Dr. Cathal McCrory:

The intervention has to be multifaceted and identify a number of strands. If we really want to disrupt the trajectory, the first thing we have to do is get in when it is first identified that the mother is pregnant. When I speak to mothers who are pregnant, that is the stage when they want to do the utmost for their children. They are really thinking about this issue. I refer to the health promotion literature, advice and the direct supplementation of diet, in particular for low income groups.

The second aspect is breastfeeding the infant, for which there are a number of reasons. People have argued over why breastfeeding is protective against the development of obesity. Generally, the energy density of breast milk is much less than formula milk. Mothers who breastfeed also tend to delay the introduction of solid foods and we know that the introduction of solid foods before the age of about six months is also associated with an increase. We know that children who are breastfed also grow more slowly. The study I referenced in my submission shows that individuals who are bottlefed gain weight more quickly.