Sorca Clarke (Longford-Westmeath, Sinn Fein) | Oireachtas source

I thank the ladies for their time this morning and the incredibly informative presentation they gave. In the spirit of full disclosure, I should say that breastfeeding is something close to my heart and I have nursed four children through various mechanisms because of different influences. I will come back to that as we go through the questions.

I agree that choice is key but that choice must be fully informed. The education should start before a woman becomes pregnant or a baby is born. At a much younger age we should educate women about breastfeeding and how it can fit into a lifestyle, along with the difficulties it may present. Having a baby disrupts a lifestyle as people may know it. We can accept that and the universal health benefits to both the baby and the mother.

There is now a position where women are leaving hospitals, where most births take place, much earlier than they would have before. That golden window of time and the first few days before a woman's milk comes in fully are absolutely key. If there is no support or ineffective support, we will simply not have the level of breastfeeding we want to see and we need to see taken at that early stage. The more women we have breastfeeding at the start clearly leads to higher rates of longer term breastfeeding. That is a question that must be addressed.

I had conversations with various people before coming here this morning but I know from personal experience that we must see a societal shift in how we view, support and encourage breastfeeding mothers and remove some of the barriers that exist. Another Deputy told me yesterday of her experience breastfeeding, and I told her how I nursed one of my children on the floor of a shopping centre, which was unacceptable. That is an example of a real barrier that could be quite easily challenged or changed. Again, it would rely on a societal shift.

We can consider the professional needs that exist, including lactation consultants, counsellors and peer support, and they must be matched on the other side with a societal shift in how we view breastfeeding. I agree with Ms Byrne that we need an audit of the infant feeding policies of hospitals. I would like to see formula being offered as opposed to being the predominantly accepted way in which a mother would feed a child. It absolutely should be there and there is a role for it but it should be available on request. Many more women would breastfeed if they knew they would be fully supported from those very early days right through whatever length of time they chose to nurse their children.

We must also have a review of our tax system to go with that. We need to look at how it is we apply VAT to the likes of hospital-grade breast pumps, breast pads and nipple guards. These are all tools to help a woman breastfeed for longer. We do not acknowledge they exist and we certainly do not encourage women to use them. Although we acknowledge there is a problem, we need to get to the point where women know they exist.

I say this as a woman whose second child was in the special care baby unit, SCBU, and due to various medical influences at the time, I was pumping and dumping. I never knew I could hire a hospital-grade breast pump until somebody happened to mention it to me in passing. It is a question for us to consider. When we look to address these challenges and encourage women, we must be more varied in our thinking and have a more multifaceted approach to how we do this. When we identify a challenge or barrier, we must approach it with evidence-based and target-based outcomes for what we want to see.

I spoke to a number of providers of breastfeeding support equipment and it was interesting that their view is the practice must be more accessible with better uptake. When a woman experiences a problem without support or education, the first reaction is to stop, which presents a real challenge. It is something we should take on board and listen to women about.

We must challenge the information and disinformation out there. There is a lot of information bandied about and some of it is based on tutti-frutti or pie-in-the-sky type of stuff, and that must be challenged. We must also actively promote the positive aspects of breastfeeding, which are varied. When we speak of breastfeeding we tend to concentrate on the challenges but there are many positive aspects of breastfeeding.

We also need to see a network of professional supports. Community healthcare organisations, CHOs, were mentioned and mine runs from Westmeath to Louth, so I ask for a significantly greater network than asking a woman in Westmeath to travel to Drogheda. These networks must be accessible, fit for purpose and almost tailored to what a lady needs. No two women encountering difficulties with breastfeeding will have the same problem, so such networks must be professional and easily accessible. The people involved must be aware of a lady's need.

GPs and public health nurses are wonderful people but they must have more education and be aware of the supports in the communities in which they work. When they encounter a lady experiencing difficulties, they should be able to refer her to the support groups, even if they are peer support groups. They should also put the idea in the mind of a lady who is doing well that she might be able to encourage other women in her network who might be struggling a little bit. We must have greater education around the supports and ask those who are doing well to relay their experience and perhaps promote breastfeeding.

I would like to see a new mother pack for every new mother in the country. This would be a small pack with various travel-sized bits and pieces. In that pack there should be more information on breastfeeding. It could include a couple of breast pads or a nipple protector. Something along those lines should be included in those packs. This recognises there are women breastfeeding, feeding with formula or a combination of both.

I thank the witnesses for their time as this has been a very informative discussion. I hope to meet them again.