Written answers

Tuesday, 9 April 2024

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1340. To ask the Minister for Health if he will give due consideration to the establishment of an infant feeding communication forum across departments that is, with responsibility for children, health, and marketing of commercial formula milks and the Health Service Executive to align government policy, funding and Health Service Executive practices for the purposes of increasing breastfeeding initiation rates and the duration of breastfeeding; and if he will make a statement on the matter. [14232/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1341. To ask the Minister for Health if he will take the necessary steps to standardise breastfeeding education for healthcare professionals in maternity units and support in-service, role-specific breastfeeding education and training to enable implementation of the Baby Friendly Initiative in all 19 maternity units; and if he will make a statement on the matter. [14233/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1342. To ask the Minister for Health if he will take the necessary steps to fully implement the World Health Organization Code of Marketing of Breast-milk Substitutes and its subsequent World Health Assembly Resolutions in legislation and ensure that this legislation is monitored and enforced in a transparent manner independent of industry, with particular attention paid to advertising and marketing online via baby clubs and social media influencers; and if he will make a statement on the matter. [14234/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1343. To ask the Minister for Health to provide independent, evidence-based breastfeeding-related education and training to all healthcare professionals likely to encounter breastfeeding mothers or infants/young children in their clinical practice (details supplied); and if he will make a statement on the matter. [14236/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1344. To ask the Minister for Health if he will take the necessary steps to provide for greater availability of breastfeeding preparation classes and breastfeeding support groups, and modes of delivery of same (details supplied); and if he will make a statement on the matter. [14237/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1345. To ask the Minister for Health if he will develop effective strategies for increasing awareness of infant and young child feeding materials within other sectors outside of the health service, for example, workplace settings, county councils, and allocate resources as required by the Health Service Executive to implement breastfeeding campaigns; and if he will make a statement on the matter. [14238/24]

Photo of Colm BurkeColm Burke (Cork North Central, Fine Gael)
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1347. To ask the Minister for Health if he will develop an infant and young child feeding in emergencies preparedness plan specific to the Irish context in line with international guidance, incorporating and building on the operational guidance prepared by the Infant Feeding in Emergencies Core Group of the Emergency Nutrition Network; and if he will make a statement on the matter. [14240/24]

Photo of Hildegarde NaughtonHildegarde Naughton (Galway West, Fine Gael)
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I propose to take Questions Nos. 1340 to 1345, inclusive, and 1347 together.

Encouraging mothers to breastfeed is a priority, both for the Department of Health and for the HSE National health policy, including the Healthy Ireland Framework, 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 breastfeed, as well as taking action to increase breastfeeding rates in Ireland.

The HSE Breastfeeding in a Healthy Ireland Action Plan 2016-2021 is the framework for progressing supports for breastfeeding in Ireland. A HSE Breastfeeding Action Plan Implementation Group was established to oversee delivery of the plan and a national breastfeeding Co-Ordinator was appointed as lead. The Department of Health works closely with the HSE National Breast-Feeding Co-ordinator in the implementation of HSE Breastfeeding Action Plan 2016-2021, which has been extended out to 2025. A considerable number of areas have been progressed over the last number of years and there are a number of initiatives currently underway.

The Department is working with the Department of Health in Northern Ireland towards the establishment of an all-Island Breastfeeding Network in the near future. In collaboration with the Institute of Public Health (IPH), it is anticipated that this Forum will provide opportunities for research, promotion of breastfeeding and stakeholder engagement to be developed across the island.

Education and training for Health care professionals HCPs is provided through undergraduate, postgraduate, and voluntary avenues. Currently the HSE administers a breastfeeding course on HSELanD that is approved by the Nursing and Midwifery Board of Ireland (NMBI) which is available to all midwives, PHN’s and other HCPs. This updated National Infant Feeding Education Programme (NIFEP) focuses on standardising the delivery of breastfeeding education and skills training, maximising blended learning, and ensuring health care staff are up to date with emerging evidence. To date five thousand staff have enrolled on the course.

Training is provided in health specific undergraduate courses such as medicine, nutrition and dietetics, Speech and Language Therapy (SALT). Other postgraduate certificate courses are available specifically for Infant Feeding, such as the Breastfeeding & Lactation postgraduate certificate course in UCD. The International Board-Certified Lactation Consultant training (IBCLC) is another qualification that can be undertaken voluntarily through the IBCLC commission.

Further exploration in the development of a level 9 postgraduate education qualification for infant feeding will remain on the HSE agenda to strengthen professional development for healthcare professionals in promoting breastfeeding.

An important action of the HSE Breastfeeding action Plan is to strengthen compliance with the WHO 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. Marketing of breast milk substitutes and new standards for infant feeding in maternity services requires that there be 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.

Furthermore, in 2022, revised Infant Feeding Standards for maternity and neonatal services were published in Ireland. This followed a review of the Baby Friendly Initiative (BFI) in Ireland, and the publication of revised WHO guidance for the implementation of BFI in 2018. The Standards describe the infant feeding practices and management process required within services to implement the HSE Infant Feeding Policy for Maternity and Neonatal services.

