Ms Deborah Byrne:

I thank the committee for inviting us and the members for attending. Behind Bainne Beatha, our campaign for improved breastfeeding support services in Irish maternity units, are four working mothers: me, Megan Etherton, Lucia Prihodova and Felicienne Rahill. We launched in February 2021, and are running this in our spare time without funding or political affiliations. We are not a breast is best group. We respect a parent’s choice to formula, combination or breastfeed. However, the Irish maternity service does not appear consistently to support those who wish to breastfeed.

We hear often about Ireland’s breastfeeding rates being the lowest in Europe, but there is judgement of mothers in that language. Mothers in Ireland know about the importance of breastfeeding, and according to the Irish Maternity Indicator System, IMIS, report, at 63.8%, the majority of them do initiate breastfeeding, but by the time they leave the hospital, this figure is almost halved to 37.3%. What happens in those days between birth and discharge from the hospital? Our report, personal experiences and the stories we have heard since launching provide some insight into the reasons behind this sharp decline. We would like to share some of those insights with the committee and five key asks of our Government and action by the Houses of the Oireachtas to make vital interventions.

From our report, 37% of mothers reported that midwives were too busy and overworked to provide the assistance needed. A quote:

I have had 3 babies and while the hospital did support breastfeeding, I never saw a lactation consultant despite requests each time. I was a section mum so in for several days - never available. Saying you support is not the same as providing hands-on support. Midwives were v good but v busy with everything else.

I also experienced this on the birth of my first child. Therefore our first ask is for adequate staffing, and for the number of international board-certified lactation consultants to be increased in line with international benchmarks and to be accessible in all Irish maternity units.

One in three mothers in our report received conflicting advice about how to breastfeed. One respondent said that "All of the midwives said different things which was really hard to filter through as a new mother". I too faced conflicting advice during my time in hospital. Our second ask is to see mandatory evidence-based continuing professional development on breastfeeding for midwives and certified lactation consultants.

In our report, one in three mothers were offered formula despite stating their wishes to breastfeed. One mother wrote, "New mothers shouldn’t need an advocate to defend their intention to breastfeed, fending off formula or conflicting advice from the 'experts' when they are exhausted and post partum in the middle of their baby’s first night." I too left the hospital formula-feeding my baby against my wishes. Our third ask is a national audit of the implementation of the national infant feeding policy for maternity and neonatal services, and a review of the promotion and distribution of formula practices across all maternity units.

The national maternity experience survey of 2020 results showed 47.3% of women did not know how to give feedback or make a complaint about their maternity care. Therefore our fourth ask is for the national maternity experience survey to expand to evaluate comprehensively service user experiences of breastfeeding support in maternity care, and to have service user representation on the national breastfeeding implementation group for current and future action plans.

In our report, we found 60% of mothers sought help with breastfeeding privately, spending an average of €440. I personally had to spend almost €700 to be able to breastfeed after a difficult experience in hospital. Maternity units can be a level playing field, offering a great opportunity to reach a cross section of the 60,000 plus women who give birth in Ireland each year and to extend the opportunity to anyone who wishes to breastfeed. Therefore our final and most important ask is for the full implementation and assessment of the breastfeeding action plan to ensure proactive, skilled, timely breastfeeding assistance for mothers and babies, regardless of location, demographic or ability to pay.

There are amazing midwives, public health nurses, voluntary support groups, including Cuidiú, representatives of which are present today, and lactation consultants who manage to save mothers’ breastfeeding journeys after their difficult experience in hospital. However, thousands are falling through the net every year, bringing about added potential health risks for mothers and their babies. Not investing in this crucial period is a sure-fire way to guarantee we are cutting our breastfeeding rates within hours of birth. We need to flip the narrative which blames mothers and instead address low breastfeeding support rates in Ireland. Breastfeeding is a component of the national maternity strategy, the strategy on women and girls from the Department of Justice, the national obesity plan and the national cancer plan. Fianna Fáil, Fine Gael and the Green Party identified breastfeeding as a priority in the programme for Government and we would like to see them honour this commitment.

We are grateful for the opportunity to be able to share these stories with the committee. Now we are looking for the full implementation of what has been promised in the national maternity strategy and the breastfeeding action plan. Breastfeeding reduces risks of multiple health issues for mothers and babies and they deserve the protection of the Government.