 The next item of business is a debate on motion 11935, in the name of Jenny Minthowe, and supporting breastfeeding in Scotland. Ad nim, I invite members to wish to speak in the debate to press their request to speak buttons. I call on Jenny Minthowe to speak to and move the motion up to 15 minutes minister. Thank you, Presiding Officer. I am delighted to open this debate, to celebrate and support breastfeeding in Scotland and to that end, to move the motion. I am clear as Minister for Public Health and Women's Health, and women's health. Improving the health of babies and young children is fundamental to underpinning Scotland's overall population health. To enable us to do this, our ambition should be for every baby in Scotland to be breastfed. This is not to say that I don't believe that parents should have a choice in how they feed their children. They absolutely do. Ond rwy'n dechreu caith, iawn i ôl oes yn ddiddordebwych o'n ddiddordebwych o'r ffordd y developedorion, oedd hynny mewn rhan o blwyddyn nhall addysg i gael, iddo o hoffa, i gael i'n credu ei ddiddordebwych. Rwy'n ddiddordebwych o'r hoffa, o beth o'n ddiddordebwych, rwy'n ddiddordebwych o'n ddiddordebwych i gael a meddwl i gael. Rwy'n ddiddordebwych o'r ddiddordebwych o'r hoffa i Eurofnair arwag i chi. matte feeding and the provision of human milk is the most accessible and cost effective activity available to public health, which is known to prevent a range of infectious and non-communicable diseases. Despite welcome recent improvements in Scotland, we are still in a place where the majority of babies are wholly or partially formula fed for most of their first year of life. The evidence on the benefits of breastfeeding for both mother and baby is clear. It is more than nutrition.The physical act of breastfeeding itself brings many additional benefits, contributing to the health and development of babies that has lifelong impacts.I thank the minister for giving way and I am listening to what she is saying and I am really interested in this area.In particular, in relation to areas of higher deprivation, you find that the take-up of breastfeeding tends to be lower. Has the Scottish Government done any research on this? Is there a clear focus to make sure that we are getting to the people that we really need to be getting to?I thank the member for that intervention and I am coming to that later on in the speech. In fact, it is more than just simply research that we have done. We have put things in place, like the family nurse partnerships. The evidence is strongest of the benefits of exclusive breastfeeding for the first six months of life. To fully realise the potential that breastfeeding has on our nation's health, it is evidence that we need to listen and act upon. In November, my colleague, the Minister of Children and Young People and I launched the Early Child Development Transformational Change programme to focus on driving change in children's earliest years. One of the key pillars of that programme is nutrition and health. According to the World Health Organization, breastfeeding, alongside the quality of a young child's diet, sets the trajectory for lifelong health and wellbeing. Collective efforts across whole systems are needed to deliver on our ambitions to improve child health outcomes. In recent years, Scotland has seen a noticeable positive shift in breastfeeding rates for breastfeeding at birth and beyond in both younger mothers and those from more deprived areas whose rates were historically low. We now have the highest rate of breastfeeding at 68 weeks on record at 47 per cent, including evidence that breastfeeding inequalities are reducing. I believe that this is amazing and the achievement has been driven by the collective efforts of infant feeding teams across our NHS and their third sector partners to focus on what works best. I congratulate everyone involved, especially the mothers themselves. Thanks to those efforts, alongside our additional investment of £9 million over the last five years, we now know what can and is making the difference that we want to see in Scotland. That investment has had some tangible long-lasting impacts. For example, in NHS Ayrshire and Arran, where their peer support project is integrated into their local infant feeding offer, and NHS Lothian, where they tested targeted interventions in one locality with low breastfeeding rates that have been successfully scaled up. We also continue to invest in our national donor milk bank, the only one of its kind in the UK, to innovate and expand to continue to provide a safe supply of breast milk to some of our sickest and smallest babies. I am grateful to those who continue to provide donor breast milk to support this work. Using human milk as a bridge to breastfeeding means that Scotland is following international best practice. Protecting, promoting and supporting breastfeeding is a fundamental principle of the World Health Organization code on marketing of breast milk substitutes. It provides robust and clear direction to all countries on how to achieve this. I am clear that regulation has and continues to have a clear role in protecting all parents from the impacts of inappropriate marketing and promotion of infant formula. It also prevents free distribution of infant formula. It has been shown in many countries, including the UK, that these tactics seriously influence infant feeding choice. We have seen over many years, indeed decades, how the marketing of infant formula has influenced parents choice. The most recent Lancet series on breastfeeding sets out clearly where these influences can cause harm. Those marketing practices undermine parents' confidence in understanding their babies' feeding behaviours as part of normal development. They also undermine breastfeeding. Regulation on marketing, as opposed to alternatives such as voluntary codes, remains the best way to achieve this consistently and equitably and in the best interests of babies. Given a child, the best start in life can be seriously affected by today's cost of living. We know that many families are struggling with the cost of infant formula and I welcome the recent interventions to review the marketing of this product and lowering of price. The cost of infant formula, which is the only other nutrition apart from breastfeeding that babies can be fed, has increased in some cases by 25 per cent over the past two years. The Competitions and Markets Authority and Glasgow MP Alison Thullis, among others, have made the case for change. The CMA report stated that families could save up to £500 buying cheaper formula options. I note that some of the costs of some infant formula have recently come down, which is welcome, but they were already too high, leading to some families being unable to make formula feeds safely. All babies should be fed safely and responsively, and feeding choices should be fully informed, supported and free from harmful commercial influences. That comes back to my overall ambition to improve the health of babies and young children as both a fundamental underpinning of overall population health and a human right. Scotland will be the first UK nation to incorporate the UNCRC into domestic law, ensuring that we are a country that respects, protects and fulfills children's rights. Protecting those rights means thinking differently and acting differently. They should include how we support the choices that women make on how long they want to breastfeed for. One of the barriers to that is how new mothers are supported to return to the workplace. NHS Scotland has worked with breastfeeding experts to develop their new, once for Scotland guideline on breastfeeding and return to work, which launched in November. That has been welcomed by the sector. Although those rights are already enshrined in law, they are not always acted upon in ways that make a difference. That can impact on the decisions of how long babies are breastfed and even if they are breastfed at all. We know that due to the on-going pressures on all families with the cost of living crisis and balancing the needs of employers over the needs of their families, some mothers are returning to work earlier than they might otherwise have done. This is influencing their infant feeding choices. This new guideline is an exemplar of how employers can act positively to consider the needs of women as mothers first and support their breastfeeding goals. I would like all employers to look at these guidelines and focus in on the action that they could take to make a difference. Now I want to return to my points about culture and societal norms. Normalising breastfeeding is much harder than it should be. This debate is not about breastfeeding versus formula feeding. It is a debate about gaining a deeper understanding of how infant feeding choices are made and, most importantly, how they should be supported. However, it takes more than supporting individual choice to make a difference. It takes action from communities, senior leaders, businesses and organisations to gain the knowledge and understanding to change societal norms and culture around breastfeeding. It is about breastfeeding being visible in areas where pregnant women and new mothers visit regularly. I am pleased in my home island of Isla that the bookshop is a breastfeeding friendly place. I admit that progress has been made, but the Royal College of Midwives are saying that midwifery is in crisis with turnover in order to improve culture. Does the minister recognise that we need to do something to help on midwives? I thank Tess White for that intervention. I think that it is clear that the Scottish Government recognises and has helped to improve the number of midwives that there are. In fact, yesterday I was speaking to two in my own constituency and I think that it is clear to enable mums and families to have the best start that we need to ensure that we have got the right number of midwives. With investment, the Scottish Government has helped to increase numbers over the past few years. Holly McNeish's poem, Embarrassed, is about her experiences of breastfeeding her baby. It is a stark poem and could be argued calls some elements of society out. I spent the first few months of her beautiful life feeling nervous and awkward and wanting everything right, surrounded by family till I stepped out of the house. It took me eight weeks to get the confidence to go into town. Now the comments around me cut like a knife. As I rush into toilet cubicles feeling nothing like nice because I'm giving her milk that's not in a bottle. I think that it's a powerful poem and it really has made me look at things and conversations that I've had since reading the poem have emphasised the powerful words that Holly has used. I commend everybody to read it. Scotland should do better and it can do better. That's why in 2019 we launched our national breastfeeding friendly Scotland scheme. Despite there being laws to support breastfeeding in public, including our world-leading legislation in Scotland, we still hear too many stories of mothers being stopped from feeding their babies and feeling uncomfortable doing so openly. Seeing other women breastfeeding in communities and hearing breastfeeding, I'm sorry, I do have to continue, hearing breastfeeding discussed and promoted as part of normal life that children experience when they're growing up, will also make a difference. At our recent national breastfeeding celebration event, I announced that following a successful pilot, the early learning modules of this scheme had been launched. Those resources will help embed the normalisation of breastfeeding to our youngest children through play and learning, supporting intergenerational behaviour change. I am fully aware there is more to do. Bringing all our learning, evidence and practice closer together can make even more of a difference. That is why we will be working closely with our stakeholders, setting out our route map for the future. There will be a focus on consistency and equity for our evidence-based practice and support that is both universal and targeted. This will be developed around the becoming breastfeeding friendly review from 2018, and we will set out progress on those recommendations and learn from our national improvement programme, which we aim to publish in the spring. We will also be clear how we will use data to measure progress over the coming years, and how we can continue to share learning and innovation between cross-sector partners. We know that mums and new parents welcome and value support from their peers, especially for infant feeding. To better understand its reach and impact, we will review peer support across Scotland over the next two years. Informed by new parents who have used those services or tried to access them and our service providers. We are clear that we remain committed to the UNICEF UK baby friendly initiative. With all settings, maternity and community in Scotland accredited, we continue to use those standards as a foundation for continuous improvement. Those standards are built around core aspects of infant feeding care, including skin-to-skin, the mother and baby bond, and helping parents to respond to feeding cues. Public Health Scotland is off to a good start, and the parent club website has great accessible information. I want breast milk to be seen as the normal nutrition for babies, and for all new parents to have the information and support they need to provide safe, responsive infant feeding. I am determined to make that happen and to confirm that I commend this motion to Parliament. Members, I wish to know that we have a fair amount of time in hand this afternoon, and as long as possible, the members will receive that time back for any interventions. I now call on Tess White to speak to and move amendment 11935.2 up to 11 minutes, Ms White. Thank you, Presiding Officer. The benefits of breastfeeding are well known, but the difficulties establishing and sustaining breastfeeding for mother and baby are not widely recognised. For many new mothers, breastfeeding can feel like an unexpected battle, especially after childbirth. You're overjoyed, but on your knees from exhaustion, poor latch, not enough milk, too much milk, thrush, blocked milk dots, tongtie, mastitis, cluster feeding, infant weight loss. Something that is supposed to be natural can feel like anything but, and one mother shared with me that the problem she experienced as she tried to breastfeed felt like the first failure as a mum. Another mum told me that she cried every time feed times came around as she was told by hospital staff that breast is best. She felt like she was failing when her baby didn't latch or feed properly. I worry that an unintended consequence of promoting and celebrating breastfeeding is that new mothers who can't breastfeed or don't want can feel a sense of shame. Policymakers and health practitioners need to be sensitive to this, because feeding your baby means so much more than policy guidance and government targets. Most new mothers will require some level of support to successfully establish breastfeeding, and that support will often come from midwives following the baby's birth, who can advise on attachment