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Breastfeeding etc. Bill

Volume 450: debated on Friday 20 October 2006

Order for Second Reading read.

I beg to move, That the Bill be now read a Second time.

I thank all the hon. Members who took part in the previous debate for their restraint, allowing this Bill to be reached. The Bill aims to make 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; and for connected purposes.”

The policy objectives of the Bill are, first, the promotion of public health and, secondly, the tackling of discrimination.

On public health, detailed research over many years has confirmed the entirely intuitive proposition that breastfeeding is healthy for babies, mothers, families and society. Babies who are breastfed are less likely to develop many illnesses in infancy, childhood and adulthood. That is why the World Health Organisation, UNICEF and our Department of Health all recommend that babies should be fed only breast milk for the first six months of life. Breastfeeding reduces the risk of babies developing gastroenteritis, for example. The authority for this is a publication in the name of Howie, P. W. et al. in 1990, published under the title, “Protective effect of breastfeeding against infection” in the British Medical Journal, vol. 300, pages 11 to 16.

Women who breastfeed can significantly reduce their chances of developing breast cancer. This link was shown conclusively in a collaborative re-analysis of data from 47 epidemiological studies in 30 countries published in The Lancet, vol. 360, in July 2002. The study included more than 50,000 women with breast cancer and more than 96,000 women without the disease. The authors found that the relative risk of breast cancer decreased by 4.3 per cent. for every 12 months of breastfeeding. The study’s stated interpretation in The Lancet is:

“The longer women breastfeed the more they are protected against breast cancer. The lack of or short lifetime duration of breastfeeding typical of women in developed countries makes a major contribution to the high incidence of breast cancer in these countries.”

I am sure the all hon. Members would support breastfeeding and would encourage women to breastfeed. Can the hon. Gentleman say how many more women he would expect to breastfeed, should his Bill become law?

I shall come to statistics for the United Kingdom. About seven out of 10 women start breastfeeding, but by six months—the recommendation that is widely promoted—only three in 10 are breastfeeding, or as few as one in 10 are breastfeeding exclusively. So the figures are poor in the UK, even in comparison with other developed countries. I thank the hon. Gentleman for his interest.

Wider benefits for families and society include an association between longer duration of breastfeeding and low risk of a child becoming overweight in later life. A study in the name of Harder, T. et al. states that one month of breastfeeding is associated with a 4 per cent. decrease in the risk of becoming overweight in later life. That was published in the American Journal of Epidemiology in September 2005. A second benefit is cost savings for the national health service. An old NHS estimate updated by UNICEF shows that for every 1 per cent. increase in breastfeeding, more than £500,000 a year would be saved in the treatment of gastroenteritis alone. So promoting breastfeeding makes sense as a public health objective.

How well are we doing in the UK? That is the question that the hon. Member for Shipley (Philip Davies) asked. That brings me to the second policy objective—tackling discrimination. In the league table of breastfeeding rates, the Scandinavian countries are top. In Norway a starting rate of 97 per cent. of all mothers has been achieved, with 80 per cent. still breastfeeding at six months. The latest survey evidence for England discloses that about seven out of 10 women start breastfeeding their babies but fewer than one in 10 are still breastfeeding at six months, yet most mothers want to breastfeed their babies for longer.

National surveys find that three quarters of mothers who give up breastfeeding before six months say that they wanted to continue longer. Why do so many mothers stop breastfeeding earlier than they say they would wish? NICE—the National Institute for Health and Clinical Excellence—looked for the possible answers to the question and published some conclusions in a draft “Effective action briefing on the initiation and duration of breastfeeding” in November 2005. Under the heading, “What factors influence participation in breastfeeding?”, NICE stated:

“The reasons for low breastfeeding rates in the UK include the influence of society and cultural norms, as well as clinical problems, the lack of continuity of care in the health services and the lack of preparation by health professionals and others to support breastfeeding effectively.”

It specifically refers to

“the experience of living in a culture where breastfeeding is embarrassing and difficult to do in public.”

Since November 2005, NICE has worked on and, in July 2006, published new guidelines for post-natal care of women. “Routine postnatal care of women and their babies” is NICE clinical guidance 37, and it contains an excellent section on support for breastfeeding in all health settings. It recommends, for example, that all maternity care providers should implement an externally evaluated, structured programme that encourages breastfeeding, using UNICEF’s baby friendly initiative as the minimum standard. The baby friendly initiative has a proven effectiveness in increasing breastfeeding rates where it is already in place.

In general, I support the hon. Gentleman’s drift, but I have a question to which I genuinely do not know the answer. The Minister may be able to help, if she has time to make a few comments. Given the technical ability for women past the menopause to bear children with the aid of a lot of hormones, has any work been done of the effect on the breastfed child of those hormones?

