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Part of the debate – in Westminster Hall at 12:00 am on 26th May 2004.

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Photo of Annette Brooke Annette Brooke Shadow Spokesperson (Home Affairs) 12:00 am, 26th May 2004

I am pleased to have finally secured this debate. It seemed appropriate to raise issues relating to breastfeeding close to breastfeeding awareness week, which was, of course, earlier this month. The Minister will be aware that two relevant early-day motions were tabled that week, both attracting more than 70 signatures. One notes that the UK has one of the lowest breastfeeding rates in Europe and also identifies some of the many health benefits from breastfeeding. The other highlights issues relating to baby food marketing. I want to make it clear at the outset that I consider it an important matter of personal choice for a mother how her infant is fed. However, the provision of facts, support and encouragement for breastfeeding, and regulation of the marketing of baby milk, all help to support an informed choice.

I acknowledge that the Government are supporting important initiatives, but there is always more to be done, given the advantages of breastfeeding and the disadvantages of not doing so. The health benefits of breastfeeding are well known and I shall quickly mention a few. The risk of gastroenteritis, respiratory, urinary and ear infections, eczema and childhood diabetes are all likely to be reduced. There is widespread concern in Parliament and across the country about childhood obesity. That has been brought to a head, I imagine, by this morning's coverage on the "Today" programme of the leaked report.

In response to a recent parliamentary question, I was told:

"In 2002, the Committee on Medical Aspects of Food and Nutrition Policy reviewed the benefits of breastfeeding in its Scientific Review of the Welfare Food Scheme and stated that breastfed babies are less likely to become overweight as children. Since then, a further review in 2003, by Dewey et al, found that most large studies show a protective effect of breastfeeding against overweight in children and adolescents." —[Hansard, 17 March 2004; Vol. 419, c. 383–4W.]

I understand that further research is being carried out. I suggest that among all the other recommendations that are likely to emerge from the Health Committee's report when the final version is published and responded to by the Government, the starting point should be the baby's start in life or perhaps even the mother's diet. I am not an expert on that, but childhood obesity requires us to go right back to the beginning.

I visited a specialist children's dentist in my constituency last week and was surprised to learn of further benefits in relation to jaw development. There are also, of course, many health benefits for the mother, including reducing the risk of pre-menopausal breast cancer and ovarian cancer, not to mention aiding weight loss after pregnancy.

Around two-thirds of women start to breastfeed their babies in the UK. However, the last five-yearly survey carried out by the Office for National Statistics showed that 21 per cent. of mothers who started breastfeeding had stopped in the first two weeks and 93 per cent. of them would have liked to have breastfed for longer. Just one in five babies are receiving breast milk by the time they are six months old, although the World Health Organisation recommends that babies need nothing other than breast milk for the first six months of life. It contains everything that a baby needs. There are huge variations in breastfeeding rates according to social class, age and area, so it is important to tackle the inequalities.

Excellent work is taking place in many areas to support and encourage breastfeeding. I am particularly pleased that Poole primary care trust employs a breastfeeding co-ordinator and I congratulate Mandy Grant on her work. I recently attended the inaugural meetings of two new bosom buddies groups. One of my constituents, Julie Dyball, played an important role in the latest one to be set up in Upton. Through regular weekly meetings, it provides a social environment for mothers and toddlers as well as support from other mothers and breastfeeding counsellors. How does the Minister intend to ensure that good support is available across the country? Also, what support will he give to maternity units seeking baby friendly status? I am pleased that Poole hospital is likely to apply for that.

I have wondered about how I became quite so involved with breastfeeding because, until a year ago, I simply thought that I had been there and done that way over 30 years ago. I recall that my main motivation to breastfeed was based on economic grounds, an important factor for many mothers today, but perhaps not always recognised as there tends to be a lower rate of breastfeeding in areas of deprivation.

