Healthcare Support Services: Conception to Age Two

Alison Thewliss Excerpts

Tuesday 15th December 2020 Westminster Hall

[Alison Thewliss (Glasgow Central) (SNP)]

It is a pleasure to see you in the Chair, Sir Christopher. I thank the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing this debate and for the work that she has done on this agenda. I chair the all-party parliamentary group on infant feeding and inequalities. We have worked on many of the things that she has been working on, but in a very focused way around the importance and significance of infant feeding for babies between conception and age two.

Breastfeeding is a really important part of babies’ health as they grow up, but that has not been matched by breastfeeding support services and investment in them across the UK. Breastfeeding support services have been very much a Cinderella service. They are run by dedicated volunteers who are often unpaid and the first to go when budget cuts are made. They are often treated as a “nice to have” rather than as the essential support service that they are for many families. We know and all the evidence suggests that women want to breastfeed, but they are being failed and let down time and again because the services that they need when things get tough are simply not there.

On the Breastfeeding Cuts UK Facebook page, Ayala Ochert has documented cuts in recent years in Sunderland, Stoke-on-Trent, Peterborough, Wigan, Dudley, Luton, Kent and Reading among many others. Services have been cut without any thought being given to the impact on the women and babies. There is a real postcode lottery in these services. Some local authorities value breastfeeding and invest in services, but some do not even consider it. Since lockdown, breastfeeding support services have been forced to close due to social distancing requirements. We understand why that is, but it has been a huge blow to the many who use those services and who might struggle to go online. In many cases, it is difficult to get that support online because of the need to have somebody there by their side to show them exactly what needs to be done. Not having that makes it incredibly difficult.

Emma Pickett, a fantastic breastfeeding counsellor, has mentioned the ongoing issue of the shortage of venues as they have closed because of lockdown. She has asked whether other health providers plead with café owners and vicars to set up clinics. I do not think so, Sir Christopher. It is important that the venues are there for people when they need them.

On the issue of the postcode lottery, I should like to mention the issue of tongue-tie treatment. Getting tongue-tie assessed and treated in new-born babies is incredibly important for people trying to make sure that their babies latch on properly, but this again is a postcode lottery. Many places do not think it is important, and many parents are forced, if they can afford it, to pay for private treatment for tongue-tie division, which is not acceptable. It is an important service, it ensures that breastfeeding can continue, and the Government need to see it as such.

I want to thank all of the volunteers at the National Breastfeeding Helpline who have had to do an incredible job to support families through lockdown. Their volunteers saw 124% more calls between April and September than this time last year. That is an awful lot to ask of volunteers. They have had to ramp up their training and make sure that the calls are answered, because they know that the people at the other end of the phone are absolutely dependent on their expertise and advice. It is important for the Government to look at more funding for services at the National Breastfeeding Helpline because they need to be seen as an essential service and funded properly.

Women and babies have been left out of the conversations around lockdown. Very little consideration has been given to the impact on women who were on maternity leave or about to be on maternity leave, who lost out on provision and were often forced to either take their maternity leave early and lose out on that provision or were told that they were not eligible for furlough. Many have lost out. I pay credit to Bethany Power and all her colleagues, who have pushed so hard on behalf of those excluded groups who have experienced gaps in support and have not had the maternity experience they wanted. That has been compounded by the Government’s failure to provide the financial support they needed at such a vital time, which has in turn compounded their isolation.

The spending review provided no specific funding for public health services such as breastfeeding support, which, as I have said, is absolutely essential. Breastfeeding has been overlooked by the Government’s obesity strategy and online harms strategy, even though we know that online advertising can have a huge impact on how women choose to feed their babies.

A significant number of people have raised concerns about babies and mothers being separated in hospital, despite all the evidence showing that it is desperately important for mums and babies to stay together in those early months, and that breast milk is a protective factor due to the antibodies present in it. Mums and babies should be kept together unless it is impossible to do so; in many cases, it is possible to do so. Advice should be given by Public Health England as well as other health authorities to make sure that can happen. If we separate mums from babies unnecessarily, it upsets the rhythms of breast milk and leads to complications for mothers, such as mastitis, if they are not able to breastfeed when they need to.

Issues have also been raised by Dr Wendy Jones, who runs the Breastfeeding Network’s drugs in breastmilk helpline. She has concerns about the advice on vaccination for lactating mothers. I fully appreciate that there are ethics involved in the drug and vaccine trials and that generally we would not test on pregnant and breastfeeding mothers, but her concerns are about the advice in the PHE Green Book, which changed in just a matter of days. Initially, it said:

“There is no known risk associated with giving inactivated, recombinant viral or bacterial vaccines or toxoids during pregnancy or whilst breast-feeding”.

Two days later, however, that changed to say:

“Until more information is available, it is also recommended that women who are breastfeeding should not be vaccinated until they have finished breastfeeding.”

I would like some clarity from the Minister as to precisely why that advice changed. There will be many people working on the frontline of health and social care who are breastfeeding, which can continue for much longer than the recommended six months. It can last for up to two years and beyond, so we need to be giving proper advice, with evidence behind it, to those mums on the frontline who might be breastfeeding. They need to know what the advice is and what it is based on, so that they can make the best possible choice. They should not be told just to cease breastfeeding, because, as I have said, the impact on babies is considerable, and the antibodies passed through breast milk are very helpful. Interesting research has been done on mums who have had coronavirus, and on the antibodies passed through to babies. The Government should pay attention to the incredibly interesting research that is emerging.