and position and assess the baby for the tongtie or a tongtie. However, midwives are increasingly called away from essential times supporting infant feeding to cover acute care. Community midwives, too, are so important in supporting maternal and infant physical and mental health in those crucial first days. Postnatal care is often called the Cinderella service, something that midwifery services strive to provide but often struggle to deliver because the capacity just simply isn't in place. The Royal College of Midwives is clear that midwifery services in Scotland are facing some real challenges, which is why the Scottish Conservatives amendment today emphasises the importance of staffing. Demographic and societal changes are putting increasing pressure on workforce demand and the SNP government is failing to step up to the challenge. Meanwhile, the retention of experienced midwifery staff continues to be an issue with many wanting to leave the professional together because they worry they cannot deliver the required quality of care. Presiding Officer, the figures are striking. Globally, if almost all mothers breastfed, then 823,000 infant deaths and 20,000 maternal deaths from breast cancer could be prevented. But if Scotland is to realise the ambition to support women with their feeding journeys, it's vital that the resources are in place. Without these resources, the risk is that new mothers fill the pressure to breastfeed without the interventions to succeed. That won't just impact breastfeeding rates, it can have a damaging impact on maternal mental health. Of course, while midwives are a crucial source of support for mothers wanting to breastfeed, peer support services have done so much to help new mums as they establish breastfeeding, which can take several weeks. Breast Buddies Angus is an amazing peer support group which provides weekly support groups, local WhatsApp group chats, antenatal classes, one-to-one support by text and phone and a private Facebook group. It provides the targeted support and community spirit that so many mothers miss in the isolation of early motherhood. It's during those initial days and weeks that it helps so much to have someone else to say, me too, or that's completely normal. Cara Jameson is one of those wonderful volunteers who has helped countless mothers to navigate their feeding journey across forfer, montrose, carnusti, a broath, breakin and moneyfee. She says that the peer support group struggles from year to year to secure reliable funding, like so many other third party sector organisations which work alongside public services. The support network is desperate for long-term funding to help it survive. Cara has also shared her concerns about the centralisation of specialist infant feeding support services in Dundee. A new mum in Montrose with a baby with a suspected tongue-tie must travel an hour each way to be seen at Ninewells. Mothers recovering from a C-section must not drive, so it's up to two hours one way by public transport to access specialist infant feeding support. I have regularly raised geographical disparities in specialist healthcare services with the SNP Government, especially about maternal mental health. Postcode lotteries like this can act as a barrier to accessing care. These services need to be delivered as locally as possible to ensure no mum is left behind. And there are other obstacles as well. For babies requiring a tongue-tie division, waiting lists can be variable. Even a few days can feel like an eternity for parents whose baby is struggling to feed and losing weight. Interventions to support feeding in the interim, a cycle of breastfeeding, pumping and combination bottle feeding can be physically and emotionally exhausting for the mother who is in postpartum recovery. The Labour amendment is right to highlight concerns that health visits for mothers and babies are being reduced to staffing pressures, which is a massive concern. This is happening in Angus in my own region, where parents were contacted by health officials to say there would be no scheduled reviews between the three month check-up and when children are aged between 13 and 15 months. There are very real concerns for the well-being of babies and families who will be left without support for a year. We must recognise that breastfeeding is usually established in the first month to six weeks after the baby's birth, and that the resources needed to be available in that crucial window to support mothers who want to try it. So many moms want to persevere, but they find that they just can't, which is why it's so interesting that at the time of the health visitor first visit, around 10 to 14 days of age, less than half of babies, 37% were exclusively breastfed, that's just 37%. The drop-off rate for some mums can stem from embarrassment or anxiety over feeding in public, and I share the aspiration that this becomes normalised so no mum is worried about being judged. One mum shared with me that she was so nervous about feeding her baby in public that she sat on the floor of a nearby women's toilet. Another reason I add why preserving women's spaces is so important. An important two is the language used by health practitioners and society more widely. Women are not chest feeders. It's a term I note has been incorporated into NHS's own guidance for managers and employees on breastfeeding in the workplace, and it's wrong. Presiding Officer, breastfeeding can contribute to a beautiful bond between mother and baby. The health and economic benefits are proven, but breastfeeding can be very difficult, painful and exhausting. Pregnant women and new mums need to know they're not alone, that it isn't always a smooth journey and that support is in place to help them navigate. It's very important that we do support midwives. The SNP Government must ensure that support continues and that it meets the rising complexity of care and level of demand. I am pleased to open today's debate on breastfeeding for Scottish Labour and can I move the amendment in my name. I have both a personal interest in this important topic, having trained many years ago as a dietician and met with many mothers and babies over the years. It is also an area that Labour MSPs before me have championed. I don't think that I can speak about breastfeeding in the Scottish Parliament without mentioning the world-leading legislation brought to this Parliament by my friend Elaine Smith. The Breastfeeding Scotland Act 2005 makes it illegal to stop a mother feeding her baby under the age of two years, either by breastfeeding or bottle feeding, in premises where the public have general access. Legislation, I am absolutely sure, has contributed to the improved rates of breastfeeding mentioned in the Government motion today. I want to start an agreement with Government today and really emphasise that Scottish Labour fully supports the initiatives in Scotland to improve breastfeeding rates and that closing the gap on inequalities is paramount. Breastfeeding plays a big part in improving health over an entire life. I will take the intervention from Rachael Hamilton. Thank you to Carol Mockham for taking the intervention. It was just about the breastfeeding act that she was talking about. I breastfed three children but never in my time ever saw anyone using that act to protect their breastfeeding for children of their child under two. I just wondered if she thinks that it is time that we have an awareness campaign that makes sure that women are aware of that act because I think that it is something that has just sort of disappeared in that sense. Carol Mockham, I can give you the time back. Thank you very much for that intervention. It is a very good point that time passes and we perhaps forget some of the legislation that comes out in making sure that people in our communities are aware. Funnily enough, I was at a women's group earlier today over lunchtime and I very much spoke about that legislation and about that notion about how we make legislation work for people in their communities. So an intervention that works for me today. If I just go back to speaking in general terms, children get one chance at childhood and it is incumbent on all of us, whether we are family members, members of the public or politicians, to do what we can to get it right for every child. At this moment, when a child is born, when we can ensure that children have a chance to flourish and improve their health and wellbeing over their entire life, I think that we are all agreeing in the Scottish Parliament that we should encourage that. But not only that, at this wonderful moment, we have a chance to improve the life of the mother. Long-term health benefits of breastfeeding are well documented. This is an amazing opportunity and government must ensure the approach to breastfeeding really champions this fact as well. Presiding Officer, it is clear that improving breastfeeding rates in Scotland would help to improve the health of babies and mothers and reduce inequalities in health. This is why this is such an important debate today. Because there is such strong evidence that breastfeeding benefits both mother and baby, there is great value in government committing to invest in policies supporting and promoting it. Public Health Scotland is clear that breastfeeding provides the best nutrition for babies and young children and supports children's health in the short and long term. We have heard that breastfeeding reduces children's risk of gut, chest and ear infection and leads to small but significant improvement in brain development. For mothers, breastfeeding benefits mothers' health with strong evidence that it reduces the risk of breast and ovarian cancer and in some evidence that it may also promote maternal health, healthy weight and reduce the risk of type 2 diabetes. The benefits of breastfeeding for both baby and mother are seen across the world and it is important to note that this does include high-income countries such as Scotland. At times, that can be questions. It is perhaps easier to understand the benefits in less developed countries, but it can be overlooked in Western society that there are clear benefits. Unicefs UK are absolutely clear that increasing the number of babies who are breastfed could cut the incidence of common childhood illnesses, as described above, and not only benefit that individual, but overall it then estimates that it could save the NHS across the UK. Up to 50 million each year. It is interesting that breastfeeding rates in comparable Western countries with similar population sizes and demographics show that it is possible to dramatically increase rates with a supportive breastfeeding culture and the political will to do so. So continued investment and commitment from the government is entirely sensible. Comparing results can be difficult as many nations across Europe gather details in slightly different ways, making it difficult to compare, but analysing countries with positive changes in rates helps to establish what can be done to introduce breastfeeding friendly initiatives. Over the last decade, Unicef UK have complimented Scotland on its work in this area, highlighting market improvements in breastfeeding rates, particularly the rise in breastfeeding at six months in one of the studies that I looked at from 32 per cent in 2010 to 43 per cent in 2017. The view is that those results highlight the positive impact of national infant feeding strategies across Scotland, including supporting maternity and community services in Scotland to achieve baby friendly accreditation, which I will come back to later in my remarks. The latest figures that we know in Scotland show that two out of three 66 per cent of babies born in Scotland in 2022-23 were breastfed, but at least some time after their birth 57 per cent of babies were being breastfed at 10 to 14 days. It is thought that the increase here was mainly due to the mixed breast and formula feeding, but all improvements are welcome. However, we need to acknowledge that it is slow and merits strong scrutiny from government to ensure that they are committed to on-going improvements. We also need to make sure that the data is easily accessible and user friendly. It is not easy to find light for light figures, and that would definitely be helpful when we are trying to be supportive in initiatives and work constructively to support the Government in this. Current guidance recommends that babies should receive just breast milk for the first six months. We have heard that sometimes we do not achieve that very well and then introduce the introduction of solid foods after that, but that children should continue to be breastfed up until their second birthday, or for as long as the mother and baby wish. In Scotland, we do have some of the lowest breastfeeding rates in the world, and we know that many women are stopping breastfeeding before they actually want to. That is where we have a responsibility to make sure that that does not happen. What we want to do as legislators is to make sure that women have a real choice to breastfeed should they wish to do so. I have mentioned before that there is good evidence that interventions can work to improve breastfeeding rates, and that is why Scottish Labour has sought to bring forward the amendment today to highlight the need to ensure that women have all the levers in place to support breastfeeding, and key to that is health visitor services. We are hopeful that the Government will see this in the way in which it is intended to nudge them to make commitments to support the vital health visitor services across Scotland. Scottish Labour is concerned by reports that health visitors for mothers and babies are being reduced due to staffing pressures. As the amendment states, we call on the Scottish Government to guarantee that families are able to fully access this service. I spoke to a number of women in preparation for today's debate, and every single woman mentioned to me the strong support within the hospital is there, but the absence is once they are home. If we want to support women to breastfeed, certainly to exclusively breastfeed, we need to have longer term support and health visiting guarantees this. Overall, I acknowledge that there is more of a comprehensive approach needed as mentioned by the Minister and by Tess White. The reality is that, in a debate like this, if we do not accept that there are funding restraints and that the sectors such as the NHS and the third sector are being stripped of funds, then we are not doing it justice. To make those initiatives work, we have to have in place good training and provision for our health savers workers and longer term funding for the third sector. I am conscious of time and in closing I want to reiterate Scottish Labour's support for a real choice for mothers to breastfeed. We support the legislation in place in Scotland and the schemes aimed at ensuring breastfeeding is embedded in our communities and businesses across Scotland. We hope that the Scottish Government will address the issues raised in today's debate to make breastfeeding a reality for all the mothers and babies who wish to breastfeed and would benefit greatly from it. I am