Meeting of the Parliament

Meeting date: Tuesday, March 17, 2020

Official Report 939KB pdf

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Breastfeeding etc (Scotland) Act 2005

The final item of business is a members’ business debate on motion S5M-21178, in the name of Elaine Smith, on the 15th anniversary of the Breastfeeding etc (Scotland) Act 2005. The debate will be concluded without any question being put.

Motion debated,

That the Parliament acknowledges that 2020 marks the 15th anniversary of the Breastfeeding etc. (Scotland) Act 2005, which received royal assent on 18 January 2005; understands that the act made it an offence to prevent or stop a person in charge of a child who is otherwise permitted to be in a public place or licensed premises from feeding milk to that child in that place or on those premises, and to make provision in relation to the promotion of breastfeeding; notes the subsequent work that has been carried out to support women in breastfeeding their babies both at initiation and in sustaining maternal feeding; welcomes the progress made in increasing breastfeeding rates, as reported in February 2018 in the first Scottish Maternal and Infant Nutrition Survey, which found that 43% of mothers were continuing to breastfeed up to six months after birth, compared with 32% in 2010; is, however, concerned that 27% of women responding had sometimes decided not to breastfeed their baby in a certain place because they thought that they would be made to feel uncomfortable; believes that there is more work to be done to change societal attitudes to understand that a child has a right to be breastfed, wherever and whenever they are hungry or thirsty, to ensure that women can feel completely comfortable with this normal, nurturing, maternal behaviour in public spaces; celebrates and supports breastfeeding as being good for mums, babies and society, and encourages any woman who feels they have experienced an infringement of their lawful protection to seek legal redress in line with the provisions of the act.

17:48  

I have a registered interest, having received funding from Unison and Boots the Chemist and assistance from the Govan Law Centre.

I thank Emma Harper MSP for asking about the possibility of a debate on the 15th anniversary year of the Breastfeeding etc (Scotland) Act receiving royal assent. We should also thank her for her decision to volunteer to help the national health service during the unprecedented pressures of coronavirus.

The 2005 act was the first member’s bill to pass in our new Parliament building. During the chamber stages of the bill, a number of breastfeeding mums and babies were in the public gallery. Sadly, there are none today, due to the circumstances, but anyone who is interested can watch via our live stream.

I could never have imagined that, 15 years on from the 2005 act, the world would be suffering from such a horrendous viral pandemic, which not only is a very real threat to life but has fundamentally changed normal life as we know it.

At present, the advice to breastfeeding mums is that they should thoroughly wash their hands before breastfeeding. If they are unwell, they should wear a mask while feeding or express their milk so that someone else can feed their baby. There is no evidence that the virus is passed through breast milk, and World Health Organization guidance, which is frequently updated, reminds us that breastfeeding protects babies: mums can supply their own designer food to their babies.

We should also be aware of the distressing reports of mothers desperately searching supermarkets for formula milk due to recent panic buying, and we should ask people to be considerate of the needs of others at this difficult time.

Rather than rehearse all the reasons why breastfeeding is good for mums, children and society, I will outline the history of the bill and my hopes for the future. I am sure that other members will want to cover health, local support groups and other issues.

The initial idea and motivation for a member’s bill to support and protect breastfeeding in public came from my own personal experience. Breastfeeding my son, Van, showed me that society did not always support breastfeeding in public, with women being asked to feed in toilets, being stopped altogether or simply fearing to breastfeed due to such attitudes. In fact, some desk-based research for the bill, funded by Unison, found that, among other things, the fear of being stopped was a big influence on women’s choice to breastfeed. I take this opportunity to thank Kay Sillars, who did that piece of research.

In 2001, I was asked to speak at a breastfeeding conference in Lanarkshire. While researching for the conference, I discovered that Coatbridge had some of the lowest breastfeeding rates in Scotland. Since the country itself had among the lowest rates in Europe, that was extremely concerning. I brought the issue forward as a members’ debate, which was the first time that the Scottish Parliament had debated breastfeeding. Of the 10 members and one minister who contributed to that debate, only two are still serving MSPs—myself and the Deputy Presiding Officer, Christine Grahame.