There is a lot more that the UK Government can do to support breastfeeding. I could talk about this for quite some time, but I want to make sure that other colleagues are able to speak. I urge the Minister and the right hon. Member for South Northamptonshire, who secured the debate, to meet the all-party parliamentary group on infant feeding and inequalities at the next possible opportunity. We have been having meetings online, which has been great in encouraging people to come together, but I urge the Minister to put some funding towards this—not just warm words—and make sure that breastfeeding is protected in everything that the UK Government do.

--- Later in debate ---

[David Linden (Glasgow East) (SNP)]

It is, as always, a pleasure to serve under your chairmanship, Sir Christopher. As others have done, I want to start by congratulating the right hon. Member for South Northamptonshire (Andrea Leadsom) on securing today’s debate. The right hon. Lady—I would say she is a friend—has been an absolutely tenacious campaigner on this issue. I remember badgering her with questions on a Thursday morning when she was Leader of the House; she would always, even in Government, still find ways of getting this issue to the Dispatch Box. I think it is fair to say that the Government’s loss is this policy area’s gain. The issue is a massive passion of the right hon. Lady’s, so it is right that she leads the debate today.

In summing up for the Scottish National party today, I want to acknowledge the five contributions from Back-Bench Members. We have had very thoughtful speeches from my hon. Friend the Member for Glasgow Central (Alison Thewliss) and the hon. Members for East Worthing and Shoreham (Tim Loughton), for Strangford (Jim Shannon), for Congleton (Fiona Bruce) and for Truro and Falmouth (Cherilyn Mackrory). People who have a genuine interest in a policy will come to debate in Westminster Hall; I certainly felt this morning that Members were speaking about something they knew about, rather than something from a parliamentary research unit or parliamentary Labour party handout.

Before I outline what the Scottish Government’s policy landscape looks like in terms of the first 1,000 days, I want to reflect on the Royal Foundation’s study conducted last month in partnership with Ipsos MORI on early years in the UK. The results were fascinating: only 10% of parents mentioned taking the time to look after their own wellbeing when asked how they had prepared for the arrival of their baby. Ninety per cent. of people see parental mental health and wellbeing as critical to a child’s development. Parental loneliness has dramatically increased during the pandemic, from 38% feeling lonely before to 63%, and more than a third of all parents expect the covid-19 pandemic to have a negative impact on their long-term mental wellbeing. That focuses some of the immediate challenges, but what are the solutions?

For a start, Members will forgive me if I reference largely what happens in Scotland. This is very much a devolved area, but as a result of third-party obligations I want to offer some thoughts from that perspective. North of the border, the Scottish Government are investing £50 million, overseen and directed by the perinatal and infant mental health programme board, to improve perinatal and infant mental health services in Scotland across all levels of need—from specialist services, through to befriending and peer support. In addition, the Scottish Government have established the infant mental health implementation and advisory group. It provides clinical advice and support to inform the development of mental healthcare from conception to three years of age, and oversees the testing and implementation of evidence-based and innovative models for the delivery of those infant mental health services.

I want to look slightly wider at the policy initiatives currently in place and how those tie in with the topic we have been focusing on this morning. North of the border, the Scottish Government recognise that life chances and future attainment start at birth and we are certainly using our devolved powers to deliver a comprehensive package of support to ensure the best start for every child in Scotland. The Scottish Government provide a generous package of support for families to help them through this challenging time, including the three Best Start grant payments for people on low incomes, all providing a higher level of support or eligibility than the Department for Work and Pensions benefits that they replace. We have replaced the British Government’s Sure Start maternity grant with the Best Start grant and pregnancy and baby payment. That payment is higher than the UK Government payment and does not put a limit on the number of children supported: we believe that every child should be treated equally.

We have introduced baby boxes, which provide essentials to new parents in Scotland, of which more than 47,000 were delivered in 2019. Indeed, 93% of parents are taking up a baby box at the moment and there is nearly a 100% parent satisfaction rate. I declare an interest and speak from experience, as a result of receiving one in 2018 when my daughter Jessica was born. We are also delivering both nursery and school-age payments for our Best Start plan, together with the pregnancy and baby payment. We made £21 million of awards in 2019-20. Best Start Foods also provides a £17 payment for healthy food every four weeks during pregnancy and for any children between one and three years old, and £34 for babies up to the age of one.

[Alison Thewliss]

My hon. Friend makes a good point about the Best Start Foods grant. The level of the equivalent payment in England is woeful and, although it will go up in April, there are families just now who cannot afford essentials like infant formula. Does he agree that the Government should put up the payment now to see families through the winter?

[David Linden]

I am grateful to my hon. Friend for that intervention. I can remember—in a previous life, before I was elected to this place, when I worked for her—helping on the all-party parliamentary group on infant feeding and inequalities. I pay tribute to the work that she has done on that. The point she has made to the Government today is very much based on what the APPG has heard, so I would be more than happy to take that comment on to the Minister.

The Scottish child payment is also—and I quote—a “game changer” in the fight against child poverty that is available nowhere else in the UK. It could support up to 194,000 children this year. Together with the Best Start grant and Best Start Foods, this will provide over £5,200 in financial support for eligible families by the time their child turns six; for the second and subsequent children, it will provide over £4,900. To further support that early years provision, the Scottish Government will continue to review and transform maternity and neonatal services over five years through the Best Start programme. Through that, we will deliver person-centred care that reduces inequalities, keeps mother and baby together, provides choices and improves experience of care and clinical outcomes for the 50,000 pregnant women and their babies who use the services every year.

In the brief time I have spoken this morning, I have taken a quick canter through some of the support being provided in Scotland. I hope it has been helpful in adding to the wealth of information and policy initiatives that we have considered. I very much look forward to supporting the right hon. Member for South Northamptonshire as she seeks to raise the early years agenda in this place. She will have all of our support.