Brendan Ryan (Dublin Fingal, Labour)
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197. To ask the Minister for Health if the HSE has plans to provide information regarding medicine that is safe for breastfeeding to pharmacies, general practitioners and hospitals; and if he will make a statement on the matter. [29165/17]

Brendan Ryan (Dublin Fingal, Labour)
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198. To ask the Minister for Health if the HSE plans on using the information regarding medicine that is safe for breastfeeding by a person (details supplied); and if he will make a statement on the matter. [29166/17]

Brendan Ryan (Dublin Fingal, Labour)
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199. To ask the Minister for Health the HSE's plans to launch a public awareness campaign to promote the health benefits of breastfeeding; and if he will make a statement on the matter. [29167/17]

Brendan Ryan (Dublin Fingal, Labour)
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200. To ask the Minister for Health his plans for health care facilities and practitioners to have a support database that will recommend local breastfeeding support groups to new mothers; and if he will make a statement on the matter. [29168/17]

Brendan Ryan (Dublin Fingal, Labour)
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201. To ask the Minister for Health the HSE's plans to create public spaces for breastfeeding support groups in primary care centres; and if he will make a statement on the matter. [29169/17]

Catherine Byrne (Dublin South Central, Fine Gael)
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I propose to take Questions Nos. 197 to 201, inclusive, together.

Some of the matters raised by the deputy are largely encompassed in the recent Health Service Executive publication entitled Breastfeeding in a Healthy Ireland: the HSE Breastfeeding Action Plan 2016 - 2021.

This Action Plan sets out the priority areas to be addressed over the next 5 years to improve breastfeeding supports, to enable more mothers in Ireland to breastfeed and to improve health outcomes for mothers and children in Ireland. The Action Plan outlines the actions needed to enhance breastfeeding rates and provide skilled supports to mothers, through our maternity services, hospitals, primary care services and in partnership with voluntary breastfeeding organisations and other stakeholders.

These actions include the implementation of policies at hospital and community level; investment in breastfeeding training and skills development for healthcare staff; and partnership working to promote a culture that accepts and supports breastfeeding. The Action Plan is available at .

I am also pleased to advise the deputy that breastfeeding initiatives are also reflected in the Creating a Better Future Together: National Maternity Strategy 2016-2026. This national strategy emphasised the importance of dedicated staff, such as the HSE National Breastfeeding Coordinator and statutory and voluntary supports, in promoting and supporting breastfeeding in Ireland. It referred to the National Breastfeeding Coordinator that works with a national committee to oversee the implementation of breastfeeding action plans and monitors progress in relation to breastfeeding targets; liaising with local breastfeeding committees, maternity hospitals, community health services and voluntary breastfeeding organisations.

Initiatives referred to in the national strategy included an annual National Breastfeeding Week, the HSE website , and an on-line Ask the Expert support service provided by International Board Certified Lactation Consultants. Other initiatives mentioned included breastfeeding support groups, the development of a breastfeeding competencies framework, and a breastfeeding policy for primary care teams and community healthcare settings.

Moreover, the National Maternity Strategy reiterated that along with practical supports that can be provided to mothers, such as supports to continue breastfeeding on return to the workplace, a broader societal change is required in order to promote a more positive culture around breastfeeding. This should support women to feel confident about their choice to breastfeed. The Maternity Strategy emphasised that this includes engaging extended family members and childminders who, perhaps due to not being aware of the importance of breastfeeding, may not be best informed to support a family’s choice to feed their baby expressed breast milk while in their care. It referred to breastfeeding promotion campaigns that should be tailored and targeted to help the wider community, including family members, childminders and employers, to play their role in improving Ireland’s breastfeeding initiation and duration rates.

I want to also assure the deputy that the recently published Dept. of Justice and Equality National Strategy for Women and Girls 2017 - 2020: creating a better society for all, contains two actions on increasing the proportion of mothers who breastfeed.

There are some resources available to healthcare professionals in relation the use of medicinal products by breastfeeding mothers. In the first instance the Summary of Product Characteristics (SmPC) should be consulted whenever a practitioner is considering prescribing a medicine to a breast-feeding mother or where the healthcare professional requires information on the suitability of a medicine for breast feeding.

Under EU legislation, product information associated with a medicine consists of the SmPC and the package leaflet. The SmPC is a legal document approved as part of the marketing authorisation of each medicine and forms the basis of information for healthcare professionals on how to use the medicine. This information is presented according to a predefined structure and includes the situations where the medicine must not be used, defining patient populations who must not take the medicines, and special warnings and precautions on the use of the medicine. This includes qualitative and quantitative information on the benefits and the risks posed by the medicine. Section 4.6 of the SmPC provides available information regarding the use of the drug during pregnancy and recommendations on the use or not of the medicine during pregnancy. Recommendation on the need to stop or continue breastfeeding while on the medicine is also provided.

The information contained within the SmPC is updated throughout the lifecycle of the medicine as new data emerge.

The decision on whether to use a medicine during breastfeeding should be reached following a discussion between a prescriber and their patient about the potential risks and benefits of that medicine. In accordance with the Medical Council’s Guide to Professional Conduct and Ethics, medical practitioners must ensure as far as possible that any treatment, medication or therapy prescribed for a patient is safe, evidence-based and in the patient’s best interests.

Patients with queries about the suitability of using a medicine during breast feeding are encouraged to speak to their pharmacist or general practitioner.

Finally, as the questions from the deputy relate mainly to service issues, I have arranged for them to be referred to the Health Service Executive for direct reply on some of the specifics referred to by the Deputy.