Ms Geraldine Cahill:

It takes a multipronged approach in that everybody needs education at every level. Even the lady who does the cleaning on the maternity wards needs to have some training in breastfeeding because she is interacting with a new mum. Even if all she ever says to her is that she is doing great, that makes a difference to a mother's experience. We need, therefore, training at every level, particularly at the neonatal level and the obstetrician and GP level.

Very few GPs will refer women to lactation consultants. They will refer for a skin disease or a little knobbly bit somewhere on a person's body and yet, women go into GPs with nipples that are literally torn apart and they do not refer them to a lactation consultant. There is something missing in their education that GPs do not value this role of the specialist in breastfeeding. That seems to happen right throughout the whole system.

Midwives are crucial and play a pivotal role in breastfeeding. They do a tremendous job with the lack of resources they have. Some of them will be really interested in breastfeeding and will go to loads of education sessions. Some of them will not be that interested and will concentrate on the birth and pregnancy care, which is their main role. We need them to have some education. The lactation role is very separate and very postnatal, however. That specialism is needed in order that people can get educated and develop their own skills and competencies in that area.

My view is that the competencies have not been put in place. We have education into which people can go. It is out there all the time. However, we have not put in place competencies and we are not checking people's competencies. The World Health Organization has much of that and the World Breastfeeding Trends Initiative, WBTI, looks at it. Many tools are, therefore, available. It is up to us to start using them. That needs the Government to show the willingness to take that step to look at competencies.