Once I started to talk to mothers in my constituency and members of the National Childbirth Trust, I became aware of how many dimensions, and obstacles and obstructions, there were to supporting breastfeeding today. On the support aspects, clearly it is important that there should be good training for all professional workers, including nurses and health visitors, who will be in contact with a new mother. I have been impressed by the work carried out by Bournemouth university on that issue. As a consequence of securing the debate, I received representations from the Royal College of Midwives—the Minister will not be surprised by that. Although the Government plan to recruit more midwives, the latest statistics from the NHS and the Royal College of Midwives annual staffing survey reveal that we are not recruiting as many as we need. That shortage has an inevitable impact on how much support midwives can offer women on acquiring skills such as breastfeeding. That is an important point, despite the nature of the lobby. The training of breastfeeding counsellors who work on a voluntary basis is also important. Schemes such as bosom buddies could not exist without voluntary support.

During my trip to learn about breastfeeding in this day and age, I was shocked when I asked local GP surgeries and local primary care trusts about breastfeeding levels in my constituency. The statistics all seemed incredibly good. I have thought about that and it seems to me that we must not be complacent. There is a danger of focusing on the percentages of women who start breastfeeding. It is important to have comparable data, across different areas, monitoring the first six months and beyond.

Last autumn, I learned from Poole PCT that guidelines were awaited, and I discovered from the response to a parliamentary question that guidelines for PCTs on the collection of statistics on breastfeeding initiation were made available to national health service staff on 28 November 2003. Are those guidelines being followed by all PCTs? What further steps is the Minister taking to ensure that there is good data on which to make further decisions?

On the cultural aspects, it seems that we have reached a strange position in society when some people become embarrassed at a mother discreetly feeding her baby in a public place. I was travelling on a crowded tube the other day, and a baby was crying. The mother addressed the situation quickly and efficiently. Result: happy baby and less stress for the other passengers, including me. Attitudes are slowly changing, but we have a long way to go. If a mother wishes to use a quiet and private place for feeding when she is out shopping, for example, the facilities are often poor, if there is any provision at all. Living in a tourist area, I am very aware that the facilities are lacking.

There can be no quick fix for societal attitudes, but leadership at a national and local level can clearly contribute over time. Support needs to come from society as well as from health professionals, family and friends. Greater understanding and positive attitudes are needed to encourage and support breastfeeding women and to enable them to carry on for as long as they would like. Ideally, breastfeeding should be a normal part of everyday life. I could not help but notice the contrast between the UK and Ghana during a visit I made to that country last year.

We have a strong call to make to the Government on the marketing of baby food. In 1981 the United Kingdom signed up to the international code of marketing of breast milk substitutes, adopted by the World Health Assembly as a minimum requirement to protect infant and young-child feeding, and hence their health. The international code is a unique and indispensable tool to protect and promote breastfeeding, and to ensure that the marketing of breast milk substitutes, feeding bottles and teats is appropriate.

It applies to all products marketed as partial or total replacements for breast milk, such as infant formulas, cereals, juices, vegetable mixes and baby teas promoted for children under six months. The United Nations Committee on the Rights of the Child has expressed concern about low breastfeeding rates in the United Kingdom and called on the Government to implement the code fully. Clearly, all the excellent supportive work and increases in breastfeeding initiation are undermined by company promotion that violates the code but is permitted by UK law. The market for breast milk substitutes is worth more than $20 billion; it is very big business. Monitoring by the International Baby Food Action Network found a surprising amount of illegal promotion as well as code violation.

Last year—I asked rather a lot of questions on this issue last year—I asked the Secretary of State whether he would take steps to ensure that jars of baby food could be labelled to say that breastfeeding is encouraged for six months rather than four. The answer was comprehensive. It stated:

"Current European Commission legislation provides that weaning foods may be labelled as suitable for infants from four months of age. This is due to be reviewed in the new year in light of the World Health Assembly (WHA) Resolution 54.2 on Infant and Child Nutrition to strengthen activities and develop new approaches to protect, promote and support exclusive breastfeeding for six months."—[Hansard, 10 December 2003; Vol. 415, c. 502W.]

Can the Minister give me an update on that?