grateful for the opportunity to speak to the Liberal Democrats in this important debate and I thank Jenny Minto for securing chamber of time for it. We have come a long way in this country in terms of our approach to breastfeeding, which was laid out in the 2005 act. That legislation represented a step change in our attitude and society's attitudes to breastfeeding, which until then I think were still shrouded in stigma and at times regressive. Even after that legislation, I was brought up personally against that stigma when my wife and I went to a bar with our newborn son Finn some 15 years ago, so a couple of years after the act was passed or a little bit later even still. We rang up the bar and asked if it was okay to bring a child in. We were going to be having some food with friends. They said that children were welcome until 8.30. That was until Jill started to breastfeed Finn and we were made so uncomfortable that a member of staff suggested that the advice that we had been given was wrong and that we had to leave. We phoned out the bar again later and we advised that there was nothing wrong with the advice that was given originally and we could see that we just made waiting staff feel uncomfortable. Breastfeeding has an important role to play in children's health outcomes. We know for instance that it helps to protect children from a range of infections and illnesses such as asthma, diabetes, obesity and heart disease. We also know that there is a role to play in protecting mothers too from ovarian cancer and from breast cancer. There are all the added financial advantages to families who can save on the cost of formula. We should be proud of the distance that we have travelled in this country. It's a point of pride that we were the first country to legally protect breastfeeding in that legislation back in 2005, taken through Parliament by Elaine Smith of Labour and backed by Liberal Democrat Labour Coalition votes behind her. That act made it a criminal offence to deliberately prevent or to stop someone from feeding a child under the age of two in a public place in Scotland. Although we have come that distance, there is still work to be done to ensure that every mother has the support that they need to make the best and most informed choice for themselves and for their baby. A recent infant feeding survey found that 65 per cent of babies born in Scotland were breastfed for at least some time after birth and 46 per cent of babies still being breastfed after the six to eight week mark. But what is notable about this survey is that those mothers living in more affluent areas were more likely to breastfeed than those in deprived areas. This is a health inequality. There is also a disparity when you look at how health boards are performing when it comes to supporting those mothers to breastfeed. Government must give health boards the support that they need to close the gaps, with a particular emphasis on those less affluent areas. We can't have a postcode lottery when it comes to giving children the best start in life. It is also very important to say that that decision whether to breastfeed is of course always solely the mothers. Women must be given all the information that they can about the benefits of breastfeeding and provided with all of the advice and in person support if needs be to help them to actually breastfeed if they so choose, but that support must always be support and never ever pressure. Having a child is a life changing event. For many people sadly that change is not as straightforward as they had assumed it might be or we would wish it for them. Postpartum is a very vulnerable time for new mothers and some women find it more challenging than others to feed their baby. Breastfeeding can also become more difficult because of infection or mastitis. It is vital therefore that when people talk about the benefits of breastfeeding we do so in a way that does not stigmatise any mother who is unable to breastfeed or chooses not to. There are cultural aspects to this as well. It is also vital that any mother who struggles with postnatal depression is given all the support and care that they need to cope. It is deeply concerning that only 14 per cent of Scottish health boards met a UK-wide standard devised by the Royal College of Psychiatrists for specialist perinatal mental health support. Scottish Liberal Democrats were proud to be the first party in this Parliament to set out a comprehensive and dedicated strategy for improving detection and treatment of maternal mental health issues, bolstering our perinatal mental health offer. It was gratifying when the Government adopted much of that blueprint. However, despite the good work that has been done in this area and the good progress that has been made, there sadly continues to be that postcode lottery for perinatal mental health. Women across Scotland cannot afford the Government resting on its laurels on their issue. Protecting mothers and giving newborn babies the best possible start in life has to be an absolute priority for everyone in this chamber, not just for the Government but for this entire Parliament. We now move to the open debate. I call for Stephanie Callaghan to be followed by Rachel Hamilton around six minutes. I am delighted to speak in today's Scottish Government debate, celebrating and supporting breastfeeding in Scotland. Breast milk is the perfect source of nutrition for babies. I am lucky enough to have fed three babies myself too. We will hear and watch about the health benefits today. Back in the middle ages, breast milk was deemed to possess magical qualities, and I would argue that they weren't far from the truth. Today's motion rightly welcomes the rise in Scotland's breastfeeding rates, and the Scottish Government's 9 million targeted investment, including support from infant-feeding teams and family nurse partnerships, is beginning to close the stark inequalities that exist for some groups. However, we need much, much more than that. We need a radical shift in thinking and in actions. Ambition is key, and looking to the long term, we should be aiming to double the current breastfeeding rate, 94 per cent instead of 47 per cent of babies breastfeeding at 68 weeks old. We should be looking for creative ways to inspire many more young women to successfully nurture their babies for the first six months of life with breast milk only, as recommended by the World Health Organization. We must do more to tackle social attitudes towards breastfeeding mums of all ages, recognising that women's breasts are first and foremost for nurturing children. That's a huge challenge, but it should absolutely be our ambition, because current breastfeeding rates in other countries demonstrate that it's entirely possible, as we've heard already today. The Scottish Government has a commendable history of investing in children's wellbeing from the Scottish child payment to prenatal care and 1140 hours of early years education. The baby box initiative is also noteworthy, and I hope to hear more detail about its role in normalising breastfeeding from the minister today. Not too long ago, Presiding Officer, yes, certainly. Rachael Hamilton. I note with interest reference to the baby box. I just wondered what was in the baby box that supported women to breastfeed. Stephanie Callaghan. I thank the member for that intervention. What I'm asking is that I hope to hear the detail on that. I had asked a parliamentary question before and she's confirmed that that would be the case. Not too long ago, Presiding Officer, most of our grannies embraced breastfeeding, but the huge surge in popularity of modern formula sadly brought a significant shift in infant feeding practices. The decline in breastfeeding resulted in a profound loss of knowledge that had previously been shared across families and communities. In a very short time indeed, that network of support that so many mothers relied on for breastfeeding success just disappeared. While acknowledging the role of artificial formula milk, it should not be normalised as convenient, like-for-like alternative to breastfeeding because it isn't. Presiding Officer, beyond the well-established nutritional and physical health benefits of breastfeeding, there is a grown body of research highlighting its far-reaching psychological effects. For example, breast milk stimulates cognitive, social and emotional brain development in our babies and children, advantages that last a lifetime, and the benefits are not confined to our children. Breastfeeding mothers often report lower levels of anxiety and stress, and clinical evidence backs that up. However, there are some qualities that make breastfeeding really magical. There is the very first feed after birth that is rightly hailed as a baby's first vaccination, an injection of immunisation from the mum. Breast milk adapts when mum or child is sick, providing specific antibodies to combat that illness. In morning breast milk, there is a rising cortisol that acts like an energy drink to wake you up, and in the evening melatonin rises and acts as a sleeping potion, helping to develop a baby's curcadian rhythm. Best of all, when mum's breastfeed, the love hormone oxytocin is released, inducing a strong sense of love, calm and connectedness between mums and babies. I know from my work as a breastfeeding peer support volunteer that many mums look forward to making that magical breastfeeding connection with their baby. While a tiny number of mums cannot physically breastfeed, many mums feel it they feel. Most often, that stems from a lack of intensive support in the crucial early hours, days and weeks post-birth. Until we rebuild our multi-generational network of family and community knowledge, mums will still require the assistance of health professionals and volunteers to overcome challenges that low milk supply, mastitis and latching issues. I thank Stephanie Callaghan for giving way and a commender for the work that she has done in relation to the area. It is on health visitors because, in my own experience, my daughter Charlotte has not had all of her health visits because they are so understaffed that they are not able to fulfil all the milestones within a baby's journey. Does she find that concerning? What can we do to try and get more people to become health visitors to make sure that we have the support to make mums breastfeed? I thank the member for her intervention. I think that it has gone off the speech a little bit there, but certainly it is something that I know we definitely need to work really, really hard at doing. Not every mum will succeed at breastfeeding and there is no need for guilt because our best is always going to be good enough. Social acceptance is also key, feeling that it is okay to feed your baby wherever and whenever they are hungry. At urgent employers to play their part by joining the breastfeeding friendly Scotland scheme, it is really quick and easy to become a supportive space for feeding mums. Breastfeeding groups are really vital too, providing a safe environment where mums can observe other speeds and swap tips and suitable codes for covering up during feeding because let's face it, no mum wants their post pregnancy belly on show. Witnessing the progress of mums who are struggling to feed one week but thriving the next also is a big boost to confidence. It can be much easier to share your challenges really honestly with volunteers or other mums than it is sometimes with busy health professionals. I could talk about breastfeeding all day and much of my passion comes from personal experience, but it is also about the mountains of irrefutable evidence that breastfeeding gives our babies and children the very best start in life, and that is certainly worth celebrating and supporting. I'll finish with the words Keith Hansen used in his contribution to the Lancet breastfeeding series that encapsulate the extensive health, nutritional and emotional benefits that breastfeeding provides for children, mothers and for wider society. He said, if breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel prize in medicine and economics. Thank you very much Ms Callaghan. Just a reminder, we've got a bit of time in hand so anybody taking interventions should get the time back. I now call Rachel Hamilton to be followed by Karen Adam around six minutes. Thank you Presiding Officer. Today's debate focuses on the important topic of breastfeeding and speeches from colleagues across the chamber have recognised this and also shared their vital personal experience. I thought that was a very good speech that we've just heard and I want to also bring my own personal experience to this because bringing life into the world is one of the greatest experiences and a joy. I feel very lucky to have done so. It's a very exciting time, but it also can bring, as others have recognised, a whole host of challenges for many mothers, which includes breastfeeding. I breastfed, as I said earlier, three of my children and that did have its ups and downs and I lurched from euphoria to exasperation. I put a lot of pressure on myself, I felt judged, I felt the stigma, as some have described, of feeding in public. I worried all the time that my baby was hungry or I worried that they had had too much. I also had mastitis and very large refrigerated cabbage leaves became my best friends. I felt very awkward. The Presiding Officer doesn't understand this, ladies. He's frowning. It's very useful. You buy a giant cabbage, Presiding Officer, you put it in the fridge and you peel one by one the leaves and then I can only leave it to your imagination what you do with those leaves, Presiding Officer. I struggled with the basics of latching on the breastfeeding itself. Some midwives were helpful, some health visitors were helpful and some were not. To succeed at breastfeeding, mothers must also look after themselves. I think some of us have slightly forgot to talk about the health of the mother as well today, nutritionally, emotionally and enable the mother to get plenty of rest, but that's of course sometimes not a reality. By the time I had cracked breastfeeding and there were a lot of cracks, I had to return to work when you'll never believe it my eldest was 12 weeks old and my middle daughter was 14 weeks old. By the time I got to grips, yes. I'm very grateful to Rachel Hamilton for taking my intervention. I'm loath to interrupt her speech. I'm enjoying it very much and it is bringing back some degree of nostalgia to our early days of parenthood. I recall being taught to help my wife to achieve the latch that she describes. Does she recognise that fathers can actually be part of the breastfeeding journey and can support their wives more than just in moral ways but also sometimes technical ways as well? I totally agree that there's a paternal support that has to be recognised and can be encouraged and an awareness of that today hopefully will filter out of this chamber. My husband wasn't helpful, he was very good at making a nice cup of tea at about five in the morning. As I said, my eldest daughter was 12 weeks when I went back to work, my middle daughter was 14 weeks when I went back to work and I just couldn't believe it because I had