Come on, TV producers, soap writers, celebrities and “TOWIE” stars watching this debate—get to it. Get breastfeeding on TV and get mums seeing it. I want mums to feel comfortable in public—even in Claridge’s, for goodness’ sake. We need to show that it is totally normal, natural and acceptable, and that those who have a problem with it simply need to get over it.
I once again thank the hon. Member for Glasgow Central for securing this important debate and for all she has said and done on this issue in the short time she has been in this House. I thank the other hon. Members for coming along and making their expert contributions. I have rarely heard such strong and powerful arguments for the benefits of breastfeeding and I thank every hon. Member who came to speak here today. I am sure that with such powerful advocacy from hon. Members and from groups and organisations throughout the country, National Breastfeeding Week will be a huge success in raising even greater awareness among parents.
I hope that the Government will listen to the concerns about women getting back into work after having a baby and will address the specific issues that affect them to ensure that that transition is best for both the mother
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and her baby. We all want to see the best outcomes for all parties, but only by taking action to help can we see progress. Simply hoping for the best will not be enough, so for the sake of babies, their mums and our society in general, let us hope for a successful awareness campaign and an equally successful response from the Government.
The Parliamentary Under-Secretary of State for Life Sciences (George Freeman): It is a pleasure to serve under your chairmanship, Mr Bone. I pay tribute to the hon. Member for Glasgow Central (Alison Thewliss) for initiating the debate and for her leadership of it. I particularly commend her for tweeting a picture of herself breastfeeding to help launch and publicise the Breastfeeding Network and the campaign this week.
I commend the hon. Members for Dulwich and West Norwood (Helen Hayes), for Aberdeen North (Kirsty Blackman) and for Washington and Sunderland West (Mrs Hodgson) for raising in a short time a number of very important issues. They include issues about the importance of breastfeeding and about women in the workplace; issues, which we had all hoped would become legacy issues, about prejudice and discrimination; and important issues about geographic variation and inequality, including the importance of cultural leadership in changing attitudes.
There were specific questions on policy, which I will try to come to in a moment. I just want to take this opportunity to celebrate and promote National Breastfeeding Week, which runs from 20 to 28 June. It is an excellent initiative and it is particularly good to see it so active on Twitter, which may be to the credit of the hon. Member for Glasgow Central, and to see the plethora of activities going on around the country and the sharing of good practice and experiences by women and health professionals in place-based and virtual networks. That is genuinely inspirational, and the Department and I look forward to seeing other activities organised by local groups around the country this week.
It will not have escaped your beady eye, Mr Bone, that I am, on a gender basis, the least qualified person in the room to be responding to the debate, but I am pleased that the shadow Minister, the hon. Member for Washington and Sunderland West, highlighted the fact that I am the Minister responsible for life and health sciences. This issue goes to the heart of our thinking more broadly about how we unleash the power of the NHS and our health system more generally to support and drive public health.
Before coming to the House, I worked in biomedical research. I had the great privilege of working at the Institute of Child Health, which is doing extraordinary work on the importance of pre and post-natal nutrition for long-term health outcomes. Extraordinary data are beginning to appear on the importance of early nutrition in determining our long-term health. As the Minister responsible for the National Institute for Health Research, as well as the whizzy high science of tomorrow’s technologies, I can say that we also have at the heart of the NHS a commitment to ensure, through the institute, that we are constantly using the power of our health system to drive public health and to promote best practice.
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The Department of Health is working closely with our partners at UNICEF, the Royal College of Midwives, the Institute of Health Visiting, NHS England and Public Health England to co-ordinate our awareness messaging this week. This debate provides an invaluable opportunity for Members of Parliament to discuss these important issues.
It may help if I begin by setting out the Department’s view on breastfeeding in England, which is the only place for which I can speak. It is widely agreed that breastfeeding delivers significant health benefits for both the mother and her baby and is more cost-effective for mothers than other methods of infant feeding. A mother’s milk provides a perfect balance of nutrients and vitamins for the first six months of a child’s life. That is why the World Health Organisation and the Department of Health encourage exclusive breastfeeding for the first six months.
The Department is aware, however, that infant feeding choices are complex and personal, based as they are on individual and family circumstances. That is right. Not all mothers choose to or are able to breastfeed. In line with UNICEF’s “Baby Friendly” guidelines, all mothers should be supported to make informed decisions and to develop a close relationship with their babies soon after birth.
The evidence shows that, in addition to providing all the nutrients and vitamins that a baby needs, breast milk also protects him or her from infections and diseases. Breastfed babies are less likely to develop diarrhoea, vomiting and chest infections, leading to fewer hospital visits; and they are less likely to become obese both as children and in later life. Breastfeeding can also reduce the chances for some women of getting diseases such as breast or ovarian cancer later in life. The evidence and data also show that breastfeeding as soon as possible following birth helps to start the bonding process between a mother and her baby. We know that secure parent-child attachment results in better social and emotional wellbeing among children. Furthermore, evidence shows that that, in turn, has important implications in terms of life prospects for the infant.
