Ms Richelle Flanagan:

I have a couple of points. In response to Deputy Fitzpatrick's question about breastfeeding, he may like to take it up with one of our research dietitians, Ms Roslyn Tarrant, who has done a great deal of research in the area of breastfeeding and weaning within the Irish female population. Our rates are definitely at the lower end. Those who are breastfeeding are the more well educated and those who have thought it through before they give birth, during the antenatal period. It is very much the case that we need to hit that point before they give birth, during the pregnancy and even before. It is shown that even grandparents have an effect on the child's level of obesity down the line. We need to get in as early as possible.

As Dr. Murphy stated, there is definitely research to show that people are weaning far too early. The FSAI has launched new infant feeding guidelines, which are supposed to be rolled out through the public health nurses. The problem is that there are not enough public health nurses because of the moratorium on recruitment in the public service, as is the case with other health professionals. With regard to weaning foods, mums are using packaged products. That is something that needs to be addressed. There are guidelines about the safety of these weaning foods for babies but there are no guidelines about the levels of sugar, fat, etc. That might be something to be examined.

I read a report that stated that according to the legislation one can breastfeed in the workplace but one must give notice six weeks beforehand. Often, there is a lack of access to a place suitable for breastfeeding. Embarrassment is a big blockage. In that regard, one will also see in Ms Roslyn Tarrant's research that there is a fear that breastfeeding is not something that is acceptable.

One point I must make about breastfeeding is that the mums are blamed constantly for different things. We must be supportive and encourage them. The WHO supports exclusive breastfeeding, but it comes down to choice. Many working women are under a great deal of pressure in this economic time, and they must be given more choice. We must support them in their choices and encourage them to breastfeed as much as they can, whatever that may be. We need to have a more helpful society when it comes to breastfeeding.

On the comment made about the food guidelines, as the committee will be aware, the food pyramid and the healthy eating guidelines were relaunched last June through the Department of Health, the FSAI and the HSE, with the involvement of the Irish Nutrition and Dietetic Institute, INDI. They are a fantastic resource. They are not a weight-loss guide but I can guarantee that if people followed them they would naturally lose weight.

We were asked about the top five issues with regard to obesity. One can say the top issue is the food on the top shelf. People are snacking too much on high-fat or sugary foods and drinks. Portion control is another. The food pyramid tells people about appropriate portions. I gave a talk only yesterday in a workplace and it is always the case that people are astounded when I tell them that a portion of rice is 25 g. That is nothing. Thirty strands of spaghetti is a portion of carbohydrate. The messages we need to get out to people are about portion sizes and about the top shelf. Alcohol is another issue; people do not understand the amount of calories that are in the alcohol they consume - that is, 100 calories per 100 ml of standard drink. These are many of the messages contained within the food pyramid.

With regard to the food pyramid, it is wrong to denigrate something that is a public health document. When the delegation from "Operation Transformation" appeared before the committee, they did that. It was incorrect. They also mentioned that dietitians were not up to date. I represent dietitians and clinical dietitians, who are regulated by the statutory body CORU, the Health and Social Care Professionals' Council, which deals with protecting the public from poor information. We represent the expert view, just as physiotherapists and behavioural psychologists do, with our paediatric consultants. It is quite a complex issue.

The food pyramid is only for those aged five years and over. We do not have food guidelines for under fives. That is something else that should be put in the committee's report. I ask that there be food guidelines for under fives, along with a food pyramid and portion controls for children, because we need to start early.

With regard to what is available for children, much work is being done. There are websites such as littlesteps.eu. Members said that parents were listening in to this meeting. That website is a fantastic resource from safefood. There is also an initiative called way2live.eu, which is a combined initiative from the INDI and safefood. They are both great resources for empowering parents. The Food Dudes programme has proved to be fantastic. It is parents who affect children's choices, but when it comes to teenagers, their peers also have an influence. Children are affected by their parents' choices, but within the school setting, that programme, under which children bring in a fruit and vegetable, has been shown to be extremely successful. Like other programmes, however, it has not been supported enough. Breakfast clubs were mentioned. There is the Healthy Food for All initiative, under which HSE dietitians have helped to develop a resource for breakfast clubs in deprived areas.

There is much fantastic work going on, but we always come back to the crux of the issue - that is, the need to co-ordinate and replicate those initiatives that are working, which is not happening at the moment. There is funding, but if one wants to find better ways of utilising the funding, one should examine the programmes and move the funding to areas that are working. It is criminal that we are saying we need to find funding for something that is preventative. As we stated, 25% of the adult population are obese. By 2030, which is only 17 years away, the rate will almost double, to 47%. All of the chronic diseases are a direct result of obesity. To my mind, it is a no-brainer that one should provide the funding by finding it wherever one can. This will solve many of the other problems that are coming down the line.