During my speech, I mentioned an incident involving a mum and baby who were put off of a Lothian bus for breastfeeding on the bus. In responding to the debate, the minister, Malcolm Chisholm, said:

“There have been many instances of hostile reaction to mothers who breastfeed in a public setting. Elaine Smith referred to the incident in Edinburgh in which, we were all horrified to learn, a mother was told to get off a bus because she was breastfeeding. Ministers wrote to Lothian Regional Transport, as it then was, but under current laws we do not have powers to enforce anything on a bus company in that regard”.—[Official Report, 17 May 2001; c 901.]

There it was: my challenge was to change the law to give powers so that that appalling situation could not happen again.

The Scottish Parliament unit that supports individual members in bringing forward legislative proposals initially ruled out my idea out, giving an opinion that it was that it was reserved as a matter for the United Kingdom Parliament. Having a can-do attitude, I found a solicitor who was willing to help me write a bill for Scotland. Mike Dailly, of the Govan Law Centre, deserves much of the credit for the protection that is now available to mums and babies; he also deserves my thanks.

We set up an advisory group that included trade unions, the health sector, the voluntary sector, the police and business, and the national breastfeeding adviser to Scottish Government at the time, Jenny Warren, was a fantastic support. I also thank my office manager, Lesley Dobbin, who has worked with me for most of my time in office and has supported me and helped with her own breastfeeding knowledge and research over the years.

Unfortunately, the Presiding Officer at the time, David Steel, would not grant the bill competence, so it fell at the 2003 election. I resurrected it the following session, and Mike Dailly and I rewrote it to focus on children’s health. Presiding Officer George Reid approved it as competent for consideration by this Parliament—a lesson in how our devolved powers can be used creatively to deliver the legislation that we need.

Then the hard work started: getting political support, giving evidence to committee and steering the bill through its chamber process. I was also lucky to gain the assistance of Susan Deacon, who had been the health minister when I initially proposed the bill. She was a great help, not only with the process, but with her knowledge, encouragement and personal support. The majority of parties were eventually persuaded to support the legislation—with the exception of the Tories. However, I thank them now for supporting my motion tonight and for being in the chamber.

UNICEF calls breastfeeding a public health imperative, for which Government, policy makers, communities and families all share responsibility. Unfortunately, although rates have been increasing, breastfeeding is still not the norm and society still falls down on celebrating and supporting breastfeeding.

There is also concern that austerity and cuts to local government and health funding impact on breastfeeding support. Therefore, it is vital that politicians such as us lead the way in continuing to demonstrate the value of breastfeeding and support its promotion—to improve not only health, but the impact on the family purse and the economy in general.

It really is shocking that natural maternal feeding of hungry and thirsty babies that benefits mums, babies and society as a whole is still sometimes seen as unacceptable. One major issue that influences that is that breasts are sexualised in our society. In addition, attitudes to breastfeeding are tightly tied to misogyny. Professor Amy Brown notes that the higher a man scores on sexist traits, the more he is opposed to women breastfeeding in public.

The Breastfeeding etc (Scotland) Act 2005 has played a part in changing attitudes, but women must also feel confident using the legislation. Although there are still reports of problems in public, the only case that I am aware of involved a big retail store in Glasgow, which, disgracefully, threw a mum, who was also a paediatric doctor, and her tiny hungry baby out of its shop and onto Sauchiehall Street. The case was investigated and reported by the police, but the shop was merely given a slap-on-the-wrist letter from the procurator fiscal. Breaches of the 2005 act need to be taken seriously, because they can have a detrimental impact on the health and wellbeing of mums and babies.

Education from a young age is vital in normalising breastfeeding. I was pleased to learn recently that North Lanarkshire Council’s lesson plans on infant nutrition include children learning about breast milk and caring for a baby. Des Murray, the council’s chief executive, said of the project:

“We strongly believe that lessons on infant nutrition at such an early age will help increase the number of mothers breastfeeding their babies in future years.”

