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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 Stephen Ladyman Stephen Ladyman Parliamentary Under-Secretary, Department of Health 12:00 am, 26th May 2004

I congratulate Mrs. Brooke on securing the debate and on taking an interest in a subject that, as she said, she thought she had left behind many years ago. However, she shares that interest with my hon. Friend Ms Drown. I am sure that this will not be the last time that we discuss the subject.

Breastfeeding provides the best possible start in life and has considerable benefits for mother and baby. As the hon. Member for Mid-Dorset and North Poole said, those benefits continue long after breastfeeding has ceased. That is why, in line with the World Health Organisation code, the Government recommend exclusive breastfeeding for the first six months of a baby's life, with continued breastfeeding along with complementary feeding after that.

The Government also recognise the positive impact on public health that will occur by increasing levels of breastfeeding. That will be particularly significant among mothers from disadvantaged groups. Indeed, two of the Government's priority areas for health improvement—cancer and coronary heart disease—could be positively affected by increasing breastfeeding levels. For example, mothers who breastfeed are less likely to develop pre-menopausal breast cancer and are more likely to lose the excess weight that they gained during pregnancy. Breastfed infants are five times less likely to be admitted to hospital with common infections, such as gastroenteritis or respiratory infections, during their first year of life. Moreover, there is emerging evidence that breastfed infants are less likely to become obese in later childhood.

As far as reducing health inequalities is concerned, mothers from low-income groups are the least likely to initiate and to continue breastfeeding. "Tackling Health Inequalities: a Programme for Action", launched by my right hon. Friend the Secretary of State in July last year, sets out a framework with a strong focus on the prevention of health inequalities. It highlights the need to increase breastfeeding levels, especially among low-income groups.

The infant feeding survey in 2000 found that 71 per cent. of mothers initiate breastfeeding. However, there are striking differences in breastfeeding levels, related to levels of education, geographical location and age. For example, in the UK, 85 per cent. of mothers in higher occupations initiate breastfeeding compared with only 52 per cent. of mothers who have never worked. Some 78 per cent. of mothers aged 30 or over initiate breastfeeding compared to 46 per cent. of mothers aged less than 20.

That is why we have made a commitment in the NHS plan to increase support for breastfeeding and have set a target in the priorities and planning framework for 2003–06 to increase breastfeeding initiation by 2 per cent. per year, focusing in particular on women from disadvantaged groups. The Commission for Healthcare Audit and Inspection will be inspecting against an indicator to monitor progress towards meeting that breastfeeding initiation target.

In addition, a national service framework for children is being developed to set standards across the NHS, the social services for children and young people, and maternity services. Breastfeeding will be included in the development of that national service framework, which we hope to publish in July. The hon. Lady asked what the Government will do to ensure that there is consistent performance in increasing initiation rates. Those two elements—the indicator and inspections by the Commission for Healthcare Audit and Inspection, and the national service framework for children—will be particularly relevant. Further work is also being undertaken by the Health Development Agency, which has appointed two collaborating centres in maternal and child nutrition. Their work will include increasing the body of evidence on what encourages breastfeeding and moving that evidence into practice.

Last year, the three-year infant feeding initiative was successfully completed. It was supported with just under £3 million from the public health development fund. The overall aim was to consider ways to increase breastfeeding rates among disadvantaged groups. As part of the initiative, 79 best-practice projects were funded. The majority were local projects looking at best practice and practice development.

The Department of Health commissioned an evaluation of the 79 projects and the findings were published in a report in December last year. The report makes clear the important contribution the projects made to understanding how women from disadvantaged backgrounds can be supported and encouraged to breastfeed. The strategies and lessons learned from the 79 projects need to be shared and disseminated to those supporting and encouraging mothers to breastfeed to assist them in delivering the priority and planning framework target. For example, some of the key findings relating to antenatal education and peer support programmes support other research findings, which means that midwives and health visitors have a key role to play in increasing breastfeeding rates.

I acknowledge the comments made by the hon. Lady about the recruitment of midwives. That is exactly why the Government, working with the Royal College of Midwives, have developed a six-point action plan to improve the rate of recruitment. I note what she says about lobbying from the RCM, but I assure her and the RCM that we are making significant progress. I wish I could wave a magic wand and produce all the midwives that we need, but I cannot.

We have produced a practical, user-friendly resource pack for health professionals, based on the evaluation of the projects and current research evidence, and plans for its dissemination are in place. The resource pack has drawn on the experiences of all those involved in breastfeeding. Genuine local partnerships involving health professionals, the voluntary sector and mothers enable communities to identify and prioritise local need and ensure that effective interventions and resources are targeted on the areas with the greatest need. The commitment in the NHS plan to reform the welfare food scheme will also ensure that children in low-income families have access to a healthy diet and will help to bring equality to mothers who are breastfeeding.

We consulted on proposals for reform towards the end of 2002 and published our response to the consultation setting out our intentions to introduce a new scheme in February. The healthy start scheme provides vouchers for fresh fruit and vegetables as well as liquid and infant formula milk from the beginning of pregnancy, and an additional voucher from birth for the first year will be available to all mothers. Breastfeeding mothers have long felt that they lose out and the new scheme redresses the balance. It will also increase the choice available to all mothers in the scheme. Healthy start will free the NHS and child health clinics from the obligation to supply infant formula milk to mothers on the scheme, which will enable health professionals to concentrate on what they do best: providing high-quality care, advice and support to pregnant women and their families.

We are taking other steps to raise awareness of the issue: national breastfeeding awareness week, funded by the Government, is an annual public health campaign and is a main vehicle for raising awareness about the health benefits of breastfeeding. The hon. Lady referred to this year's campaign, which took place two weeks ago, in support of the priorities and planning framework target to encourage new mothers and mothers-to-be to "give it a go". Although the evaluations of this year's campaign have not yet been collated, the media coverage on breastfeeding was supportive and all the broadsheet press mentioned the campaign.

National breastfeeding awareness week is channelled through the NHS. Last year, health professionals distributed more than 1.25 million pieces of material produced by the Department of Health, professionals and voluntary organisations, who also helped to generate more than 550 regional press reports about breastfeeding during last year's campaign.

The Government are committed to the promotion and support of breastfeeding internationally, which brings me to the concerns that the hon. Lady expressed about the World Health Organisation's international code of marketing of breast milk substitutes. The World Health Assembly adopted the WHO code of marketing breast milk substitutes in 1981 prior to the development of what are now called follow-on infant formula milks. The WHO code, which the Government support, aims to protect and promote breastfeeding and establishes principles for ensuring the proper use of breast milk substitutes, including their marketing and distribution.

Rules on the composition, labelling and advertising of infant formula are harmonised throughout the EU by the EU directive on infant formula and follow-on infant formula. The principles of the WHO code relating to the labelling, advertising and provision of information about infant formula are incorporated—