Alice-Mary Higgins (Independent) | Oireachtas source

I want to follow up on something. I think Senator Sherlock mentioned it. There is a little bit of a red herring at play in some of the responses we have been having in this debate with this reference to the EU regulations. Regulation (EU) 2016/127, which supplements Regulation (EU) No 609/2013, relates to the compositional and information requirements for information on infant formula and follow-on formula. That regulation specifically relates to the product and how it is composed, such as what the acceptable level of pesticide is. That was one of the debating points when the regulation was being debated, because apparently there is an acceptable level of pesticide. It deals also with other information requirements having to do with packaging. It is absolutely not related to the area in question, namely, online promotion, marketing and commercial activity around breast milk substitutes in all their forms. We must be clear we do not have a red herring thrown in here. Even if it was an EU directive, it would not have prohibited us from having appropriate standards in many areas. We see many countries in Europe are often ahead of each other when it comes to health and safety standards. Certainly, it in no way constrains us from regulating here. I worry this debate would send a signal to an incoming commission that it was constrained from regulating or, indeed, prohibiting breast milk substitutes in whichever form. It is important we are clear on that.

It is important to focus on the relevant piece of international guidance, that is, the WHO code. It has been there since the 1980s and has a number of very specific provisions the WHO highlighted as being not applied and not respected. Again, this is not simply around the content but also the content delivery. Some of the provisions in the WHO code are really clear. They state things about not seeking direct contact with pregnant women. They mention not having commercial communications presented as information. Some of the things we know about are directly in breach of the WHO standards. I refer to the baby clubs and the online chat with an expert mum who is employed by a company promoting a commercial product. There are also the advertising campaigns people are encouraged to enter before they even give birth and where they then must give permission for follow-up emails to come in week by week encouraging them to engage.

We need to be clear that this is not an opinion. It is not about the choice issue that everybody agrees with. The question is about what is getting promoted and what the impacts are. The WHO has been clear to the point it has stated that it believes that if there is not regulation of the advertisement or promotion of breast milk substitutes, then states are breaching the Convention on the Rights of the Child. We have in the Bill a provision that mentions high-fat and salty foods as something with a direct effect on children. We know breast milk substitutes, and certainly their promotion, has an impact on children.

On the argument this is providing some kind of service, we must be clear, as Senator Sherlock outlined, that we absolutely need greater supports, not just in the form of lactation consultants but also midwives. The latter group needs to be better supported and resourced within our health system in general. Many other supports are needed there, including longer follow-on times for those who might need that. There are many supports that should and could be offered, including, as I mentioned, something available in the North of Ireland that we do not have here, namely, a public breast milk bank. That does not get promoted as an option for those who cannot breastfeed because it makes nobody any money. What it does is support women who need support at that time.

There are many public health measures we should be doing better but the core point is that does not argue against this regulation because they should not have to compete with a huge commercial advertising budget. Marketing happens for a reason. Companies do not commercially promote and advertise for no reason. They do it because it increases sales. It literally has a direct effect. Internationally, about 10% of global sales, about $6 billion, is spent on promoting breast milk substitutes and formula milk. That is equivalent to the entire budget of the WHO. The WHO and, indeed, our own health service should not be up against that level of competition over who can reach people with those messages and who can give those supports. That is key. I wanted to bring in the WHO aspect because we were focusing a lot on Ireland because we have such extraordinarily low levels of breastfeeding. Only 6% of women are breastfeeding to six months exclusively.

I will finish on the international responsibility because it is important. This is not just about what we do here and how we give supports and things. This is around the message we send internationally. The Lancetestimated 800,000 infant deaths could have been avoided internationally if the WHO's code had been respected and applied with respect to formula milk.This is an industry which uses a lot of very inappropriate practices. It can create situations where people use water that is contaminated. Its advertising has very serious consequences. Precisely because Ireland is one of the world's largest manufacturers of formula milk it is important that we get it right. It being such a big industry in Ireland is not a reason for us not to regulate it but to regulate it and outline very clear constraints and, where necessary, prohibitions around how it is advertised and promoted. Ireland exports one third of its formula milk to China where breastfeeding levels have halved in the last ten years. There is a global health responsibility on us too. We are a country that could send a signal that we recognise that this is a product which is sometimes needed and should be available for those who need it but it is not a product where profit maximisation and commercial promotion at all costs is appropriate. This is the chance for us to send that signal. It must be reflected in the Bill. There have to be some amendments that send that clear signal and put addressing that issue clearly on the agenda. We cannot simply leave it to the discretion or potential discretion of a commission in the future.