I whole-heartedly agree with that, and I encourage other councils to follow NLC’s lead.

The principle of normalising the feeding of babies in public and of providing legal protection for a baby to be fed where and when it needs that, whether by breast or by bottle, underpins the 2005 act. When I closed the stage 3 debate on 18 November 2004, I said:

“If passed, the bill is not an end, but the beginning of the Parliament pursuing practical ways to support and encourage breastfeeding. Although I am having the final word in this debate, I assure Parliament, the minister and all those with an interest in breastfeeding that I will have much more to say on the subject during the rest of this parliamentary term and I am sure that many of my colleagues will too.”—[Official Report, 18 November 2004; c 12118.]

Well, I have had much more to say over the years. I will continue to celebrate, support and promote breastfeeding when I can, and I ask other members to join me in doing that, too.

17:56  

I welcome the opportunity to speak in this important debate, and I congratulate Elaine Smith on securing it and, indeed, on all her hard work on the issue over many years. She will know that I have spoken in her debates and signed her motions on this important matter on a number of occasions. I also congratulate her on the 15th anniversary of the passing of the bill that she pioneered.

I wish to make it clear that, today, I am not speaking for myself but for my colleague Emma Harper, who has been urgently called away.

There is no doubt that the 2005 act has given mothers greater security and protection to breastfeed in public, as well as raising awareness of breastfeeding and its benefits to both mother and child. Although not all mothers breastfeed, for many different reasons, it is important that mums who wish to breastfeed are supported in their choice. Breastfeeding provides immune system support for the baby, and skin-to-skin contact is an important part of breast and bottle feeding.

When Emma Harper was first elected, she met Veronica King, a health and wellbeing specialist and maternal and infant nutrition lead with NHS Dumfries and Galloway, who was originally tasked with leading the breastfeeding welcome scheme. In 2018, Emma was at the formal launch of the scheme by NHS Dumfries and Galloway, which was well attended by mothers and interested parties from across the region. She agreed to work with Veronica to raise awareness of the work that was being carried out, with the aim of encouraging more businesses to sign up to the scheme. Emma wrote to all appropriate businesses and public spaces across Dumfries and Galloway—about 230—to make them aware of the work that Veronica was carrying out and to urge them to take part and achieve “breastfeeding welcome” status. Although there has been some interest and a generally positive response, when Emma met Veronica again just last week, it was pointed out that there could be significant improvement in the number of businesses taking up the scheme.

We know that breastfeeding offers considerable health benefits for both mother and baby, and it is important that the community supports a mother in her decision to give her baby the best start in life. University of Glasgow research indicates that many new mothers across Scotland give up breastfeeding because they feel isolated and embarrassed and that they might offend other people by feeding in public. Of course, that feeling stimulated Elaine Smith’s bill all those years ago. We need to continue working to change that narrative and to support business and the public to promote breastfeeding and take part in the various national health service board schemes, which are free to participate in.

In Dumfries and Galloway, businesses can display a “Dumfries and Galloway is Breastfeeding Friendly” window sticker and scheme certificate once they have applied, as long as they can demonstrate that they offer an environment that allows mothers to feed without interruption or obstruction. By taking part in the scheme, mothers can distinguish whether a business is an inviting one, which can increase repeat business and attract more mothers by word of mouth through the mother and baby groups that women attend. Emma is happy to continue to support such work, and she appeals to local businesses to play their part in achieving a breastfeeding-friendly Scotland.

I will briefly mention the world-leading work that is being undertaken by the Scottish Government to promote breastfeeding-friendly practices.

In June 2019, the Government published the “Becoming Breastfeeding Friendly Scotland: report”. It identified eight key recommendations that should be progressed to scale up the protection, promotion and support of breastfeeding. Many stakeholders and local groups have welcomed the recommendations, which were developed through evidence-based research and engagement with mothers and businesses, and are being implemented by the Scottish Government in partnership with others.

