Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Senator Pauline O'Reilly and her colleagues for tabling this Private Members' motion. I am delighted to be here. I am responding to the motion on behalf of the Minister for Health, Deputy Stephen Donnelly, and the Government. It is great to see so many people who have advocated for this very important policy. I see a lot of friends who I have worked with in the Department over the last two years, ably supported, I understand, by Ben. They are very welcome and I believe they do great work as well, so I thank them very much. The motion calls for a range of supports and measures relating to breastfeeding in Ireland. The Government is not opposing the motion as it aims to promote an increase in breastfeeding rates in Ireland through a number of measures and supports.

I welcome this opportunity to update the House on the work my Department and the HSE have been doing in this important area and the broader area of women's health. This discussion is especially timely given that last week was the HSE National Breastfeeding Week and given the emphasis on women's health in recent budgets, including budget 2023. The Healthy Ireland framework, which was published in 2014, and the Healthy Ireland strategic action plan, published in 2021, set out a vision for improving the health and well-being of our citizens. Ireland continues to have a culture of bottle feeding. Promoting an increase in the number of new mothers breastfeeding is a priority item in this framework. We all know how important it is that our children get the best possible start in life and this is something all Government partners have prioritised in the programme for Government. In 2016, the HSE launched Breastfeeding in a Healthy Ireland: Health Service Breastfeeding Action Plan 2016-2021. This is our roadmap for progressing supports for breastfeeding in Ireland and it has been extended out to 2023. My Department works closely with the HSE national breastfeeding co-ordinator, who has overall responsibility for the implementation of the action plan and with the national breastfeeding implementation group to progress a range of actions under the action plan's priority areas.

I would like to highlight to Senators some of this progress that is of particular relevance to the issues in this motion. Midwives and public health nurses are the primary front-line staff to support breastfeeding, from the antenatal period with the delivery of breastfeeding preparation and antenatal classes, to enabling mothers to establish breastfeeding in the early days and weeks.Breastfeeding mothers receive follow-up support throughout the postnatal period where needed. The HSE provides and funds voluntary breastfeeding organisations to provide community-based supports throughout the country. There are approximately 110 breastfeeding services available nationwide, and many are returning to in-person meetings each week as suitable spaces within communities are secured and more staff and volunteers to run the groups are available.

In order to support those mothers who need extra support to breastfeed, for whatever reason, infant feeding and lactation nurses and midwives in HSE services provide a specialist support service. In 2021 the Minister for Health announced funding of €1.58 million as a ministerial priority to provide an additional 24 lactation consultants to ensure nationwide availability of and access to such specialised lactation support within hospital and community services. That is annual, recurring funding. That brings us to the 34.5 new dedicated infant feeding and lactation posts approved in the past two years alone, of which 20 have been filled, with a further 11 in recruitment. Filling approved lactation posts remains a priority for the HSE to further build and enhance breastfeeding supports across all community healthcare organisations and hospital groups. In total, there are 44.6 whole-time equivalent dedicated lactation consultant posts across maternity hospitals and units and public health nursing services to provide specialised care for mothers experiencing challenges with breastfeeding. Each hospital and community service with these post-holders has a pathway of care to access lactation specialist services when required. Infant feeding and lactation midwives and nurses also play an important role in supporting pregnant women and mothers from marginalised groups or communities and who need additional support to breastfeed. The HSE, as the House will be aware, has partnered with Pavee Point to develop culturally specific health information on breastfeeding.

The health service breastfeeding action plan supports as best practice the use of expressed breast milk where breastfeeding is not possible. Access to suitable breast pumps is provided free of charge to all mothers of preterm and hospitalised infants as well as breastfeeding mothers hospitalised after maternity or paediatric discharge. In addition, all maternity and children's hospitals have clinical guidelines relating to the care of sick and preterm babies and the prioritisation of mothers' breast milk and donor-expressed breast milk, DEBM. Such breast milk is available in all hospitals providing care to these babies. The HSE has a national purchasing contract in place with the Western Health and Social Care Trust Human Milk Bank, which is based in Enniskillen. The HSE does not currently have plans to establish or to operate a human milk bank in the Republic of Ireland, but this will be kept under review in line with clinical infant feeding guidelines and availability of DEBM.

The HSE policy on the marketing of breast milk substitutes and new standards for infant feeding in maternity services requires that there is no advertising of formula milk, teats, bottles or soothers in any part of the maternity services and that staff take active measures to protect themselves and parents by not participating in formula industry-sponsored training and events. The HSE provides evidence-based, impartial information and support on feeding options and does not advise on any particular brands where others are formula-feeding.