requested part-time hours. I am digressing slightly here but I was told that I wasn't allowed to have part-time hours because if I had part-time hours the men in the organisation which represented about 95% of the organisation would also have to have part-time hours. As far as I knew at the time, I didn't notice that any of my male colleagues were breastfeeding. Thankfully, the Government has updated employment conditions for maternity leave and improved that flexibility. As part of that whole health aspect for women who are bringing up children and breastfeeding, that is a really important aspect. Moving on to my third daughter, a few days after giving birth to my youngest, I became really unwell and eventually after six weeks I was diagnosed with a very painful condition called rheumatoid arthritis, which I have talked about in this chamber before. However, it meant that I had to get help from my parents, I actually had to move in with my parents and they had to help me pick up Willa, help me to not breastfeed but pick up the baby so that she was in position for breastfeeding and all the other things that go along with having a newborn. That reminded me of that experience, especially preparing for this speech. If you think about it, the challenges that I faced perhaps were similar to being a single mother or having a disability, having an illness as I did, having a caesarian with no help at all, having twins or triplets. It's almost impossible to look after yourself without support, it's impossible to eat well and to sleep well and therefore then impossible to give breastfeeding your really best go. Why did I choose breastfeeding? Well, it's possibly the same reasons that others have chosen breastfeeding, but the question remains why one in three babies in Scotland are not breastfed at all. Despite it being free and convenient, which was attractive to me, it has huge health benefits, as has been mentioned before by my colleagues. There is a vast disparity between breastfeeding rates in the most affluent and deprived areas. The minister mentioned that breastfeeding rates have been climbing in Scotland, but it's vital to understand why they are not higher and the levers that we have to act to change that where possible is important in the action points that I hope the minister will take away today. We need to ask what is preventing women from breastfeeding other than the basic things that I have highlighted during this speech. We should also note for many women that it is difficult, it's an emotionally taxing experience and has highlighted it's not easy for everyone. My own experiences, as I said, were mixed with the midwives and the health visitors, but of course most of them, they work round the clock, they're fantastic, they're very supportive, they do an incredible job and their support and advice and encouragement is something that can make all the difference. I think that the minister will recognise that she would be the first to admit that there is more work to be done, but it is the grassroots organisations that are pulling out the stops to support women breastfeeding. Yesterday I visited Berwickshire Swap, it's a team led by Leanne Drummond in iMouth at their industrial unit and they run a sustainable children's clothes swapping charity across the borders and they respond to families in need with emergency clothing parcels. The organiser, Leanne, told me that at all the swap events they have a quiet area where women can breastfeed, which is fantastic and also helps them with social isolation and they can chat with each other about some of the problems and issues that they may be having and of course it's a very natural thing to do so why shouldn't they? Breastfeeding in the Borders is also another incredibly important support service that has 30 volunteers and that was the intervention that I was going to make to you minister was around not just the people that you highlighted in your speech that are paid individuals but the people who are doing this off their own back and there's many across all of our constituencies and regions and we should give credit to those. But Julie from their breastfeeding in the Borders told me yesterday that in 2022 they helped 344 women with one-to-one support, which I think is fantastic and the local mums said things like this and I quote, It's such a valuable resource. You are amazing, keep doing what you are doing and it's an incredibly supportive service so well done to Julie and breastfeeding in the Borders. We clearly need more public acceptance as others have spoken about of breastfeeding and in 2017 the Scottish maternal and infant survey, nearly a quarter of women said they felt uncomfortable about breastfeeding in public. Do you want me to close? I think you need to be concluding. We all know the benefits and I just think that in conclusion it's vital that everybody, not just women or mothers, celebrates and supports breastfeeding in Scotland. Thank you, Ms Hamilton, particularly the personal tutorial elements of your contribution. I now call Karen Adam to be followed by Claire Baker around six minutes. Thank you, Presiding Officer. I'm having flashbacks with smells of sour milk and cabbage now. Thank you, Rachel Hamilton. I'm actually delighted to take part in a debate on a subject which is very close to my heart to, no pun intended. I'm speaking today as an MSP of course but I'm also talking as a mother who breastfed six children in very different circumstances and each experience was unique. While I say that I did love it, it was sometimes fraught with significant challenges and painful at that. Before I begin, I want to emphasise the utmost respect for the varied choices and circumstances of all parents. Some face medical, physical or personal choices that make breastfeeding difficult or impossible. It's vital to remember that the ultimate goal is the health and wellbeing of the child and fed is best. It's a principle that we must all embrace, whether through breastfeeding, formula feeding or a combination of both. What matters most is that children are nourished, loved and cared for. In Scotland we must strive to create an inclusive society where everyone feels supportive irrespective of feeding choices. In reflecting on my own journey I can't help but recognise how each different experience of postpartum motherhood has been for me, particularly my first time as a mother aged 16 in 1991 and my last in 2011 at the age of 36. Now the societal landscape around breastfeeding and maternal support underwent a significant transformation over these two decades but so did I as an individual. As a young mother at 16 navigating the challenges of breastfeeding was daunting, the support and messaging around breastfeeding was different then and as a young person advocating for myself in the face of these challenges was not always easy. I was more vulnerable, less informed and heavily reliant on the support systems around me and this is a reality for many first time mothers, especially those in non-supportive environments. The role of professional support in these formative stages cannot be overstated. This experience starkly contrasts with my journey at age 36 where I found myself more confident and assertive. The societal messaging around breastfeeding had evolved and so had the support structures but more importantly I had evolved. I was better equipped both emotionally and intellectually to advocate for my needs and those of my child. Each of my child's needs were different and my body also responded differently each time from feeding for three months and going up to as long as two years with another. What stood out was the incredible support that I received from midwives and health visitors and those in my circle. Stephanie Callaghan, I thank the member for taking that intervention. I am wondering your baby that you fed for three months, did you find it quite a bit of a nightmare afterwards having to wash bottles and sterilise bottles and heat up milk and mix bottles because I know I certainly found that incredibly difficult and would never have given up had I realised. I thank the member for that intervention and I will go on to talk about why it ended a bit early but absolutely one of the perks of breastfeeding is the convenience of it and particularly the cost of it as well. I would say that the guidance from those professionals and my circle around me in the encouragement and the expertise that they gave me was vital and they didn't just help me feed, they helped me believe in my ability to nourish and nurture. That is vital as I can attest that unfortunately the negative perceptions and a lack of understanding from those around me in one particular time of my life coupled with my vulnerable postpartum state led to a premature end to one of my breastfeeding journeys and I was disappointed with that and it just shows how far support can really take you. Those contrast and experiences highlight an essential aspect of our discussion today, the varied needs of mothers at different stages of their lives. It underscores the importance of tailored support, recognising that a one-size-fits-all approach does not suffice and every mother's journey is unique. Our support systems must be flexible and responsive to those varied needs. As we delve deeper into the subject of breastfeeding in Scotland, it is crucial to acknowledge and celebrate the Scottish Government's commendable efforts and achievements in this area. The Scottish Government has not only recognised the importance of breastfeeding but has also taken concrete actions to support it across the nation. One of the most notable achievements is the significant investment in breastfeeding initiatives with an investment of over 9 million. The Scottish Government has shown a strong commitment to enhancing breastfeeding support services and this funding has been instrumental in increasing breastfeeding rates and reducing inequalities in breastfeeding across Scotland, reflecting a dedicated effort to ensure that all children, regardless of their background, have the best start in life. Furthermore, the Government's endorsement and integration of the UNICEF UK baby friendly initiative in maternal, neonatal and community settings has been game changing. By embedding this initiative in the NHS and in core nursing and maternity education curricula, Scotland has taken a comprehensive approach to improving the quality of care for mothers and babies. This initiative not only promotes breastfeeding but also supports mothers in developing a strong bond with their babies, which is crucial for the overall wellbeing of both mother and child. In addition to those initiatives, the Scottish Government has actively worked towards creating a supportive environment for breastfeeding mothers in public spaces. The national breastfeeding friendly Scotland scheme is a testament to this effort, encouraging businesses and public spaces to welcome and support breastfeeding mothers. The initiative is a significant step in normalising breastfeeding in public and making society more inclusive and supportive of mothers' choices. To note that supporting breastfeeding in public is vital, but also calling for rooms where breastfeeding can be done in private as to a mother's choice, I spoke to my daughter last night, my first child, who I had the honour and joy of seeing breastfeeding my two granddaughters, our own two children. Her thoughts on the debate today and she said that ultimately it was about support and choice and while it is great to encourage breastfeeding in public, many women want to feed completely topless. Some have fussy feeders who wriggle, roll around and make a mess, which find quite difficult to navigate in a public setting and therefore they do prefer a place that is in private, so to have that option is essential. In closing, I would like to express my gratitude to the Scottish Government for its support and commitment to breastfeeding, because I personally know how important it is. Those efforts have not only made a significant difference in the lives of countless mothers and children, but I have also positioned Scotland as a leader in promoting and supporting breastfeeding. I am grateful for the opportunity to speak in this afternoon's debate. Breastfeeding can be an emotive subject, and while we are celebrating the benefits and the importance of encouraging breastfeeding, we also recognise that every child's feeding journey is different. A number of factors will impact on a decision or ability to breastfeed, and our role as parliamentarians and policy makers is to ensure that those who want to are supported as well as they can be. The decision to exclusively breastfeed or to mixfeed or to formula feed is not one that we should question on an individual basis, but what we must do is provide a supportive, encouraging and enabling environment for every woman who wants to breastfeed. We should ensure that every public space is a welcome environment. Elaine Smith's member's bill has already been highlighted this afternoon that it gave women the right to breastfeed in public spaces without challenge. It was a groundbreaking piece of legislation that challenged public attitudes and provided protection for breastfeeding women, but we can do more to ensure that the environment is supportive. While we welcome the overall increase in breastfeeding rates and recognise the related health benefits for both children and mothers, we must also note that, for Scotland and the UK, breastfeeding rates are comparatively low. In recent years, we have seen positive steps being taken in addressing public attitudes and in the provision of information and support, but there is still much more that we can do in addressing the differences in rates that persist across age, location, ethnicity and social economic background. There are strong generational and peer group pressures on mothers when they are making decisions about how to feed their baby. The PHS report on infant feeding statistics from November last year shows an increase in breastfeeding among younger age groups, which is really positive, yet the gradient across age groups persists, and in 2022-23 mothers aged over 40 were more than three times more likely to breastfeed than mothers aged under 20. Babies born to mothers in more affluent areas are still much more likely to be breastfed than those in the most deprived areas. We need to ensure that expectant mothers have access to information and help that they need to make a decision on breastfeeding. We need support groups available in familiar community settings and we need to see better co-ordinated and comprehensive provision that is clearly communicated from an early stage. A finding from the UNICEF report becoming breastfeeding friendly, which was about Scotland, found that this was something that really did need to be improved. The third sector and voluntary organisations play a vital role in this area, but it is the role of health professionals to signpost and support women. We cannot wait until mothers are at a point of struggling to breastfeed before they know what help is available to them. Being a new parent can be exceptionally difficult, and while feeding is a personal journey, it is