However, one issue that has been brought to Emma Harper’s attention is the need for greater promotion of breastfeeding in our rural areas, such as in her home area of Dumfries and Galloway. I therefore ask the minister to give assurances that rural Scotland is absolutely kept in mind when progressing the recommendations. I will revert and speak for myself for a moment: as someone who has island communities and rural areas in my constituency, I am also keen for them to be prioritised. Indeed, the minister represents a large rural area.

I, again, congratulate Elaine Smith on securing the debate, and I encourage businesses in Dumfries and Galloway—and across Scotland—to take part in breastfeeding welcome schemes to support mothers who choose to breastfeed.

18:00  

I am delighted to have the opportunity to take part in Elaine Smith’s debate today and congratulate her on securing it. As we have already heard, 2020 is the 15th anniversary of the Breastfeeding etc (Scotland) Act 2005, which received royal assent on 18 January that year.

I commend and congratulate all mothers who decide to breastfeed their babies because, as the campaign slogan of old said, “Breast is best”. Breastfeeding should be a very natural thing for a mother to do, whether at home, in a public place or at work, and she should feel confident in her ability to do that. I congratulate Elaine Smith on her work to ensure that that is the case.

Most of the time we do not even notice women breastfeeding. That is how it should be; we should not think of it as being strange. As many of us know, some people feel uncomfortable about breastfeeding, but that is not how it should be looked upon.

As we know, sometimes, individuals stare. However, the Breastfeeding Network has said that that is not always because they disapprove. It said:

“We heard from one mum who was feeding her baby, and an elderly couple”

were in the vicinity.

“When they got up and began making their way over to her”

the mother was little bit concerned about what might be said. The elderly woman simply said how lovely it was to see a mother breastfeeding her baby, because she

“had previously breastfed her own children and it ... brought back fond memories.”

That is how people should be thinking about breastfeeding—fond memories; good feelings; and confidence. Unfortunately, some individuals have decided to make a fuss. We know that some passers-by have axes to grind, or that some people have specific views on breastfeeding, which they are vocal about and make public. However, we should ensure that everyone embraces breastfeeding. We should support and encourage individuals to breastfeed.

Does the member agree with me that educating people at a young age about breastfeeding may help to change such societal attitudes? Where people are not used to seeing breastfeeding as the norm, they can take on those attitudes because of ignorance.

Yes, I completely concur. Breastfeeding should be seen as the norm; people should not have to hide from it or be ashamed about it. It should be natural to do it, and it is up to all of us to ensure that we educate individuals to that end.

We have already heard about the nutritional, psychological and bonding benefits that breastfeeding promotes, and the scientific evidence is there on the benefits of wellbeing and nurturing. We also know that work is carried out at antenatal and postnatal levels. That encourages first-time mothers, who sometimes feel a bit anxious and nervous about breastfeeding. It is important that they get training and encouragement, and that approach has led to a remarkable increase in breastfeeding rates across Scotland. That should be welcomed, and we should applaud those who continue to work on the attitudes that continue to exist across society today.

It is a travesty that a quarter of breastfeeding women who provided feedback in a survey indicated that they sometimes felt concern about what might happen if they breastfed in public and that they sometimes felt uncomfortable. As Elaine Smith said, that is why we need to look at training.

I congratulate Elaine Smith on all that she has done in her endeavours on the topic. Through her deeds and actions, she has achieved so much for people around the country. That must be recognised, because breastfeeding is one of the most natural things that people do, which should be celebrated in our society.

18:05  

I join colleagues in thanking and paying tribute to Elaine Smith for the work that she has done over many years, and for giving us the chance to gather in the chamber tonight to debate something that is positive and a true cause for celebration.

I have been taking notes, because it will not have escaped members’ attention that I am working on a members’ bill—the Period Products (Free Provision) (Scotland) Bill—which has recently passed stage 1. When I embarked on that piece of work, I had no idea how challenging and time consuming it would be, and when Elaine paid tribute to her staff and the other people who helped her, it made me think about my situation. It also reminded me that it is really important that we have a Parliament that is as gender balanced as possible. If we did not have women driving such issues, we might not have the Breastfeeding etc (Scotland) Act 2005, which is important in itself and because of the culture change that it has created.

