Pauline O'Reilly (Green Party)
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The Minister of State is very welcome. To our shame in Ireland, we have the lowest rates of breastfeeding in Europe. We have one of the lowest rates of breastfeeding in the world, in fact. A recent study by The Lancet showed that 800,000 babies per year and 20,000 women per year die as a result of not breastfeeding. This should be a shock for us in a First World country.

We know that measures have been taken in Ireland. We have put in place more lactation consultants and allow for peer-to-peer support on the ground, but much more needs to be done.As a result of all of that, we in the women's caucus set up a committee on breast-feeding. I am the chair of that committee. Yesterday, I was delighted that we had members from UNICEF, Bainne Beatha, and experts from TU Dublin come in to us to present a World Breastfeeding Trends Initiative report. I was also delighted that the Minister, Deputy McConalogue, came and proudly put up a picture of himself on social media with a sign saying he supports breast-feeding in Ireland. He is the Minister for Agriculture, Food and the Marine, and it is a very good step in the right direction that we see this is being taken seriously by the Government.

Last year we introduced the Online Safety and Media Regulation Act. I was thrilled that the Minister, Deputy Catherine Martin, took on board a request by ourselves to put into the legislation a restriction on breast-milk substitutes. Why is that important? We know that when there is unlimited marketing of breast-milk substitutes - baby milk formula - breast-feeding rates go down. We also know that we have a heavily marketed industry here in Ireland. The online marketing of breast-milk substitutes is targeted at women of a particular age who might be struggling in the middle of the night with breast-feeding a small infant. If they go to the Internet for support and type in that they are looking for breast-feeding support, what pops up is an ad for formula milk. There is no doubt that when you do not have support it is easier to think that this might be the solution, but by having this heavily marketed product we are letting down the women who want to breast-feed.

We should not restrict access to formula milk at all because it is the choice of individual families what they want to feed their children, but we should take note of the fact that more than 60% of women want to breast-feed. They go into hospital wanting to breast-feed and yet the numbers who actually do it are half of that. We are letting people down when they have made a conscious decision and the State does not support them. One thing that we can do is to follow on from the Online Safety and Media Regulation Act and become a co-sponsor of the published WHO guidance on regulatory measures aimed at restricting digital marketing of breast-milk substitutes. Brazil, for instance, is willing to sponsor it. It would send a really strong signal if Ireland is a co-sponsor. This resolution is coming before the World Health Assembly in May 2024. I would like to hear the Department is supporting that, in line with the support yesterday from the Minister, Deputy McConalogue, and the Government's support for measures such as lactation consultants. We need a lot more than lactation consultants. We also need more midwives who have more time to spend with women. That is what I hear from both the health professionals and the women who are often left without that support.

Niall Collins (Limerick County, Fianna Fail)
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I thank Senator O'Reilly for raising this very important issue. Encouraging mothers to breast-feed is a priority, both for the Department of Health and for the HSE. National health policy, including the Healthy Ireland framework, the Healthy Ireland strategic action plan, the national maternity strategy, the obesity policy and action plan, and the national cancer strategy, emphasises the importance of supporting mothers who breast-feed, as well as taking action to increase breast-feeding rates in Ireland.

The HSE's Breastfeeding in a Healthy Ireland action plan is the framework for progressing supports for breast-feeding in Ireland. The Department of Health works closely with the HSE national breast-feeding co-ordinator, who has responsibility for the implementation of the HSE's breast-feeding action plan from 2016 to 2021, which has been extended to 2025. One key action of the action plan is to strengthen compliance with the WHO's international code of marketing of breast-milk substitutes and subsequent WHA resolutions. The HSE implemented its national policy to support compliance with the code in 2021. The marketing of breast-milk substitutes and new standards for infant feeding in maternity services require that there is no advertising of formula milk, teats, bottles and 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. Further measures to improve and monitor compliance with the WHO code are necessary across Departments and in partnership with cross-sectoral agencies and, as such, advertising and marketing through media falls under the remit of the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media.

Coimisiún na Meán was established in March 2023 further to the provisions of the Online Safety and Media Regulation Act 2022. This Act amended the Broadcasting Act 2009 to establish Coimisiún na Mean and dissolve the Broadcasting Authority of Ireland, BAI. In addition to undertaking the functions of the BAI as the regulator for broadcasting in Ireland, Coimisiún na Meán is to establish a regulatory framework for online safety, update the regulation of television broadcasting and audiovisual on-demand services, and transpose the revised audiovisual media services directive into Irish law. Officials from the Department of Health have contributed to the public consultation on the draft safety code and have met with officials from an coimisiún to discuss implementing codes that would restrict the marketing of high-fat, high-sugar and high-salt foods and beverages to children, and that includes infant formula.

The WHO guidance on regulatory measures aimed at restricting digital marketing of breast-milk substitutes highlights that digital environments are fast becoming the predominant source of exposure to the promotion of breast-milk substitutes globally, with practices that are diverse and constantly evolving. The WHO guidance outlines clear recommendations for the implementation of regulatory frameworks in member states which Department of Health officials can consider in future consultation with an coimisiún going forward. The resolution is currently being drafted by the ministry of health in Brazil and has not yet been shared with member states of the WHO. However, following circulation of the draft resolutions and agreement by all WHO member states, Ireland will then consider co-sponsorship. Until such time as online safety codes are developed by an coimisiún, the HSE provides evidence-based impartial information and support for feeding options in infants and young children on the mychild.ie website and social media channels.

Pauline O'Reilly (Green Party)
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I am pleased to hear the acknowledgement that the WHO international code of marketing on breast-milk substitutes has not been fully implemented by Ireland. However, this was adopted in 1981 by the World Health Assembly and more than 40 years later the WHA is now attempting to update it to include digital marketing as well. That is simply what this is about. The fact that Ireland has not fully implemented the code from 1981 is shocking. Is it any wonder that we have such low rates of breast-feeding in Ireland? We need to get moving on this. I fully appreciate what the Minister of State says. It is good news that Ireland will consider co-sponsorship of the code, but we must then implement it once it is adopted rather than let it sit on a shelf, which is what seems to have happened with the original code from 1981.

Niall Collins (Limerick County, Fianna Fail)
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I thank Senator O'Reilly for raising the very important issue of restricting digital marketing of infant formula. Research indicates that breast-feeding gives a child the optimum start in life and that increasing our breast-feeding rates will contribute to improvements in child and maternal health and can contribute to a reduction in childhood obesity and chronic diseases.

The Senator's question has highlighted the need for a regulatory framework to restrict the marketing of breast-milk substitutes, and this work will be progressed in consultation with Coimisiún na Meán and in the development of new online safety codes. The HSE's breast-feeding implementation plan runs to 2025 and the Department of Health will continue to work with the HSE's national co-ordinator in delivering on the five-point action plan.

The vision of Healthy Ireland is that everyone can enjoy physical and mental health and well-being to their full potential. The Government remains committed to improving breast-feeding rates and moving towards normalising breast-feeding within our community.Promotion of breast-feeding as part of healthy lifestyle choices will remain a priority for new policy development over the coming years.