not one in which mothers should ever be left feeling alone or unsupported with. We have seen an increase in rates across all health boards from 2012-2013, but geographical inequalities have also increased during that time. Those rates are impacted by a range of factors, including age, level of deprivation and ethnic diversity, as well as attitudes that are within the local community. However, they highlight the importance of delivering local support that recognises those factors. Looking at NHS Fife's annual report on children and young people for 2023, the rate of breastfeeding at the six and eight-week mark has increased in the last 10 years to 41.9 per cent. It is still below the overall rate for Scotland, and there continues to be a sharp drop in the number of women who start breastfeeding to those who continue to do so at six to eight weeks. I am keen to hear more from the minister about how more localised and targeted steps could be taken to focus support to the areas where rates remain low and in helping to reduce the number of women who stopped breastfeeding earlier than they would be wished to. If we are to get any closer to the WHO recommendations for exclusive breastfeeding until six months, we must not only increase initial rates but address the drop-off. That needs to begin as early as possible. Research has also shown that decisions around infant feeding tend to be made prior to pregnancy or in the first trimester, underlining the importance of public information and attitudes and the impact that that has on those decisions. When it comes to home visits for newborns, having support available for feeding must be provided for at that stage. Scottish Labour has called for a home visit by a breastfeeding support worker within the first week a baby spends at home, as well as further consultation to ensure that their needs are met. An amendment today highlights reports of visits being reduced as a result of staffing pressures, which will be covered by other colleagues in their contributions, but we have to ensure that all families are able to access the health visiting pathway. While the Government motion highlights a role for breastfeeding in supporting the economy, the SPICE briefings notes additional cost of formula feed. We also need to recognise that there are economic challenges related to breastfeeding. A US article published last year titled No such thing as a free lunch looked at the direct marginal cost of breastfeeding, including equipment, modified nutritional intake and time opportunity for breastfeeding mothers. A breastfeeding mother needs to be a well nourished mother and needs access to simple things, often things like bras and clothing that enable breastfeeding and this can be out of reach for some mothers. It found in comparison to a year's supply of formula, breastfeeding for a year could cost significantly more. The time opportunity costs for breastfeeding of three to four hours per day may be prohibitively high, particularly for those in a lower income or those with other caring responsibilities. A need to be part of our approach to ensuring that breastfeeding remains a viable option for those who wish to do so. While we are focused today on the importance of encouraging and celebrating breastfeeding, I would like to briefly touch on increasing costs related to formula feeding and the risk to the health and safety of babies and recognise that the minister did also raise that. There are a number of reasons why mothers choose formula milk and this will include mothers who breastfeed or have breastfed. We need to ensure that there is an affordable and consistent supply of infant formula. The UK Government has a role in strengthening law around marketing and both our Governments need to ensure the level of support provided through schemes like best start, keep pace with inflation and increasing costs so that infant formulas are affordable within the allowance. In times of financial difficulty, babies being fed infant formula can be increasingly vulnerable and it is vital that services work to ensure timely and sensitive support is provided. I am just about to close, but I will take it. I thank the member for giving way. Does she welcome the efforts recently by some supermarkets to lower the pricing of formulas to make it more affordable for families that are experiencing a tough time just now because of the cost of living crisis? I very much do though, it is a bit overdue and there are still families who cannot afford to purchase. I was visiting the Big Who project in Loggelly last week that has a partnership with Amazon and one of the biggest demands they have on supply is for infant formula and infant and baby essentials. Encouraging and supporting breastfeeding is an important public health activity and one that we must continue to work at. There is much more that we can do to ensure that support is available more readily, more locally and at an earlier stage. By delivering that alongside improvements in public attitudes, in creating feeding-friendly places and by having supportive employment practices, we can create an environment that can help more women begin and continue their breastfeeding journey with their baby. I thank the member for giving way. Approximately 20 years ago, a young or I should say younger me was a trainee social worker attended appearance group setting with my practice teacher then. When I returned from it, I was apologised to for the fact that one of the mothers had been breastfeeding during the session. If I am being absolutely honest, I have not even noticed, but I did start to reflect on that experience and the fact that I can still remember it now probably tells you something. In my early 20s at the time, I had not even thought of breastfeeding as a thing and that is probably why I had not noticed it. But why also had I been apologised to for potentially making me uncomfortable? It is clear that at least at this time there was still a stigma and breastfeeding was likely taking place in non-public settings. As that motion from the Government states, we must therefore celebrate progress where it happens. This afternoon's topic of debate is an opportunity to celebrate and continue to support positive trends that have been seen with breastfeeding rates across Scotland. I think that it is important, like Carol Mawkin, Claire Baker and others that I pay tribute to my former colleague and, indeed, constituency predecessor Elaine Smith for her great work in this area. Breastfeeding is a multifaceted topic that touches on issues such as health and wellbeing, public education and, of course, poverty and inequalities in Scotland today. First and foremost, breastfeeding is undoubtedly the best method of ensuring newborns are nourished, as well as providing the healthiest foundation for a child's short and long-term wellbeing. The NHS currently recommends that babies should be exclusively breastfed for the first 26 weeks of their lives. In studies that indicate that breastfeeding helps to reduce a baby's risk of infections, diarrhea, vomiting, obesity and even cardiovascular disease in adulthood. Likewise, for mothers, there is increasing evidence that breastfeeding can lower risk of various diseases. For those reasons, it is self-evident that improving the breastfeeding rates in Scotland would also improve the health of babies and their mothers, which would in turn reduce health inequalities. The data is promising, as others have said, just over 20 years ago, probably around about the time that I just referenced, 44 per cent of babies were being breastfed by 14 days old. That increased to 53 per cent in 2019, and most recent post-pandemic figures now show this rate to be 57 per cent. By six to eight weeks, this figure stands at 47 per cent. While those stats are encouraging, as is the highest figure in record, more can be done to continue this upward trend. I fully support the Scottish Government's decision to invest over £9 million of funding to support breastfeeding since 2018. That funding has helped to provide sustainability for protection, promotion and support for breastfeeding in Scotland. The Scottish Government, though, cannot work in a vacuum, as we have heard today, and relies on the knowledgeable and valued experience of those healthcare practitioners in third sector groups and peer support bodies, who help to identify on-going issues and best practice to increase these rates. Bob Doris. Fulton MacGregor, for giving away. I am just reflecting on my own experiences as a dad of partners in general. I have heard the testimony of Karen Adam and others in the chamber. If partners—there is a partner—need to be educated in the stress, tension, expectations, judgments, stigma and everything else that goes with a new mum that we can never know. If we are an active partner, we very quickly see the consequences of that and perhaps anti-natal classes. I was fortunate, Presiding Officer. I had an NCT and an anti-natal class where myself and my partner attended, with other couples and perhaps a more active role for fathers. Are any partners where appropriate ahead of birth, but in the weeks after birth will be vital in giving the support that mums really deserve in merit? Fulton MacGregor, I will give you the time back. I thank the member for that intervention. I couldn't agree more with him in his, he knows. The cross-party group in Shared Parington often looks at these sort of issues and I know that he's very active in that group in that area as well, so thank you. It is the goal of the Scottish Parliament and indeed I hope across all parties in the chamber and I haven't heard anything today that suggests otherwise that Scotland should be a breastfeeding friendly place for all. Although the trends are positive, the data shows inequalities which must be a point of focus for future supports. Breastfeeding rates are highest amongst older mothers from less deprived areas, therefore we must encourage higher breastfeeding rates for younger mothers from the most deprived areas. At this point I must give particular credit to the infant feeding teams across all the health boards. Their diligent work ensures that mothers are offered help with positioning and attachment with breastfeeding which empowers mothers with the contents to breastfeeding. I think that Stephanie Callhan, for example, has given a very powerful speech today about what that support can mean. A special mention must also be given to those who work with the family nurse partnership whose home visiting programme helps educate first-time young mums on how to improve their child's health and development. It is these schemes that must be supported and invested in as they have been proven to increase breastfeeding rates for the cohorts that need it most. I feel here in Scotland that we must do more to normalised breastfeeding. For example, business owners who sign up to the breastfeeding scheme are making a positive contribution to the health and wellbeing of Scotland's families and children as well as making new mothers feel welcome and accepted. The more businesses that sign up to the scheme, the more normalised breastfeeding will become, with any perceived stigma, evaporating over time. At no time, hopefully this continues, should anybody be apologised to for somebody breastfeeding. I have already spoken about how those from more deprived backgrounds have lower reported rates of breastfeeding. This issue is, of course, exasperated by the on-going cost-of-living crisis, which further jeopardises the already-at-risk group. The increase of food prices has a knock-on effect of impacting the diets of those living in more deprived areas. I think that it is only right, as others have done, that in this debate we recognise the shocking cost of formula. I know that food banks and charities, in my constituency of Co-Bridge and Christ, have helped families with this particular cost-of-living. This is something that really needs to change. I am looking off that all three were breastfed for a period of time by the superstar of a mum. She is a superstar not just because of her breastfeeding but just in general. In all different lengths of time, it is right to acknowledge that there is no right amount of time in every child and situation that is different. I want to make mention of what I think is an important point that others have mentioned or touched on. We absolutely must end the stigma around breastfeeding, but we must not go too far the other way. A woman must never feel ashamed or belittled for no breastfeeding. The decisions of her mother and her family are extremely complex. I am at that age where, over the past ten years, I have started a family and so many folk in my social circle have too. Some have decided to breastfeed and some have not. To be frankly honest, it is not my business or MD's business why they have not and both are okay. I am beginning to hear more and more that mothers are feeling guilty for not breastfeeding or not doing it for long enough. That is not on either. I know that the minister will agree and did touch on it. We must always send the message that parents love their child and are doing the best for them at all times. I thank Stephanie Callaghan again as well as Karen Adam made to this point. Supporting and informing yes, but respecting the mother's decision and uniqueness of the situation is also important. We do not want to be here in ten years celebrating 70 or even 90 per cent breastfeeding rates but having to highlight that those not doing so are feeling persecuted in some way or another. In conclusion, continued investment in engagement stakeholders has seen promising increases in the rates of breastfeeding in Scotland. We have more to do and support the mother and the family and investing in our health services is the key to achieving the same. Many have mentioned as well as several policies and initiatives aimed at creating a supportive environment for nursing mothers has helped to make progress. All efforts are a commendable step forward towards a healthier and accepting environment for breastfeeding mothers. They also make up a strong legislative framework to protect these mothers and their infants across a broad range of public spaces and serve to encourage the practice across our country. I also want to take this opportunity to mention the incredible work that health boards and third sector partners are carrying out across the country. In central Scotland we have seen initiatives such as the breastfeeding network fourth valley and breastfeeding groups across NHS Lanarkshire which offer an incredible range of support to mothers and their infants. Several groups run weekly and offer the opportunity for mums and their babies to get advice on breastfeeding and share their concerns with experts and each other. There is no doubt that those are all significant steps towards supporting breastfeeding practices but there is still work to be done, especially to overcome the barriers that remain in place. We cannot talk about breastfeeding without addressing the fact that infant feeding differences are strongly tied to a mother's socio-economic status. Wealth disparities affect how long a mother can continue to breastfeed. Factor such as