There is no doubt that Elaine Smith’s act has played a huge role in increasing the number of women who breastfeed in Scotland, as well as in raising awareness beyond Scotland’s boundaries. However, members have already touched on the fact that we continue to have, in the UK and in Scotland, the lowest rates of breastfeeding in the world. I have been acutely aware of that in Central Scotland and, in particular, in Lanarkshire, where breastfeeding rates are still low in areas of higher deprivation.

However, I am encouraged by the progress that has been made and the work that is being pursued. Elaine Smith highlighted the efforts of North Lanarkshire Council, whose work to introduce infant nutrition to the curriculum in schools is key, as are its efforts to normalise breastfeeding, and to tackle and get rid of the taboo about breastfeeding in public.

Elaine Smith mentioned the underlying sexism and misogyny that still present barriers. When people have not seen others in their family or group of friends breastfeeding, that lack of visibility has an impact on their fears. I have been reflecting on my experience as a former breastfeeding mum. Elaine’s bill received royal assent in 2005—hence its 15th anniversary. My daughter was born in 2006, and not many among my immediate group of friends had had babies. My experience was positive, in the main, but it is important to say that breastfeeding is not without challenges. Women need good support from their midwife, general practitioner, friends, family and employer, if they have one.

I remember that, leading up to my return to work, there was lots of discussion about where I might want to go if I needed to express milk. I was pointed towards cupboards and other such places, which made the situation stressful. Even though the legislation was in place at that point, there was probably not enough by way of policy in the workplace to ensure that every line manager knew their responsibility and how to make things less stressful. A lot of progress has been made since then.

Elaine Smith touched on the fact that, around the world and as a Parliament, we now have to deal with the Covid-19 pandemic. Breastfeeding support groups, whether in Lanarkshire or elsewhere, provide vital support; but pregnant women and new mums who have to self-isolate might not be able to access those support networks. I am interested to hear what the minister says about what the Government is doing on online support and how we might ramp that up. If community groups cannot meet, perhaps we could divert resources from them to the national breastfeeding helpline, which is vital.

Tonight is an opportunity to reflect, celebrate and recognise the importance of legislation not just in changing the law for the sake of changing the law, but in changing our attitudes and how we behave as a society. It is an opportunity to celebrate and to thank mums, babies and the health professionals on the front line who help them every day. Long may that work continue.

18:10  

I thank Elaine Smith for lodging the motion to mark the 15th anniversary of the Breastfeeding etc (Scotland) Act 2005. I am very grateful to members for their contributions on this important matter.

I reiterate some of the advice that Elaine Smith gave at the beginning of the debate for mums who might be experiencing concern about the Covid-19 pandemic. Breast milk provides protection against many illnesses and, although there have been only limited studies, there is no evidence at all that mothers who have the virus can transfer it to their baby through breast milk. All new mums should be strongly advised to breastfeed or to express breast milk to protect their infants, regardless of the Covid-19 pandemic.

At this time, it is prudent to advise new mums, particularly those who have premature or sick infants, to limit contact with the wider public. Everyone who comes into contact with a new family should be very careful about the hand-washing guidance and about coughing and sneezing. I am very aware that babies are born into a family and a community, but at this moment in time, we need to take specific precautions.

Elaine Smith mentioned the challenges that some mums are having in accessing formula milk. If people are having difficulty accessing their usual brand of stage 1 formula, they can use any brand—they are all made to the same standard and people can switch between them. We are urgently trying to confirm through official channels that there will be a limit on how many tubs of formula can be sold at one time, in order to preserve supplies for those who are seeking them. That is my public service message.

Members might not know that the act is called the Breastfeeding etc (Scotland) Act 2005 because it focuses on the child’s right to be fed, including bottle feeding when mums and babies are out and about.

I thank Elaine Smith for her intervention, which is very welcome.

Children get only one go at childhood, and it is incumbent on us all, whether we are parents, members of the public or politicians, to do what we can to get it right for every child, and to ensure that children have a chance to flourish and improve their health and wellbeing. As we are all well aware, breastfeeding plays a big part in improving health over an entire life, and the Government continues to promote, protect and support breastfeeding.