I am pleased that the breastfeeding initiation rate in England has increased from about 62% in 2005-06 to 73.9% in the third quarter of 2014-15. The Office for National Statistics will publish the full-year figures in a couple of weeks. However, breastfeeding initiation rates vary widely across clinical commissioning group areas, from 43.9% in NHS South Sefton to 93.4% in NHS Lambeth.
While we understand that cultural differences exist in different areas, it is important that all new mothers receive the best quality of care no matter who they are or where they live. We encourage local commissioners and services to use their resources, and opportunities such as National Breastfeeding Week, to reduce such variations and increase overall breastfeeding rates.
Increased awareness of the health risks associated with not breastfeeding has brought about a drive in recent years to improve breastfeeding support and increase breastfeeding prevalence rates. Support and information is currently available to health professionals and parents through a range of channels such as the NHS Choices website under the Start4Life banner; the national breastfeeding helpline; the UNICEF UK “Baby Friendly” initiative; and local peer support programmes.
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Parents-to-be and new mothers and fathers can also sign up to the Start4life information service for parents. Subscribers receive regular free emails, videos and text messages that offer high quality advice and information based on the stage of pregnancy and the age of the child. That service includes breastfeeding and signposts parents to other quality-assured information about parenting, relationship support and benefits advice.
In the past five years, I am delighted to say that we have recruited more than 2,100 more midwives into the NHS. We are training a further 6,400, who will provide women with the information, advice and support they need to breastfeed. In addition, appropriately trained and supervised maternity support workers play an important role in supporting women with breastfeeding and helping midwives to run parentcraft classes. In the past five years, 2,000 new health visitors have been recruited and we are on track to reach our target of 4,200 by the end of the year.
I will try to answer the important questions raised in the few minutes available; if I am beaten by the clock, perhaps I can write to hon. Members. The hon. Member for Glasgow Central mentioned the National Infant Feeding Network. In 2014, the Department of Health provided £30,000 to UNICEF UK to support the establishment of the network, which shares and promotes evidence-based practice on infant feeding and early childhood development to deliver optimum outcomes. It comprises 600 infant feeding specialists and supports 30,000 health professionals who, in turn, are responsible for caring for more than 650,000 mothers.
The network approached the Department for funding support in 2015. Unfortunately, its request could not be accommodated because it came in too late for the 2015-16 budget. However, we continue to work closely with the network co-ordinators on future funding.
The hon. Lady also raised the breastfeeding rights of women in the workplace. Specific health and safety requirements relating to new and expectant mothers at work are contained in regulations 16 to 18 of the Management of Health and Safety at Work Regulations 1999. A woman can ask her employer to provide a private, safe and healthy space to allow her to express milk and a fridge to store it in.
On the UNICEF UK “Baby Friendly” initiative, I repeat that we want to encourage more women to breastfeed. That is why we welcome the revised “Baby Friendly” standards that support feeding and relationship building. It is great to see that, across the UK, 91% of maternity services and 88% of health visiting services are working towards baby-friendly accreditation. In the UK, 49% of maternity services, 51% of health visiting services, 37% of university midwifery courses and 9% of health visiting courses currently have full “Baby Friendly” accreditation.
On the infant feeding survey, I am happy to confirm that the Government’s policy is to improve outcomes for women and their babies. To do that, we need current information to inform policy and service delivery. The statistics that NHS England regularly gathers capture data from all women using NHS services, rather than from the periodic survey samples. From 2016, the maternity and children’s dataset will, for the first time, link a mother’s health and behaviours during pregnancy and
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post-natally to outcomes for herself. I will happily write with more details on that and on the issue of breast milk substitutes, since I am defeated by the clock.
George Freeman: Thank you, Mr Bone. I apologise; I was merely stretching my legs as I saw the clock hit the 5.30 button. I was not expecting the vote. I am delighted that I have more time to finish dealing with the two questions. There was an important question on breast milk substitutes.
For mothers who choose to use formula milk, it is important that measures are in place to protect babies’ health and that all the parents have the information they need to make the right choice. The Government provide advice for parents on maternal and infant nutrition via NHS Choices and the NHS Start4life information service.
The international code of marketing of breast milk substitutes is an international health policy framework to regulate the marketing of breast milk substitutes. In view of the vulnerability of babies in the early months of life and the risks involved in inappropriate feeding, the marketing of breast milk substitutes requires special treatment. “Baby Friendly” accreditation requires services to implement the requirements of the code, which goes further than UK law in regulating marketing activity. To meet the “Baby Friendly” standards, services must ensure that there is no promotion of breast milk substitutes, bottles, teats or dummies in any part of the facility or by any of the staff.