poverty, food scarcity and income insecurity are all important challenges to breastfeeding. Therefore we must also tackle the social determinants of health alongside the legal protections that have been put in place. Supporting these mothers and acknowledging the barriers that they face is key to addressing the gaps in breastfeeding practices and its uptake across our country. For many returning to work is a time where breastfeeding stops or is supplemented with formula due to practical issues such as shift times, storing breast milk safely or even being able to pump while at work. The practical challenges will be markedly different if you are working in an office environment with supportive colleagues to working in a public facing role or manual role where even wearing a pump may be difficult. As I said previously, we have made great strides in what we want to see and I am sure that there are some phenomenal workplaces who do support women to breastfeed but those practicalities are one of the issues that we need to overcome. I am very pleased that it is the Minister for Public Health leading this debate but there is a lot of work that needs to be done in some of our colleagues' portfolios to ensure that we can make the next strides forward. Mothers, as many others have said, should be supported, not shamed, regardless of how they choose to feed their babies. We must acknowledge that breastfeeding is a personal choice and whilst promoting the benefits of breastfeeding, we must also respect and support those who, for various reasons, cannot breastfeed. Every mother's journey is unique and creating an environment of understanding and acceptance is crucial in dispelling judgment and fostering inclusivity. For some, there are physical, emotional and practical reasons why breastfeeding is just not for them and their baby and we need to ensure that in our pursuit of higher rates of breastfeeding and better experiences of breastfeeding that we don't stigmatise those who can't. We need to make sure that the most important thing is good growth and nutrition for a baby. Even though we have come a long way, several of the barriers to breastfeeding are also rooted in stigma and societal attitudes. Even in spaces where breastfeeding is encouraged, many mothers continue to feel uneasy breastfeeding in public as they fear conflict or judgment from strangers. The fear is not always felt evenly with mothers who are younger, experiencing poverty or are from marginalised communities, often reporting increased surveillance and stigma. This is why several women routinely choose not to breastfeed outside of the home and for those who do, the experience is often uncomfortable. Many times the legal protections for breastfeeding in public are present but are not always widely respected. It is crucial that we empower mothers with the knowledge that they need to make decisions based on their individual circumstances free from judgment. One key aspect of this is the need to dispel myths surrounding breastfeeding as misinformation often contributes to unnecessary anxiety and deters some mothers from choosing to breastfeed. By promoting accurate and accessible information, we can empower women to make decisions that align with their personal circumstances and work towards countering the stigma and changing many of the attitudes that weigh down on mothers. We must also work harder to tackle the socio-economic barriers that make breastfeeding impossible for some. It is important to point out that safe breast milk infant formula prepared correctly with safe water or a combination of both are fine choices for full-term infants. For meaningful interventions that lead to positive outcomes for infants, we need to see support around logistical needs for disadvantaged families as privilege and better health outcomes go hand in hand. The debate around celebrating and supporting breastfeeding in Scotland is an opportunity for us to unite in our efforts to support families and their newborns. We commend the progress that has been made, but we also recognise the need for continued advocacy, education and targeted measures to deal with the socio-economic barriers that burden many mothers across Scotland. By promoting informed decision making, dispelling myths and addressing the stigma surrounding breastfeeding, we can work together to create a society where mothers feel empowered and supported in their choices. However, we must always approach this discussion with empathy and a shared commitment to value and support each family's distinct journey. Thank you, Ms Mackayne. I now call Clare Haughey to be followed by Megan Gallagher around six minutes. Thank you, Presiding Officer, and I refer members to my register of interests in that I hold a bank nurse contract with Greater Glasgow and Clyde NHS Board. Every child should get the best nutritional start in life, and families should be able to make fully informed choices on how they feed their baby. During today's debate, we have understandably been encouraging women to breastfeed, and we have discussed a range of policy initiatives to drive up breastfeeding rates. However, I want to put on record, as some of my colleagues have, that we should be mindful that some women find breastfeeding challenging, or they cannot breastfeed even if they want to. For some women, it is contraindicated to breastfeed due to the medication that is prescribed for a variety of physical and mental illnesses. I know in my own experience of working over a decade in perinatal mental health, some of the most difficult conversations that I have had with mums about choosing medication for their illness or continuing breastfeeding have been really difficult ones, particularly where mums were very depressed and felt that breastfeeding was the only thing that they were doing right. However, no matter how you feed your baby, your midwife and health visitor are there to help parents with lots of good advice, and there is good advice online, including on the parentclub.scot website. That is, of course, in addition to the wealth of support that we have heard about in today's debate, from peer support and volunteers. Breastfeeding provides the best nutrition for babies and young children and supports children's health in the short and the longer term. According to the World Health Organization, protecting, promoting and supporting breastfeeding will save more lives of babies and children than any other single preventative intervention. Globally, exclusively and continued breastfeeding can prevent about 13 per cent of deaths among children under five years old. The strong evidence that breastfeeding reduces children's risk of gut, chest and ear infections and leads to a small but significant improvement in brain development and IQ. Breastfeeding also benefits mothers' health. It lowers the risk of developing breast cancer, particularly if you have your children when you are younger and the longer you breastfeed, the more the risk is reduced. A US study in 2019, which UNICEF cited on its website, found that, compared to never breastfeeding, breastfeeding your baby was associated with a 30 per cent reduction in epithelial ovarian cancer risk. In addition, there is some evidence that breastfeeding may also promote maternal healthy weight and reduce the risk of type 2 diabetes. As the Minister for Public Health and Women's Health's motion states, breastfeeding rates have risen in the past few years, something to be welcomed. Infant feeding statistics published in November 2023 found that two out of three babies born in Scotland in 2022-23 were breastfed for at least some time after their birth. Over the same time period, 57 per cent of babies were being breastfed at the age of 10 to 14 days. That has increased from 44 per cent in 2022-23. However, in the UK we have some of the lowest breastfeeding rates in the world, and while many new mums start breastfeeding, some will stop within a few months. That is often because they feel that there is a lack of support, particularly when they want to feed their baby outside of their home, or as mums may deem breastfeeding unnecessary because formula milk is seen as a close second best. There is therefore an understandable desire to increase breastfeeding rates through a number of interventions. Some of them have been mentioned in the debate today, including education, peer support or within the health service itself, and ensuring that there is the availability and quality of breastfeeding support for new mums. Part of ensuring that breastfeeding rates increase involves normalising it in our public spaces and influencing public attitudes to breastfeeding. The Scottish infant feeding survey in 2017 identified that mums understood that they could breastfeed in public areas. However, almost half lacked the confidence in doing so. The Scottish Government launched the breastfeeding friendly Scotland scheme, which is implemented locally by NHS boards, which aims to support families in a number of ways. The scheme helps to provide mums with positive experiences of breastfeeding when out and about, allowing them to feel confident and supported. It raises awareness of the Breastfeeding Scotland Act 2005, which many of my colleagues have referenced in their speeches today, and the Equality Act 2010, which protects mums feeding an infant in public places or establishments that allow children access. It ensures that organisations are aware of their responsibilities under this legislation. According to the online map showing breastfeeding friendly Scotland venues, I am proud to say that around 40 venues are available in my Rutherglen constituency that have signed up to the scheme, including schools, pubs, pharmacies, community and third sector facilities and shops. I was delighted to sign up to the scheme in 2020. Finding a place to feel comfortable breastfeeding your baby can often make parents, particularly new parents, feel anxious, and signing up to the scheme is a small but simple way to support them on their breastfeeding journey. I want to ensure that my constituency office is an inclusive space for all staff, for constituents and for visitors, so it is important that that extends to babies who are being breastfed as well. When I was children's minister, having Scotland's baby box as part of my portfolio was a highlight. In order to support parents with breastfeeding, the baby box contains nursing pads and information on breastfeeding. In 2021, Ipsos Moray undertook an evaluation to assess the impact of the baby box scheme in Scotland on its short and medium term outcomes. The study found that a quarter of parents felt that the box had helped to support breastfeeding, and 21 per cent said that it had informed them about it. Higher numbers of respondents were positive about the inclusion of the leaflet on breastfeeding, with 66 per cent stating that they found it very or fairly useful. A lot of thought and work goes into the items that are included in the baby box. The public health minister could liaise with the children's minister to see if there is scope to further help mum's breastfeed through the contents of the baby box. That is perhaps something that she could mention in her summing up. Positively, increases in breastfeeding over the past 10 years have been greatest among those groups with historically lower rates such as young women and those living in more deprived areas. That could be a sign that interventions are working, but we should not ease up. From the tone of today's debate, it is clear that we all share a commitment in giving children the best possible start in life. We can help to realise that by giving mothers the cross-sectoral support that they require in their early days of parenthood. I do not think that anyone can dispute the health and wellbeing benefits that breastfeeding provides not just for mother but for baby as well. I can also welcome the tone of today's debate because it is right that we celebrate the progress that has been made when it comes to encouraging mothers to breastfeed. There is also that acknowledgement that some mothers experience challenges when it comes to breastfeeding and some mothers cannot breastfeed at all. I think that we have struck the balance right today in terms of making sure that the messaging is clear. I come to the chamber today with two asks for the Scottish Government. One is to carefully consider messaging around stigma. That is stigma for both women who are breastfeeding in public but stigma as it has been pointed out by so many members today for mothers who cannot breastfeed. Of course, the support that mothers are meant to receive after their baby is born. The reason that I am asking those asks of the Government today is because some mothers struggle to breastfeed. That was certainly my experience as a new mother in 2022. I do not think that I will ever forget when I ended my breastfeeding journey how I was crippled with anxiety and I felt isolated. I just felt as though I was not able to provide for my baby. It was an awful time but I think that it is important to share that experience today because I want to be able to give mothers who have struggled a voice. To make sure that they do not feel alone because when it comes to debate surrounding breastfeeding it is all very upbeat and positive. There is that real undertone in terms of mothers who are struggling for very many reasons when they are trying to give the best possible start in life for their baby. If I may just pick up on my own experience because I was so excited to start my own breastfeeding journey. I had spent weeks and months on the run-up to Charlotte's birth and I had read as much information as I could. I had bought equipment and I was so ready to welcome my new addition to my family but it just was not meant to be. The reason that it was not meant to be was because I had a bit of a traumatic experience during the birth of my daughter. It was the fact that I had taken morphine during the birthing progress that Charlotte had been delivered. She was obviously very sleepy because she had absorbed some of the side effects from the medication that I had taken during labour. The latching and the initial breastfeeding was not as natural as it should have been. No-one had really explained that to me at the time going through labour, what the impacts of taking that medication would have been and of course the consequences of that for my baby. Had I had another option and if I would do it again, I would probably reconsider that for that purpose because it really, in my view, gave me a bit of a back start in terms of breastfeeding my own baby. It was not necessarily the labour and the birth of my child that stopped the breastfeeding for me. It was shortly after I was able to bring Charlotte home that there are many visits that you get from midwives and health visitors as well. It was a midwife who weighed Charlotte and had noticed that her weight had gone down. Again, I had not been informed before the birth that that is natural of your breastfeeding. It was the midwife who suggested to me that Charlotte could go on to combination feeding. That was not what I planned. It was not what I wanted for my own baby. It really put me in a position