Set out below is the current position of the HSE in the context of its responsibilities under the Code;

  • Self-assessment against national standards for infant feeding in maternity services completed in 2023, including areas relating to the Code.
  • Five of the nineteen maternity services have implemented non-branded teats into postnatal units to reduce marketing of brands.
  • Review of procedures for infant formula completed in 2023, to ensure compliance with the national clinical policy for primary care.
The Department recognises that further measures to improve and monitor compliance with the WHO code are needed across government departments and in partnership with cross-sectorial agencies.

In particular, the Department is working with the Coimisiún na Meán which was established in March 2023 further to the provisions of the Online Safety and Media Regulation Act 2022. The OSMR Act 2022 amended the Broadcasting Act 2009 to establish Coimisiún na Meán 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.

The standards and practices that can be addressed through regulatory codes and rules include the advertisement of certain foods and beverages. In this regard, the Act states that codes and rules can be introduced which “may prohibit or restrict the inclusion in programmes or user-generated content of commercial communications considered by An Coimisiún to be the subject of public concern in respect of the general public health interests of children, in particular infant formula, follow-on formula or those foods or beverages which contain fat, trans-fatty acids, salts or sugars”.

Officials from the Department of Health have contributed to the recent public consultation on the draft safety code and met with officials from An Coimisiún to discuss their work programme.

The HSE provides evidenced based impartial information and support for feeding options in infants and young children on mychild.ie website and social media channels. HSE established the mychild.ie website, campaign and resources, including a child health communications lead in 2017. A suite of national resources is available for parents to be and new parents, including print and online information. Breastfeeding information is integrated into all mychild publications and there are a number of specific breastfeeding publications available. There are also sixty-three multipage breastfeeding guides on the mychild website. The website and breastfeeding supports available (online and in-person) are promoted through paid and organic social media advertising throughout the year alongside TV, radio and media campaigns at certain times of the year e.g. National Breastfeeding Week. The website is part of a suite of information supports provided both directly by practitioners and online. This suite of resources includes MyPregnancy, MyChild 0-2, Mychild 2-5 and Breastfeeding: A good start in life books available to all expectant parents.

In the last 4 years, the HSE has invested in a promotional campaign for parents aged 25 to 45 on mychild.ie and as one of the most popular topics, breastfeeding features strongly in this ongoing campaign. The website experienced huge growth during the pandemic with website visits rising from 1.4 million in 2019 to 5.6 million in 2021. It has had five million visits in 2022.

Parents can contact the HSE’s online breastfeeding support service through the ‘Ask our breastfeeding expert’ service on mychild.ie. The service was established in 2014 and is provided by a team of lactation consultants. It is available seven days a week with the live chat service available Monday to Friday from 10am to 3pm.

Breastfeeding support groups stopped meeting in person during the Covid 19 pandemic but are back operating; 70% are run by HSE and 30% by voluntary organisations. There are over 220 breastfeeding supports nationwide provided by HSE and voluntary breastfeeding agencies, with breastfeeding groups being available in every county and the number is increasing. The vast majority of support groups meet in person, but online options are also provided and are popular with parents, where in-person groups are not feasible/easily accessible.

All nineteen maternity hospitals provide antenatal education and breastfeeding preparation classes. A new National Antenatal Education Programme for Women and their Chosen Birth Partners in line with National Standards for Antenatal education in Ireland is being implemented across all maternity hospitals in 2024.

There is a blended approach with in-person and online delivery of antenatal education in line to meet the demand for antenatal education services and service user requests. In situations where a woman is likely to need additional support to breastfeed, the pregnant woman will also have the opportunity to have a consultation with an infant feeding/lactation midwife or nurse during her pregnancy. Over the last three years, the number of lactation consultants across community and acute services has doubled to improve access to breastfeeding supports to all new parents.

The Department does not have a policy for emergency preparedness for infant feeding protection, which was highlighted in the first World Breastfeeding Trends Initiative (WBTi) Assessment Report for Ireland, published in late 2023. Under the “Shared Island North South research programme” work is being conducted on developing an infant and young child feeding in emergencies preparedness plan for the island of Ireland. This research is being led out by staff at Queen’s University Belfast and Technological University Dublin (TUD)

A key focus of Healthy Ireland is on building relationships and strengthening partnerships between government departments, local authorities, Local Community Development Committees (LCDCs), education providers and the wider business, voluntary, community and statutory sectors. Limerick’s “We’re Breastfeeding Friendly” is an exciting example of such partnership working. We’re Breastfeeding Friendly aims to help improve the health and well-being of breastfeeding mothers, babies and their families through the development and promotion of breastfeeding friendly businesses, organisations and communities. Any business, community group or organisation that has premises open to the general public is eligible to join, for example customer services, hotels, community centres, sports and recreation facilities, restaurants, libraries, or health centres.

Research indicates that breastfeeding gives a child the optimum start in life and that increasing our breastfeeding rates will contribute to improvements in child and maternal health and can contribute to the reduction of childhood obesity and chronic diseases. Currently the HSE are evaluating the implementation of the Breastfeeding Action plan and consideration will be given to how best to support mothers to breastfeed and increase breastfeeding rates in Ireland in the coming years.

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