Under the HSE nurture infant health and well-being programme, funding for initiatives to contribute to increasing the rates and duration of breastfeeding includes the development of new standards for antenatal education, nutrition, e-learning modules and a suite of breastfeeding training programmes. Since 2018, blended learning training programmes have been provided, which has made training more widely available to a broader range of front-line staff who support mothers. The new infant feeding and lactation nurses and midwives in the HSE will provide an additional resource to ensure that training is available in all community services.

The mychild.iewebsite, part of hse.ie, provides information to parents-to-be and parents of young children. The website is part of a suite of information supports provided both directly by practitioners and online. This website covers pregnancy, labour and birth, and babies and toddlers. As a father of two young children, aged five and two, the website was very useful to my wife and to me, my wife mostly. It was very welcome.

In the past four years the HSE has invested in a promotional campaign for parents aged 25 to 45 on mychild.ieand, as one of the most popular topics, breastfeeding features strongly in that ongoing campaign. The HSE also runs My Child social media channels on Facebook and Instagram, where breastfeeding topics are regularly featured. Once a year the HSE runs National Breastfeeding Week from 1 to 7 October. This year the week focused on encouraging parents to take up the free expert help available. Parents can also contact a team of lactation consultants through the "Ask our breastfeeding expert" service on mychild.ie. This service is available seven days a week, with the live chat service available from 10 a.m. to 3 p.m., Monday to Friday.

We are all aware of the impact of advertising on people's behaviour. Ireland has signed up to the WHO international code of marketing of breast milk substitutes, which aims to stop the aggressive and inappropriate marketing of breast milk substitutes. My colleague, the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media, Deputy Catherine Martin, is currently bringing the Online Safety and Media Regulation Bill 2022 through the Oireachtas. The Bill has passed all Stages in the Seanad and has moved to the Dáil. When enacted, the Bill will dissolve the Broadcasting Authority of Ireland and establish a new regulator, coimisiún na meán. Under the Bill, broadcasting codes will ultimately be superseded by media service codes, which will apply to both video-on-demand and broadcasting services. Furthermore, an coimisiún will be enabled to make online safety codes which apply to designated online services, such as video-sharing platform services - for example, YouTube. Similar to current broadcasting codes, these new media service and online safety codes may provide for the regulation of commercial communications relating to foods or beverages which may be the subject of public concern in respect of the general public health interests of children, including infant and follow-up formula. The significant work being delivered in the breastfeeding area is part of a wider effort to invest more significantly in women's health. The Minister for Health has made women's health his top priority, with €69.2 million of our health allocation in budget 2023 ring-fenced for women's health. I would like to take this opportunity to highlight a number of positive developments in the past two years.

We have secured the €10 million allocation for the women's health fund again in 2023, maintaining this vital mechanism for the delivery of Ireland's first ever women's health action plan, which was published last March. Through that action plan, we are building a national network of new services, including 20 gynaecology clinics, 12 of which are already open, and six fertility hubs, five of which are now open. Under budget 2023, €10 million has been allocated for the first time to provide access to publicly funded IVF treatment, benefiting couples at an extremely difficult time personally and financially. Last month we launched the free contraception scheme for women aged 17 to 25. We will expand the scheme in 2023 to cover all women and girls aged 16 to 30, subject to legal advice and consultation with regard to 16-year-olds. In 2022 we have made significant progress in tackling period poverty, allocating €710,000 to support period poverty measures for Travellers and Roma within local authorities and to support organisations working with those most at risk.

Furthermore, in a measure that will have a real-time impact on the cost of living for women, we have removed VAT on hormone replacement therapy, HRT, and newer period products such as period underwear and menstrual cups.Pads and tampons were already subject to a VAT rate of 0%.

We are developing six specialist menopause clinics – one in each maternity network – for women who require complex, specialist care. Three are already open and the remaining three are due to open this year. Last week saw the launch of the Irish College of General Practitioners' quick reference guide to the menopause. We are finally lifting the taboo by talking empathetically about it. I am referring to both men and women.

I thank the Senators for tabling this motion on a topic of key importance to the health and well-being, present and future, of children born in Ireland. I would like to finish on a positive note. The latest breastfeeding data from 2021 indicate a 4.8 percentage point increase since 2019 in the number of babies breastfed at the first public health nurse visit, bringing the percentage to 58.8%, exclusive and non-exclusive. This is going in the right direction but significant progress still needs to be made to increase breastfeeding rates. With the prioritisation of women's health, including in the Seanad and through many of the initiatives of my Department and other Departments, I am confident we will see further progress. Many of the initiatives have come from the Seanad. I thank the Green Party Senators for introducing this important motion to the House. With regard to women's health, with the increase in supports for breastfeeding we will see progress over the coming years. I thank the Senators for their words, views and suggestions. We will try to take them on board.