of what I do here. Do I still try in breastfeeding as the plan was or do I go on to this combination feeding as suggested by the midwife? We followed that path and it ended up that Charlotte just wanted to bottle feed. She was not much interested in the breastfeeding anymore. That unfortunately ended my own breastfeeding journey at four months. It certainly was not what I planned and it was not what I wanted. Of course, it was the option that was made available to me at that point in time. I know so many mothers that that has happened to me as well. Another issue that happened throughout my pregnancy and when Charlotte was born was the number of midwives and health visitors that I had encountered being introduced to. That had chopped and changed so many times. I ended up with three midwives and I am currently on my fourth health visitor. That does not allow new mothers to bond, gather that important relationship and be able to information share because you do need to build up that level of trust in order to share information and make sure that they are looking after you and that you are able to give them the best information so that they can help you to support your baby. I think that the overall outlook and this is why it is one of my ask today from the Minister in terms of support that mothers get once they have had their baby is that we look at the resource for midwives and we look at the resource for health visitors because I know that it is rife in Lanarkshire in the area from where I am but I know that that is replicated throughout so many different health boards across Scotland and it really does not give mother and baby the best start because you do not have that bond with someone that you trust. We really need to look at that in terms of the support that mothers receive once their baby is home and that they are now starting their new process as a new mother. That being said, I do not blame the incredible NHS workers because they do so much but, again, being understaffed, overworked, it really does add to the pressures that they face but it does not give you the best start when you are bringing your baby home. I know that I am over time, Presiding Officer, so I will conclude there. If we can, Minister, I think that we really need to listen to mothers, particularly mothers who are struggling to breastfeed but also we need to look at that process, the support that mothers receive as they bring their baby home, make sure that they have access to health visitors, a consistent health visitor, a consistent midwife to make sure that they get the best possible support so that they can provide for their baby. Thank you. Thank you, Ms Gallacher. I now call Emma Harper to be followed by Michael Marra. Ms Harper. Thank you, Presiding Officer. I welcome the opportunity to speak in this debate about the important progress that has been made in Scotland so that we can become a breast-freed and friendly nation. I have enjoyed the contribution so far this afternoon. Like Clare Hockie, I am also a registered nurse but my experience is much less than my colleague Ms Hockie in that my training was general nursing and not really working much in the field of midwifery. This afternoon I am going to focus my remarks on the progress that has been made in Scotland but also some fantastic examples of what is happening across Dumfries and Galloway in my South Scotland region. The Scottish Government is committed to supporting breastfeeding through policy investment and interventions that support breastfeeding without shame or stigma. The Scottish Government has provided additional investment to support breastfeeding, particularly in the days immediately following birth. Over £9 million of additional funding since 2018 has been made available to support breastfeeding friendly principles. Taking a fully rounded approach, inclusive of stakeholders such as healthcare practitioners, third sector and peer support groups is the most effective way to address breastfeeding concerns. Interventions in the health service such as ensuring the availability and quality of breastfeeding support for new mothers continue to be important. Equally wider interventions such as positively influencing public attitudes towards breastfeeding and objectively promoting more appropriate marketing of formula milk and ensuring supportive employment policies that allow women to continue to breastfeed after return to work are also continually required. I welcome the minister's commitment to doing so and to ensuring continued promotion of breastfeeding that that's available. Although the UK Government discontinued UK-wide infant feeding surveys that were carried out every five years from 1975 to 2010, the Scottish Government commissioned their own national maternal and infant feeding survey in 2017. That provides continued insight into the changing environment of breastfeeding, the common challenges faced and the areas impacted the most by them. The survey, along with continued medical research, demonstrates that breastfeeding does provide the best nutrition for babies and young children and supports children's health in the short and longer term. It is worth repeating what Carol Mawkins said at the beginning that current guidelines recommend that babies should receive breast milk for the first six months of life after the introduction of solid foods should continue to breastfeed up to their second birthday or for as long as the mother and baby can wish to do that. I know that it isn't always possible and I welcome Karen Adam's comments and others in the chamber about how the emotionally taxing, the difficult, even failing to feed adequately even though choice may be for women to breastfeed. I recognise and not stigmatise people that cannot for whatever reasons that they choose to take forward and breastfeed their babies. There is strong evidence that breastfeeding does reduce the children's risk of gut, chest and ear infections. That was interesting to read and leads to a small but significant improvement in brain development. As Rachel Hamilton described, she said that breastfeeding we need to remember that it also benefits mothers health as well and we have strong evidence that it reduces the risk of breast and ovarian cancer and it is worth repeating that as Claire Hawke mentioned as well it can reduce type 2 diabetes and promote maternal healthy weight as well. The benefits of breastfeeding for both the baby and the mother are seen across the world including in high income countries such as Scotland. Improving breastfeeding rates in Scotland will help to improve the health of babies and mothers and reduce inequalities in health. It is welcome that the Scottish Government is committed to making Scotland a breastfeeding friendly place for all and that means focusing interventions to target areas of inequality. Again, it is maybe worth repeating that increases in breastfeeding over the past 10 years have been greatest among those groups with low rates historically and that is young women and those living in most deprived areas. The latest infant feeding statistics show a continued narrowing of the breastfeeding inequalities gap and the additional investment has been both targeted and based on best evidence regarding what works. Scotland's infant feeding teams are pivotal in that effort and the Government will continue to use all means necessary including Scotland's baby box, which has been mentioned by a few to normalise breastfeeding in Scotland. One of the reasons why I was interested in this debate is that I had a staff member in 2016 who was blatantly and outwardly criticised and made to feel really uncomfortable in a cafe in Dumfries while she was breastfeeding and that was like 10 years after the legislation was brought in in 2005. So I then wrote to all the cafes in restaurants across Dumfries and Galloway to ask whether they knew about the breastfeeding friendly scheme or whether they would even participate in it. I received some responses and some of them were indeed positive. NHS Dumfries and Galloway also took forward the launch of a programme or a scheme at Three Gardens in Castle Douglas and the NHS chief executive Jeff Ace at that time launched a programme so that we could widen and raise awareness about the breastfeeding friendly scheme in Dumfries and Galloway. From this debate today I will follow-up again with the businesses across D&G to find out if they still continue to participate in the scheme and whether they are promoting it again. Finally, I asked the minister to continue to do all she can to encourage businesses to become breastfeeding friendly and to encourage mothers to breastfeed. Thank you. I now call Michael Marra to be followed by Rona Mackay, Mr Marra. Recent years I have worked with and on behalf of women in Dundee and Angus on issues including the provision of breast cancer care in NHS Tayside female access to mental health services and waits of many years for treatment for pelvic organ prolapse. All too often issues relating to women's health in Tayside but I believe it across Scotland are sidelined, minimised or just ignored altogether. The population is still treated as a medical anomaly. The mesh scandal is, of course, one of the most tragic and egregious illustrations of this culture and practice. Has this been a considered debate to this afternoon with members keen to see further improvements in what is a very important factor in maternal and child health for women and families across Scotland? There has been some progress on breastfeeding rates in recent years. The number of babies still breastfed at 68 weeks has increased by 3 percentage points between 2019-20 and 22-23. Public health Scotland attributes the majority of those increases to an increase in mixed breast and formula feed-in. Public health Scotland have also observed increases in breastfeeding rates in the past 10 years among groups with historically lower rates at groups that my colleague Claire Baker was keen to highlight including younger women and those living in more deprived areas. There is a little in the debate so far about the barriers that there are both culturally and economically to women from these groups from breastfeeding. It is still less than half of all babies are breastfed at 68 weeks in 22-23. The benefits of breastfeeding for mother and baby have been laid out and they are significant. They reduce infections, diabetes and obesity for the baby and reduce the risk of breast cancer and ovarian cancer and that in turn leads to economic benefits and studies have shown that when women who breastfeed return to work they are less likely to miss work due to their baby being ill. There does seem to be consensus and welcome consensus on the need to promote the choice of breastfeeding and support mothers and babies throughout. I wish in that vein to recognise the breast buddies, volunteers and Dundee and Angus for the brilliant work that they do given friendly peer support to new mothers at a time when they can be very challenging when a friendly face is required and that some women find themselves isolated perhaps without connections to other family members who would support them in these issues. I would question to the extent to which the Government can in the words of the motion be celebrating and supporting breastfeeding in Scotland in the context of what I see as precarious health visitor services in parts of the country. I was contacted by a constituent Angus earlier this month and informed that his family would not receive a visit from a health visitor for up to one year with the cutback being blamed on staffing pressures. Parents have been told not to expect a visit when their baby is between the ages of three months and 13 to 15 months. It could mean a full calendar year with no input from a health visitor at all. We have heard a lot today about the importance of those health visitor engagements and working with midwives in the home. Angus is, hopefully, a temporary situation in Angus but it leaves service in the area well below the Government's national standard and illustrates how stretched services are. Scottish Government's universal health visiting pathway entitles all families to 11 home visits including eight within the child's first year of life. The Government rightly states that health professionals, particularly health visitors, have a vital role to play in supporting children and families in the first few years of a child's life. Of course, we could ask what we are doing if we are telling families that they are entitled to such a vital service if funding and staffing pressure on the ground mean that we can become a postcode lottery. Families in Angus are already missing out on visits which the Scottish Government's own publication says are intended to observe development to progress of the child, give advice on weaning, share information on local community services and check for signs of depression in the mother. There are other members in this chamber who have done a good job of highlighting some of the issues pertaining to mental health and the importance of that in new mothers and the challenges that all families can face and the risks associated with it. Anecdotally from health visitors in Angus, I've heard that there are staff members who have as many as three times the standard caseload of families in Angus. With the best will in the world, health visitors will struggle to deliver the same high quality service including support and advice on breastfeeding that we are discussing today when they are so overburdened. The context of the cuts that are being made in must also be stated since the pandemic there has been a marked increase in infants with developmental concerns. In 2023 Public Health Scotland reported that the number of children with development concerns was increasing year on year. The Royal College of Speech and Language therapists have reported that there is an increasing number of young children who are struggling with basic language skills. Those cuts to health visits are the last thing that families need. Visits from health visitors can be a lifeline for mothers adapting to the challenges of parenting. They are an opportunity for early detection of any deterioration in the mental health of the mother and depriving families of these visits not only risks the wellbeing of the child but the whole family. There is a concerning trend in NHS Tayside whereby a temporary crisis situation becomes the norm with people across the region being forced to live with services that fall below national expectations. Colleagues are right to highlight the centralisation of services within Dundee and how much more difficult it is for people in peripheral areas to access those services to many hours spent on public transport. I commend other members for making these points. I would appreciate it if the minister in her closing speech can tell us what has been done to deal with the acute staffing pressures for health visitors in Angus to ensure that that does not become the norm. I would welcome any information that the minister can provide about the national picture for health visitor services. I remain concerned that those staffing pressures are not isolated to Angus. Can the