I do not know whether there has been any research on that point. Although the thrust of the Bill is to promote breastfeeding, it is about feeding milk to babies in public places, so it can include bottle feeding. This is not an attempt to enforce breastfeeding if at all possible: some women, for medical or physical reasons, cannot breastfeed at all, and I do not wish to criticise them. Some women choose, for legitimate reasons, not to breastfeed, and I do not wish to criticise them either. I am trying to tackle a problem that stops women who want to breastfeed doing so in public places.

Let us assume for a moment that the NICE guidelines will deal with the reasons stopping women feeding that are health-care related. How do we combat the influence of society, cultural norms and the embarrassment about breastfeeding in public, referred to in the NICE reasons? That is where the Bill comes in.

The purpose of clause 1 is to safeguard the right of a child under the age of two years to be fed milk in a public place or licensed premises where the child is otherwise lawfully permitted to be. The Bill does not change licensing law nor does it prevent a business from excluding breastfeeding on its premises where the lawful custom or practice is to exclude children generally. Where a child is lawfully permitted to be in a public place or on licensed premises, that child may be fed bottled milk and the child’s mother will be entitled to breastfeed him or her if she so chooses. Any person who deliberately prevents or stops, or attempts to prevent or stop a person bottle feeding or breastfeeding a child in such circumstances will be guilty of an offence and liable on conviction to a fine not exceeding level 4 on the standard scale, currently £2,500.

I agree very much with the thrust of my hon. Friend’s Bill in terms of promoting breastfeeding, but I am a little concerned by clause 1, because it contains no provision for the defence of reasonable excuse. It is an absolute offence that applies across the board, but I can envisage circumstances—for example, in a theatre or cinema—in which one patron may be distracted from watching the performance or film if the woman sat next to them is breastfeeding. In those circumstances, the other customer’s rights are being offended. Does my hon. Friend agree that clause 1 should include some provision for a defence of reasonable excuse to take account of the impact on other people?

I am grateful to my hon. Friend for raising a serious and genuine point. I do not think that there should be such a defence, although clause 2, which relates to employers, contains a specific defence if employers have taken reasonable steps to ensure that obstruction or prevention would not occur. There is no intention that the Bill should be some sort of Amazons’ charter that enables women to bare their breasts in public places to offend people. Most breastfeeding mothers are especially careful to be discreet when they breastfeed in public places and that is the attitude that I seek to encourage through the Bill.

If I may, I would like to move on, as there is now little time left.

Our Parliament will by no means be alone if we legislate to give support for breastfeeding. A law exactly like this Bill was skilfully and successfully steered through the Scottish Parliament by Elaine Smith, MSP, and it came into force in March 2005. Many state legislatures in the USA have introduced similar legislation. The Minnesota state legislature passed a law in April 1998, which provides that:

“A mother may breastfeed in any location, public or private, where the mother and child are otherwise authorised to be”.

Other legislatures have promoted breastfeeding as part of a wider anti-discrimination strategy. In Australia, the Queensland Anti-Discrimination Act 1991 prohibits discrimination against women on the ground of gender, and specifically breastfeeding. The World Health Organisation “global strategy for infant and young child feeding”, published in 2003, states that

“governments should enact imaginative legislation protecting the breastfeeding rights of working women and establishing means for its enforcement in accordance with international labour standards”.

I say that this Bill offers an imaginative approach. I hope that Members accept that the problem that clause 1 would address truly is serious, and that it is sufficiently prevalent to justify legislation.

When I published the Bill, I was inundated with individual tales of outrageous behaviour endured by women who were simply trying to breastfeed in everyday locations such as shops, eating places and leisure facilities. I gave a number of examples of that in my 10-minute speech when I sought leave to introduce the Bill on 8 November last year—I refer Members to column 181 of the relevant volume of Hansard.

More toe-curlingly embarrassing stories have kept on coming since then. Margaret Boyle-White was discreetly breastfeeding on a street in a Norfolk town in 2005, when a man complained to the police; they sent a uniformed officer in a marked car to stop her breastfeeding. A woman was asked to stop breastfeeding in the waiting room of a GP practice, of all places. A woman in a supermarket cafeteria had to go to the toilets if she wanted to carry on breastfeeding. A woman in a health and fitness club was escorted from the family area—of all areas—because she was breastfeeding. A woman was asked to leave a restaurant for discreetly feeding her seven-month-old baby at the table, although that did not prevent the restaurant from charging for the full meals, even though it sent her out when she had had only the first course.

Clauses 2 and 3 are consequential measures. Clause 2 effectively prevents a person or organisation from avoiding a conviction by getting an employee to do the outlawed act. Clause 3 makes provision in respect of whom to prosecute if the offence is committed by a body-corporate or a partnership.

Clause 4 would help Health Ministers achieve uniformity in the support and promotion of breastfeeding. As I have mentioned, the Scottish Parliament has already introduced such legislation, as health is a devolved matter. Therefore, the Bill would apply in England and Wales.

Recently, the Ontario Human Rights Commission sponsored INFACT Canada to promote the rights of children to breastfeed. The message promoted is,

“Don’t think of it as a woman’s right to breastfeed. Think of it as a baby’s right to eat”.

