Second Opinion: Reports link low breastfeeding rates and early weaning to obesity

The latest Survey on Income and Living Conditions from the Central Statistics Office makes for grim reading, says Jacky Jones

 

Ireland’s children are not doing so well, if the recent plethora of reports is to be believed. Far from being the best little country to raise a family, children’s health is threatened by a whole range of public policies. First, there is the attitude of maternity hospital staff and Irish women to breastfeeding. “Baby-friendly” hospitals (not) make bottle-feeding the easier choice. Dr Geoffrey Shannon’s Seventh Report of the Special Rapporteur on Child Protection concludes that “not enough is done to promote breastfeeding”. He points out that almost all women in other EU countries breastfeed, whereas only half of Irish women even try it. Shannon wants a complete ban on the advertising of all formula foods and related products, such as teats, bottles and “follow-on” milks.

The latest Growing Up in Ireland (GUI) report, Maternal Health Behaviour and Child Growth in Infancy, notes that “Ireland has one of the lowest national levels of breastfeeding in the world”.

Women from other EU countries are six times more likely to breastfeed than Irish women, who are “too embarrassed” and only half of women who breastfeed have done so publicly. Half of all babies are weaned by four months, instead of by the World Health Organisation’s recommended six months. Both reports link the low breastfeeding rates and early weaning to obesity, which is not helped by children’s low levels of physical activity.

Ireland’s Report Card on Physical Activity in Children and Youth 2014 allocated an overall score of D minus to children aged nine to 16 for physical activity. Adolescents sit for more than eight hours a day. Active transportation scored a D and the report noted that “travel by bicycle is especially low in Irish children and should be investigated”.

Physical education (PE) also scored a D minus with a discrepancy between the recommended time for PE and the amount pupils got in schools. Only one-third of primary pupils and one in 10 post-primary students received the recommended amount of PE.

The latest Survey on Income and Living Conditions from the Central Statistics Office also makes for grim reading. The deprivation rate for 2013 was more than 30 per cent, up from 13.7 per cent in 2008. Those living in households with one or more children had the highest deprivation rate at 63 per cent. The 2014 Innocenti Report Card ranks Ireland 37th-worst out of 41 countries for how governments have prevented children suffering during the current recession. Financial stress makes children as young as three years of age less confident and more fearful. “Children feel anxious and stressed when parents endure unemployment or income loss” and the “poorest children suffer most”. Ireland ranked fourth from the bottom in terms of “there being times in the past 12 months when you did not have enough money to buy food”.

Now post-primary teachers are threatening more industrial action in March because of the proposed reform of the junior cycle. The only mistake the Department of Education and Skills (DES) made is that it didn’t abolish the exam altogether. A Junior Cert, whether assessed by teachers or external examiners, is useless. Educational attainment is the most important determinant of health and every child should have a Leaving Cert as an absolute minimum. This should be mandatory and all children must be legally obliged to stay in school until they have achieved this goal.

Out-of-school services for teenagers are not faring much better. A report from the Department of Children and Youth Affairs, Value for Money and Policy Review of the Youth Programmes that Target Disadvantaged Young People [VFMPR], shows that “the lack of measurable and verifiable outcome data available for this VFMPR examination made the task of separating good performance from poor performance near impossible”. No one knows whether the €182 million-plus spent on youth programmes between 2010 and 2012 improved the health and lives of young people.

The six reports and the mess the DES have made of junior-cycle reform point to a shockingly incoherent approach to public health policy.

There is little evidence of joined-up thinking or interdepartmental synergy. Health, education, social protection and the department are all doing their own thing, with inevitable negative consequences for the health of Ireland’s children.

It is possible to develop public policies that ensure that almost all children are breastfed, their preschool, primary and post-primary experiences promote their mental and physical health every day, and that out-of-school services help them achieve their potential. So why not just do it? drjackyjones@gmail.com Dr Jacky Jones is a former HSE regional manager of health promotion and a member of the Healthy Ireland council.

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