Dr. Sinead Murphy:

In respect of breastfeeding and weaning, there is no question but that breastfeeding is protective and is the best start a child can have from a nutritional point of view. It is somewhat strange but we do not do well with breastfeeding in Ireland. It is very socioeconomically dependent, like everything else. However, we certainly should be encouraging it, as well as encouraging facilities and so on for mothers to be able to breastfeed where at all possible. While breastfed children are less likely to be obese, there are so many contributory factors that it is very hard just to pull out breastfeeding. This just brings me back to exercise and children having the wherewithal to exercise and providing that for them. Exercise has become elitist in this country because there are not the facilities for children to go and play if they so wish, to walk to school if they so wish or to cycle to school if they had a bike. These are the types of children with whom we are dealing and we must bear that in mind. However, that is an aside.

Weaning is very important and we are bad at it. Children will be weaned as early as three months in some cases. Moreover, a little scarily, mothers will be advised to wean children at three months. This is a case then of educating, in that we talk about educating the educators and they are the pure educators, namely, the teachers. There also are the health care professionals who are going out and giving advice to these parents. They need to know what the advice should be and certainly, weaning at three months is not part of it. Moreover it happens and we hear frequently enough that mothers are advised to do this. This certainly is something that really requires quite a lot of attention. This will be very important from a prevention point of view as these are babies and hopefully we can prevent them from turning into overweight or obese children.

As for intolerance, I do not believe there is much of a relationship between food intolerance and being overweight or obesity. There is food excess and lack of exercise and as Ms Kizzy Moroney stated, there probably are 40 different factors - that probably is conservative - all contributing together. Food intolerance occasionally may play a part but I do not think it is one on which to concentrate. As for the Deputy's question on thyroid problems, that is one thing for which we screen. As members will be aware, all children are screened at birth for congenital thyroid problems with the Guthrie test. However, other thyroid problems can come on at any point in life and can contribute to being overweight. It is one thing that certainly should be checked for and again, that is part of education. In our programme, we screen all children for thyroid problems because one sees it and I can think of lots of cases in which children would come in and be battling and in which it is a case of thyroid problems. Unfortunately, most of the time, it is not an endocrine problem but is a problem pertaining to the toxic environment in which they live and the fact they are not enabled or empowered to do anything about it.