The Infant Formula and Follow-on Formula (England) Regulations 2007 are designed to ensure that all types of infant formulae meet the nutritional needs of babies, while ensuring that breastfeeding is not undermined by the advertising, marketing and promotion of such products. The regulations include strict controls on the promotion, labelling and composition of infant and follow-on formula and set out clear guidance for infant formula manufacturers on how the regulations should be implemented.
Finally, there was a question about the National Infant Feeding Network, which I think I have dealt with. If there are any other issues, I will happily respond by letter. I shall leave enough time for the hon. Member for Glasgow Central to close the debate.
Alison Thewliss: I thank the Minister and all the Members who have spoken today; the fact that they came along and participated is very much appreciated. I can see from Twitter that the debate has been getting a good and interesting response. I thank the hon. Member for Dulwich and West Norwood (Helen Hayes) for her contribution and for her support for the organisations in her area that clearly need it at this time. Where we have instances of good practice in breastfeeding in this country, we must absolutely support services in every way we can. It is absolutely true that if we lose the expertise and the service, that will set breastfeeding back hugely and it will be difficult to re-establish.
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network and about the importance of having experienced midwife support. Experienced professional advice must be given, and it can be given only, whatever the circumstances, by seeing somebody physically. The answer cannot always be to do things online.
The Minister made the point about follow-on milk, commercialisation and the implementation of the code. I still think that we have issues. We can go further to implement the code; it is clear that the implication of some of the adverts for follow-on milk is that if women breastfeed for a year or two, their milk might not contain enough nutrients for their child. The opposite is true—it contains all the nutrients that are needed. That is exactly and specifically how nature has designed it for the healthy development of children.
I thank the hon. Member for Washington and Sunderland West (Mrs Hodgson) for her contribution. She is hugely experienced and clearly very passionate about the subject, which is great. There are lots of obstacles in the way, not least women returning to work, and we need to be mindful of that and how best we can offer support. We need to make breastfeeding a normal process so that women do not feel embarrassed about asking to nip out to express milk or going to visit the nursery to feed their child.
I had a strange experience last summer as a volunteer at the Commonwealth games in Glasgow. It was the longest time I had been away from my baby at that point. I found it very difficult to explain to a room of strangers that I was nipping out for a couple of minutes to express milk and to ask whether I could hide it in the fridge somewhere. The situation is difficult and awkward; we need to be aware of that. Employers need to be aware of their obligations and how to make it easy for people, so that there is a private space where they will not be interrupted. People should not be offered a corner of a busy lunchroom and certainly never a toilet, because that is disgusting, frankly. We would not eat our lunch in the toilet, so we should not expect anyone else to.
The point about images and showing the world what breastfeeding looks like was interesting. The Minister commented that I had tweeted a picture at the weekend; someone came up to me yesterday and said, “That’s very daring of you!” and “That’s very brave of you!” To be honest, I did not think about it. I was holding a baby; there was nothing particularly to see in the picture other than me feeding my daughter. I thought, “What a strange reaction.” To me, it is completely natural; I do it almost without thinking.
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the hashtag, we will see women doing similar across the internet just now. It is a process of normalising the activity—perhaps making a breastfeeding selfie something that people do, rather than draw back from. The issue is about making breastfeeding part of everyday life that people see all the time. If people do not see women breastfeeding, do not know anyone who breastfeeds and all they see are women feeding children with bottles, they will think that breastfeeding is odd and may not feel brave enough—because it will feel brave—to attempt it themselves.
We need to think carefully about how we normalise breastfeeding and how families, extended families and friends can best support women when they are doing it. My neighbours in Glasgow were keen to help their daughters and daughters-in-law by taking their babies overnight when they were tiny to give the mother a break. Although that is a wonderful thing to do to help, it will not help breastfeeding at all and will make it all the more difficult. We all need to think about our roles as part of families, the things we say and the way in which we say them—not say, “You must be exhausted”, but rather, “Can I make you a wee cup of tea?” It is about finding ways to support people rather than passing comment or using phrases that almost feel undermining at every turn. We need to think about that as much as we can.
Mr Peter Bone (in the Chair): Order. We are all finding our way with the new system that we have only just implemented in Westminster Hall. The wind-up speech should really be very brief—probably about two minutes. I think the hon. Lady has been going for more than five minutes, so she might want to bring her contribution to an end.
Alison Thewliss: Thank you, Mr Bone. I have found it difficult because the time is not what I expected it to be, so I was unsure about whether I was running out of time and how long I had. I thank the Minister for his contribution. I still think that there are lots of issues that we, as individual Members, ought to take up in this Parliament to support mothers in any way we can. I thank hon. Members again for attending.
That this House has considered National Breastfeeding Week.