The Bill would recognise and protect that right, as well as the right of the child to be bottle-fed milk.

The Bill is also compliant with a number of international obligations, including article 25 of the 1948 universal declaration of human rights, article 11 of the 1966 international covenant on economic, social and cultural rights, the convention on the rights of the child and the international code of conduct on the human right to adequate food.

In respect of the costs of implementing the law that the Bill would establish, I am helped by having sight of the financial memorandum that the Scottish Parliament produced when Elaine Smith was piloting her Bill through. The main costs in respect of clauses 1 to 3 would relate to extra burdens on the police and the Crown Prosecution Service. However, I anticipate that they would be modest and would not require the recruitment of additional staff. Those organisations that might be at risk of prosecution, such as shops and restaurants, should be expected to alter their practices to ensure that they are compliant with the standards that the law would uphold. Consequently, the number of prosecutions might reasonably be expected to be low.

We should do all that we can to protect a woman’s right to breastfeed in public places and encourage social acceptance of that important and natural practice. Some 186 Members appear to agree, as they signed early-day motion 1046. I ask the Government, and the Members who are currently in the Chamber, also to support the Bill, and I commend it to the House.

I congratulate the hon. Member for Stafford (Mr. Kidney) on introducing a Bill on a subject that is doubtless of great importance to many people. However, I must take issue with him on its purpose, which he claims is to encourage breastfeeding—a sentiment with which we all no doubt agree. Indeed, in the past three years my wife, Debbie, has successfully breast-fed our two children, and I would certainly commend breastfeeding to any mother. But what I do not see in this Bill is the encouragement to breastfeed.

The hon. Gentleman seemed unable to say how many more women would breastfeed as a result of the Bill’s introduction, which showed that this has got nothing to do with encouraging breastfeeding. According to the National Childbirth Trust, 50 per cent. of all women who breastfeed their baby have never even tried to breastfeed in a public place, so the ability or otherwise to breastfeed in a particular shop clearly is not a deterrent to breastfeeding. This has nothing to do with encouraging more breastfeeding. It is more to do—

I am making a general point about the Bill, which I believe will not encourage more people to breastfeed. It is perfectly clear that they do not need this Bill in order to breastfeed. The Bill is about the nanny state and forcing businesses to do things on their own premises, whether or not they wish to do so.

The argument that such legislation exists in lots of other countries is not one that I have ever been particularly impressed with. There are lots of things that happen in many other countries that the hon. Member for Stafford would not like to see happen here. Many countries have capital punishment in their judicial system, which he doubtless would not support, so the question whether other countries adopt such an approach to breastfeeding is neither relevant nor irrelevant. This is more to do with the culture that exists in many parts of this House, and particularly among Labour Members. Where there is a problem, they look for two particular ingredients in tackling it, the first of which is that they are seen to be doing something. It is the great tendency of any politician that, if a particular issue arises, they must be seen to be doing something about it. The second ingredient is that their proposal does not offend anybody, and this Bill is a prime example of that culture.

The hon. Gentleman quoted with approval earlier a statistic from the National Childbirth Trust. Does that mean that he supports its aims, and does he appreciate that it supports this Bill? He talks about Labour Members, but would he be interested to know that such an approach is supported not only by the NCT but by UNICEF, the Breastfeeding Network, La Leche League Great Britain, the Royal College of Nursing, the Royal College of Midwives, the Community Practitioners’ and Health Visitors’ Association and more than 30 other organisations?

As I made clear earlier, I support encouraging people to breastfeed; what I do not support is forcing people to do things on their own premises that they do not want to do. Businesses should decide for themselves whether this is appropriate, based on feedback from their customers. They are more than capable of making these decisions for themselves; they do not need the nanny state telling them what they must and must not be doing on their own premises.

I support encouraging breastfeeding but I do not believe that this Bill will do so; in fact, it will make no difference whatsoever. It has simply fallen into the old-fashioned trap that Labour Members fall into of unnecessarily sticking their noses in and being seen to be doing something that does not offend anybody, in order to gain some cheap popular support. The Bill will make absolutely no difference whatsoever to the number of women breastfeeding in this country; it will be just yet another of the many triumphs of the nanny state that we have seen from this Government.

First, given the opportunity to choose between infant formula and breast milk, breast milk is definitely best, and we are doing as much as we can to encourage people to start breastfeeding, and to continue. This Government have introduced better maternity pay and better maternity leave, which shows that when we talk about supporting families, we then act, in contrast with the spoutings of the Opposition.

We are examining the situation in Scotland. As my hon. Friend knows, we introduced new questions to the five-yearly infant feeding survey of 20,000 women, asking them what impact intimidation or lack of confidence has on not breastfeeding in public. Since the Scottish legislation was introduced, not one prosecution has taken place.

It being half-past Two o’clock, the debate stood adjourned.

Debate to be resumed Monday 23 October.