Research is very clear that the greatest benefits for the mother and baby are gained through exclusively breastfeeding for the first six months of life. Breast milk provides a complete source of nutrition and contains a range of immunological substances that cannot be manufactured and which support the development of the digestive and immune systems of a growing infant.

A key benefit of breastfeeding is that it can happen at any time and anywhere, but for it to be effective, both mum and child need to feel relaxed. Any embarrassing interruptions can result in an upset mum and a crying, hungry baby. As the motion highlights, a key finding from our survey was that mums’ concerns about breastfeeding in public, including embarrassment and negative public attitudes, have been identified as being among the main barriers to breastfeeding. Although the act protects the right to feed a child without fear of interruption or criticism, legislation alone is not enough to ensure the support that needs to be in place to allow women to feel comfortable to breastfeed their baby in public.

In June last year, the Minister for Public Health, Sport and Wellbeing launched the Scotland-wide breastfeeding friendly Scotland scheme. The advantages of a national scheme include that there is a recognisable logo and staff training materials, such that, no matter where a mother visits, her breastfeeding experience will be the same. By signing up to the scheme, businesses and organisations can help to show that they welcome and support breastfeeding mothers, and they can inform their staff about why breastfeeding is important and how it is protected.

It was great to hear about all the work that is going on in North Lanarkshire, and I was also pleased and proud to hear that my alma mater, the Robert Gordon University, is a breastfeeding-friendly campus. We are going to extend the scheme into early learning and childcare settings and schools—of course we are. Our aim to normalise breastfeeding in all communities will begin by increasing the knowledge of our very youngest people as they progress through their school career.

Breastfeeding rates across Scotland continue to rise. The latest statistics show that more than half of babies born in 2018-19 were, at the time of their first health visitor visit, breastfed. Focus on our support to mothers to enable them to breastfeed for longer is also starting to emerge in the national statistics, which show that 43 per cent of babies who were born in 2018-19 were being breastfed at their six-to-eight week review, and that 32 per cent of those were exclusively breastfed. That represents the highest percentage of babies being exclusively breastfed at six to eight weeks since recording began.

However, there is more to do. A clear demonstration of our commitment to supporting breastfeeding is the provision of an additional investment of £3.7 million over the past two years. Health boards and third sector partners are carrying out breastfeeding projects and quality improvement initiatives. Our aim from the improvement work is to reduce the incidence of key feeding problems, particularly those that are associated with early breastfeeding cessation, as was clearly highlighted in the survey.

Our on-going commitment to the UNICEF UK baby friendly initiative includes providing more training for all staff, and developing specialist training and skills. That supports the recommendation of “Becoming Breastfeeding Friendly Scotland: report” on national implementation of consistent appropriate practice skills for all those who care for mums and babies, and it builds on the baby friendly initiative’s core standards. I am delighted that we have celebrated Scotland’s being the only country in the UK—well, I am not delighted, I wish that the other countries did it too, but it is great that Scotland is leading the way—to achieve BFI accreditation in 100 per cent of our maternity units and health and social care partnerships.

The Breastfeeding Network, the National Childbirth Trust—for which I was an antenatal teacher—and La Leche League GB have also received funding for expansion of peer-support provision across Scotland. That makes clear our commitment to including third sector partners in the work that we do. Our review of peer support is under way, and the valuable work of peer supporters will be celebrated at an event later this year.

Supporting the provision of breast milk for our very tiniest babies is crucial, and we are supporting mothers and staff in that, too. Neonatal staff will be able to attend an event later in the year at which they will hear from experts about how neonatal experience impacts on a baby and their family in the long term. Of course, we have also developed the donor milk bank.

Presiding Officer, for many years, Scotland has aspired to be a country where breastfeeding is valued and supported by our society, and where mothers can have the best breastfeeding experiences possible and can continue to breastfeed for as long as they are able to and want to. I hope that you will agree that all the initiatives, policies and investment that I have outlined today will help us to realise that aspiration.

Meeting closed at 18:18.