Patrick Costello
Question:679. Deputy Patrick Costello asked the Minister for Health the actions his Department is taking to improve breastfeeding supports and postpartum care; and if he will make a statement on the matter. [33534/23]
View answerTuesday, 11 July 2023
Questions (679)
Written answers
Encouraging mothers to breastfeed is a priority for the Department of Health. National health policy, including the Healthy Ireland Framework, 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 is the framework for progressing supports for breastfeeding in Ireland and compliance with the EU and WHO code is a key action to reduce promotion of infant formula. Additional funding of €1.58m was announced by Minister Donnelly in May 2021, to fund 24 additional HSE Lactation Consultants thereby providing support to every maternity unit in the country.
There are currently 55 dedicated lactation posts employed in the HSE, with 35.5 working in maternity services and 19.5 working in the community. 30.5 of the 34.5 of the new lactation posts approved by the DOH and the HSE’s National Women and Infants Health Programme in 2021 have been appointed. The capacity to support infant feeding as part of core child health services and supports will be increased significantly with investment in a dedicated child health workforce as recommended within First 5 strategy and Sláintecare actions.
Work is ongoing to progress priority and outstanding actions within the National Breastfeeding Action Plan 2016-2021. The plan was extended to 2023 as a result of the Covid Pandemic. The HSE’s National Breastfeeding Implementation Group (NBFIG) will undertake a review of progress against the current plan in conjunction with relevant stakeholders.
It is important that children get the best possible start in life, and this is something all Government partners have prioritised in the Programme for Government. Ireland has a culture of bottle feeding; in order to improve child and maternal health, as well as achieve reductions in childhood obesity and chronic diseases, it is necessary to improve breastfeeding rates. Breastfeeding also has the benefit of avoiding, either totally or in part, the costs associated with the use of breast milk substitutes.
The National Maternity Strategy proposes a new model of integrated care that provides three care pathways: Supported Care, Assisted Care and Specialised Care. The pathways are designed to ensure that every woman can access the right level of care, from the right professional, at the right time and in the right place, based on her needs. Under the Strategy’s model of care, all 19 maternity services now offer the Supported Care Pathway, and an Advanced Midwife Practitioner (AMP) is in place to implement the pathway in all 19 sites. The HSE’s National Women & Infants Health Programme (NWIHP) has advised that, within this pathway, responsibility for the co-ordination of care to a woman will be assigned to a named Clinical Midwife Manager (CMM), and care will be delivered by the community midwifery team, with most antenatal and postnatal care being provided in the community and home settings.
Upwards of 24% of women are booking on this pathway, demonstrating the increased choice now available to women accessing maternity care which is a central vision of the Strategy, and also an increase in care being provided in the community and closer to home. In addition, 15 maternity units are providing early transfer home and 15 units also have new home-away-from-home delivery suites, supporting increased choice for women.
NWIHP has also advised that, on average, mothers and their babies spend 2-3 days on postnatal wards post birth, with a number of mothers being discharged earlier to the care of the public health nursing services. The NWIHP has finalised a framework for the development of five postnatal hubs, which are intended to move this essential care back to the community supported by a comprehensive and multidisciplinary package of resources and for the duration of the postpartum period. The NWIHP has advised that recruitment is underway for all five postnatal hubs and they will be located in Kilkenny, Kerry, Cork, Portiuncula and Sligo. These hubs will support women for up to 14 days post birth by addressing many of the gaps identified by women in postnatal care including education, breastfeeding, physiotherapy, emotional and physical supports.
In relation to other maternity supports for women, work is ongoing on the implementation of the Model of Care for Specialist Perinatal Mental Health Services as a key priority under Sharing the Vision , our national mental health policy. Perinatal mental health services have now been developed in all maternity units/hospitals and provide specialist support to women experiencing mental health problems in pregnancy. Perinatal mental health disorders are those which complicate pregnancy (antenatal) and the first postnatal year.
Women are now asked specific questions about their mental health as well as their physical health at maternity hospital booking clinic appointments. Women can talk to their midwife and ask for support from the perinatal mental health midwife in their hospital if needed. The GP and Public Health Nurse can also provide support and signposting to the most relevant service for each woman.