Meeting of the Parliament 23 January 2024
I would like to make progress.
Using human milk as a bridge to breastfeeding means that Scotland is following international best practice. Protecting, promoting and supporting breastfeeding is a fundamental principle of the World Health Organization’s “International Code of Marketing of Breast-milk Substitutes”. The code provides robust and clear direction to all countries on how to achieve that.
I am clear that regulation has, and continues to have, a clear role in protecting all parents from the impacts of inappropriate marketing and the promotion of infant formula. The code also prevents the free distribution of infant formula. It has been shown in many countries, including the UK, that such tactics seriously influence infant feeding choice. We have seen over many years—indeed, decades—how the marketing of infant formula has influenced parents’ choice. The most recent Lancet series on breastfeeding sets out clearly where those influences can cause harm. Those marketing practices undermine parents’ confidence in understanding their babies’ feeding behaviours as part of normal development. They also undermine breastfeeding.
Regulation on marketing—as opposed to alternatives, such as voluntary codes—remains the best way to achieve the desired approach consistently and equitably, and in the best interests of babies. Giving a child the best start in life can be seriously affected by today’s cost of living. We know that many families are struggling with the cost of infant formula, and I welcome the recent interventions to review the marketing of that product and the lowering of price. The cost of infant formula, which is the only other nutrition apart from breast milk that babies can be fed, has in some cases increased by 25 per cent over the past two years.
The Competition and Markets Authority and Glasgow MP Alison Thewliss, among others, have made the case for change. The CMA’s report stated that families could save up to £500 by buying cheaper formula options. I note that the costs of some infant formulas have recently come down, which is welcome, but they were already too high, leading to some families being unable to make formula feeds safely.
All babies should be fed safely and responsibly, and feeding choices should be fully informed, supported and free from harmful commercial influences. That brings me back to my overall ambition to improve the health of babies and young children as a fundamental underpinning of overall population health and a human right. Scotland will be the first UK nation to incorporate the United Nations Convention on the Rights of the Child into domestic law, thereby ensuring that we are a country that respects, protects and fulfils children’s rights. Protecting those rights means thinking differently and acting differently. That should include how we support the choices that women make on how long they want to breastfeed for.
One of the barriers relates to how new mothers are supported to return to the workplace. NHS Scotland has worked with breastfeeding experts to develop its new “Once for Scotland” guideline on breastfeeding and return to work, which was launched in November 2023 and has been welcomed by the sector. Although those rights are already enshrined in law, they are not always acted on in ways that make a difference. That can have an impact on decisions about how long babies are breastfed for, and even whether they are breastfed at all.
We know that, due to the on-going pressures on all families because of the cost of living crisis and the pressure to put the needs of their employers before the needs of their families, some mothers are returning to work earlier than they might otherwise have done, and that is influencing their infant feeding choices. The new NHS Scotland guideline is an exemplar of how employers can act positively to consider the needs of women as mothers first, and to support their breastfeeding goals. I would like all employers to look at the guidelines and focus on the action that they could take to make a difference.
I return to my points about culture and societal norms. Normalising breastfeeding is much harder than it should be. The debate is not about breastfeeding versus formula feeding; it is about gaining a deeper understanding of how infant feeding choices are made and, most importantly, how they should be supported.
However, making a difference takes more than supporting individual choice. It takes action by communities, senior leaders, businesses and organisations to gain the knowledge and understanding to change societal norms and culture around breastfeeding. It is about breastfeeding being visible in areas that pregnant women and new mothers visit regularly. I am pleased that, on my home island of Islay, the bookshop is breastfeeding friendly.