Wednesday, 12 July 2017
The Minister of State, Deputy Jim Daly, is very welcome. This is the first time I have had an opportunity to congratulate him in the House. I wish him the very best of luck in his endeavours. I wish to raise the issue of the baby-friendly health initiative, which has been operating in Ireland since 1999, with 100% of maternity hospitals participating. Fifty-three of these hospitals meet the international benchmark. The initiative is very important and is worthy of support. Knowing that a hospital has received or won an international award designating it as baby friendly, which all our maternity hospitals should get, gives a certain comfort to the parents when going in. The initiative is supported by the World Health Organisation. It is the only international benchmark to which Irish hospitals operate. It is particularly disappointing to see that the funding for the baby-friendly health initiative has been withdrawn. There has been a lack of discussion and consultation with the organisers. We are at a stage where we cannot allow this to happen. The baby-friendly health initiative supported the staff in this hospitals and the management to improve their standards, not through a slap of the hand but in co-operation and collaboration. It is certainly the way to go. We are fighting at present to try to increase the breast-feeding rate in Ireland. The rate is very low by European standards. There is only one other country behind us, the United Kingdom. We need to increase our efforts. Currently, 56% of women initiate breast-feeding in our maternity hospitals, but this drops by 10% within 48 hours.
I am certainty interested in hearing the Minister of State's views on this matter. Why has the funding been withdrawn and why are we no longer participating in the baby-friendly health initiative?
I thank Senator Humphreys for raising this important issue and providing the opportunity to discuss it with the House today.
Increasing the rate of breast-feeding in Ireland is an important national health policy objective and is emphasised in the Healthy Ireland framework, the national maternity strategy for the period 2016 to 2026, the national obesity policy and action plan for the period 2016 to 2025, and the recently published National Cancer Strategy 2017-2026. The baby-friendly hospital initiative was launched by the World Health Organization and the United Nations Children's Fund, UNICEF, in 1991 and is a global effort to implement practices that protect, promote and support breast-feeding. In Ireland, the baby-friendly hospital initiative has been in place for 20 years and nine of the 19 maternity hospitals countrywide have baby-friendly designation.The initiative is funded by the HSE, which in 2016 commissioned a research team at Trinity College Dublin to undertake a review of the initiative. The review, which highlighted a number of issues, recommended the need for a revised model to be developed in line with the maternity strategy and the HSE national breastfeeding action plan 2016-20. A key finding of the Trinity review was that there was no difference in breastfeeding rates in hospitals that had achieved baby friendly designation and those that had not achieved this designation. Following completion of the Trinity review, the HSE initiated engagement with the baby friendly hospital initiative and other stakeholders on developing a revised model. While the HSE has made the decision to pause the existing initiative and it is not being funded for 2017, I understand that funding is available to that group to participate in the process to develop the enhanced model.
The national women and infants programme is actively working with the HSE health and well-being division, the HSE lead midwife and other key stakeholders to address governance and other issues and explore models to support the implementation of the World Health Organization-UNICEF ten steps to successful breastfeeding, which is the basis of the baby friendly hospital initiative. There is ongoing engagement and communication with maternity services and other key stakeholders as part of this work to ensure we have a model suitable for the promotion and
support of breastfeeding in Ireland. This approach will also examine the option of an all-island approach. I support the position of the HSE and I am satisfied that the work to develop a revised model will support the aim to increase breastfeeding rates in Ireland and enable more mothers to breastfeed their babies.
Can the Minister of State tell me if Trinity engaged with the baby friendly health initiative during that review? The baby friendly health initiative is an international benchmark and I am concerned as to whether there has been adequate consultation in this regard. I know some of the voluntary hospitals are continuing with the baby friendly health initiative, which is not just about breastfeeding, but about supporting and developing best work practices in our hospitals in so far as babies are concerned. Pardon the phrase, but we have policies coming out of our behinds with regard to breastfeeding but very little action. We have one lactation specialist for every 8,000 babies born whereas the recommendation worldwide is to have one for every 1,000 births. The Limerick hospital is the exception in this country in terms of best practice.
I ask the Minister of State to at least ensure the HSE engages with the baby friendly health initiative. I would like to see further details in regard to the Trinity study, in particular who exactly was consulted. As I said, the baby friendly health initiative is not just about breastfeeding and if it was reviewed within that narrow prism, that is why we got the result we did. I question why something that was maintained right through the austerity years is being cut at this stage.
The Senator has raised valid points and asked pertinent questions, and I will get answers for him. While I do not know the answer on the level of consultation the HSE had with the baby friendly health initiative, I will find that out for the Senator. I will also find out how far the Trinity study went with its consultations and how widespread they were. I appreciate that the answer I read out is not entirely satisfactory, although it does cover the basics, which is that there has been no change in the ratio of breastfeeding in the hospitals that had the initiative running and those that did not. Other than that, it does not give us the answers to the questions the Senator is asking and I undertake to get those answers and revert back to him. I will re-engage with him when I get those answers in order to try to get this back up and running and make sure we achieve what we all want to achieve, which is an increase in breastfeeding rates across the country.