minister commit in her closing speech to publish statistics on how many health boards and which health boards are meeting to have full compliance with the guarantee around health visitors and the amount of appointments that families should be receiving? In which health boards across the country are they getting the service to which, as the Government says, they are entitled to? I now call Rona Mackay, who will be the last speaker in the open debate. Ms Mackay. As we have heard during the debate, breastfed babies are getting the best possible start in life and that is what we all strive for in Scotland. I am proud that the Scottish Government has supported and promoted breastfeeding to reduce inequality in rates, while supporting the UNICEF UK baby friendly initiative across neonatal and community settings. There is strong evidence that breastfeeding reduces children's risk of gut, chest and ear infections and leads to a small but significant improvement in brain development, which Michael Marra has just been highlighting. Breastfeeding also benefits mother's health with strong evidence that it reduces the risk of breast and ovarian cancer, and some evidence that it may also promote a healthy weight and reduce the risk of type 2 diabetes. The benefits of breastfeeding for both baby and mother are seen across the world, including Scotland, but reducing stigma and outdated attitudes towards breastfeeding in public is key. This is 2024 and women must feel comfortable feeding their babies whenever and whenever they need to. Indeed, it is a criminal offence to stop a woman breastfeeding in a public place, something that I feel is often forgotten. Since 2005, if a person deliberately prevents or stops someone from feeding a child under the age of 2 in a public place in Scotland, they are committing a criminal offence. If a mother is asked to move or leave the premises completely, this is also an offence. A child should be fed when required and in the most appropriate place for them without the fear of interruption or criticism. Anyone trying to stop a mother breastfeeding or a child's mother to care her from bottle feeding can be prosecuted and if found guilty ordered to pay a fine. As the motion says, third sector and voluntary peer support remain pivotal to babies being breastfed in the first few weeks of life and beyond, preferably until six months of age. Support is often needed to help and encourage women to breastfeed for a variety of reasons. It is important that help is always in hand for mothers, particularly new mothers. I really want to stress today and I'm so pleased that every speaker has stressed this too. I don't think that women who are unable to breastfeed for whatever reason or who choose not to should be pressurised or guilt shamed. As the minister said, women should be free to choose depending on their individual circumstances and should never think they're not doing the best for their baby if breastfeeding is not for them and there should be no stigma here either. Childbirth is accelerating and exhausting and equal measure. Some women struggle to breastfeed through no fault of their own but they should always be supported to be comfortable with their feeding method. Ensuring supporting employment policies that allow women to continue to breastfeed after returning to work is essential. The National Breastfeeding Friendly Scotland scheme marks a continuation of our commitment to a breastfeeding friendly Scotland for all and builds on the breastfeeding etc. Scotland Act 2005. The BFS is a national scheme that you can sign up to for free backed by the Scottish Government and run by local health boards. Both schemes aim to help businesses and people who breastfeed know their rights and responsibilities and raise awareness of both the acts. Employers should support mums to feel confident about breastfeeding on the premises. If there is a complaint from a customer about a breastfeeding mum, they will inform them that they are signed up on the scheme and advise them about the legislation. Although the UK Government discontinued UK-wide infant feeding surveys that were carried out every five years from 1975 to 2010, the Scottish Government commissioned their own national, maternal and infant feeding survey in 2017. That provides continued insight into the common challenges faced and the areas impacted most by them. Encouragingly, increases in breastfeeding over the past 10 years have been greatest among groups with low rates historically, such as young women and those living in the most deprived areas. The latest infant feeding statistics show a continued narrowing of the breastfeeding inequality gap, and our targeted investment has been based on the best evidence of what works. The family nurse partnership has had a crucial role in supporting teenage parents, many of whom are in the lowest Scottish index of multiple deprivation areas to breastfeed. In order to successfully breastfeed, mothers have to eat and to eat well. Food insecurity also makes it harder to breastfeed with the cost of food impacting what pregnant women and new mothers need. The desperate cost of living is forcing families to make choices that no family should have to make, especially during those core 1,000 days of pregnancy and the first 2 years of life of health and development. The food foundation data shows that 27 per cent of UK households are home to children under the age of 4 who experience food insecurity in January 2023, which is higher than those for households with only school-aged children or no children at all. That cannot continue. In conclusion, I think the key messages of this debate and there have been some terrific contributions across the chamber. Really, as my colleague Karen Adam said, fed is best, but choice must be supported for every mother because we all want the best start in life for our children. Thank you. Thank you, Ms Mackay. I now call on Carol Walken to close on behalf of Scottish Labour. Carol Walken has joined us remotely around seven minutes. Thank you, Presiding Officer. In closing, I again want to start an agreement with the Government today and with all the other parties across the chamber and emphasise that Scottish Labour fully supports initiatives in Scotland to improve breastfeeding rates. I wish I could mention every member, but I do not write quickly enough or perhaps I just can't read my own writing, but thank you to everyone who contributed to this important debate. It was an excellent debate with members having the opportunity to speak and welcome interventions. The contributions were varied and I think this adds to the benefit of debating these issues within the chamber. Can I thank the minister for her contribution and her acknowledgement that Scotland should do better and Scotland must do better if we acknowledge that we really want to improve and challenge ourselves to change the breastfeeding rates in Scotland and improve them. Can I also thank the minister and other members in congratulating mothers, families and communities in their contribution to this change in breastfeeding rates? Very much the change in cultural norms around this, so many members talked about how we have developed and changed within our communities in terms of supporting mothers to feel comfortable breastfeeding. So much more to achieve everyone acknowledges and that is an important point, as I have said. Presiding Officer, it is clear improving breastfeeding rates in Scotland would help to improve the health of babies and of course of mothers and reduce inequalities in health. Many of the members spoke about that today. Today's debate therefore does hold significant importance in health inequalities. We do need to see continued progress in this area and a relentless focus on tackling these concerning inequalities, as was mentioned as I said right across the chamber by members from all the parties. Indeed, Scottish Labour are strongly of the view that closing the gap in inequalities in this area is paramount because breastfeeding plays a big part in improving health over an entire life and every child deserves that opportunity. Emma Harper mentioned or spoke about targeting interventions in this area and I do agree with this. To ensure this, we need Scottish Government to have a laser sharp focus on how we fund, promote and encourage both practice and policy in this area. Again, can I thank Rachel Hamilton for the intervention just reminding us that legislation is only as good as its implementation and how our communities find that it actually works for them. It is impossible to not thank her for the personal nature what I think it was mentioned by the Presiding Officer as a tutorial in her contribution and that led us to helpfully explore why women who tell us they would like to breastfeed and that is a really important point when we are thinking about what we are doing here in the Scottish Parliament. We are trying to set the scene to allow that choice that so many members spoke about. Alex Cole Hamilton's experience perhaps did not quite paint the same picture as Rachel Hamilton's but was an important intervention around the role of father and other family members. Can I also take the opportunity to add that the points on perinatal health are very important. I did not pick them up in my contribution but I do hope that the minister might say a few points on that in her closing remarks. Stephanie Callahan also such a personal contribution explaining the joy of supporting others to meet their goals of breastfeeding and I have met and spoken to so many peer supporters so many members touching on the peer support model to make sure that those are funded and supported to continue. It will be essential that we see the data as was mentioned by the minister on this review. Karen Adams still standing after six children it was so lovely hearing Karen Adams paying tribute to all the parents whatever they choose to do and many members mentioned this point. Claire Baker put this very well in her remarks that every journey is different and it is our job is not to place this on the women rather provide a supportive environment. I think today I have heard this across all the contributions it is for us as legislators to get the environment right to provide that choice. I want to mention the importance of the points the minister raised around marketing practices although I did not have time to raise them in my speech I think are extremely important and I think it would be useful to hear more about how we ensure those tight controls around. Also noted by the minister and others was the very worrying cost of formula milk causing distress to mothers and I know my colleague Monica Lennon has raised this in questions and Claire Baker made very important reference on affordability and the consistent approach in ensuring best start allowances meet the needs of families choosing formula. Tess White raised the important role of midwives and the pressure they are currently under in promoting the profession as a good career option but also retaining the important staff currently in the system having that great expertise and knowledge is so important. We know this is a problem and tonight Scottish Labour will be supporting this amendment. On similar lines I hope the Government will support the Scottish Labour amendments in recognising the pressures on health visitor service. Michael Marra has been approached on this issue and illustrated just how stretched health visiting services are in his area, his own area but we know this is not only in the Angus area. We do not want a postcode lottery as he described. We do not want it to be the norm or to become the normal. Guaranteed health visitors are so important to this subject and so many more as he spoke about. Having spoken to women who have been committed to breastfeeding is that vital support at home that really does make the difference. Of the women I spoke to in preparation for this debate every single one mentioned support within the hospital but an absence once home is such an important issue. If we want to support women to breastfeed certainly to exclusively breastfeed we need to have a long term support in the home and health visitors are vital to this. Scottish Labour will be supporting the Government motion and I hope that this encourages us all to work together to further improve the breastfeeding rates for all those mothers and babies who wish to do so. Thank you, Presiding Officer. Thank you, Ms Mocken. I now call on Sanjosh Gohani to close on behalf of the Scottish Conservatives around 8 minutes. Please, Dr Gohani. Thank you and I wish to draw members' attention to my register of interest. I'm a practicing NHS GP and relevant to this debate as a father of two. Two thirds of Scotland's 48,000 newborn babies each year start life by being breastfed. By the time of the mother and child six to eight week review almost half are still being breastfed. Of course breastfeeding rates vary across our population. It is much more common among older mothers and those from less deprived areas. While just 38% of white Scottish babies are being breastfed by the time they are two months old. Meghan Gallagher gave us her very personal story and reminds us that some mothers and babies cannot breastfeed or it is incredibly difficult. Some mothers may be on powerful medications for cancer, heart or kidney disease breastfeeding may not be the healthy option. Others have hyperplasia of the breast use sufficient milk. We should also consider that up to a third of breastfeeding mothers develop mastitis and we should be aware that 10 to 20% of mothers suffer with their mental health during pregnancy or the year after the perinatal period. We're talking depression anxiety, obsessive compulsive disorder post traumatic stress disorder postpartum psychosis which does impact up to two in every 1,000 mothers who give birth and I'd like to take a moment to talk about maternal mental health. Many mums who are pregnant are taking medications such as sertuline to help with their mental health and so many mums stop their medication due to a worry it will affect their baby. Can I appeal to everyone watching to please speak to their GP first because I see the devastation that deterioration of maternal mental health has which is far more detrimental. Mental health struggles can also seriously impact breastfeeding. We must avoid making mothers feel guilty because they can't breastfeed or choose not to. Another condition that's not well understood is gastroesophageal reflux around 7% of babies experience severe reflux whether they are breastfed or formula fed and reflux usually happens because the baby's esophagus the food pipe has not developed so milk can come back up easily through the sphincter. The esophagus develops as they get older and the reflux usually stops but when they're little reflux causes sickness a lot of discomfort and some babies do not gain weight they squirm during feeding some vomit they're uncomfortable after feeding there's huge distress to parents and goes undiagnosed so the message is while we favour breastfeeding mothers who formula feed are not harming their children as Karen Adams also stated we should make no mothers feel stigmatised a loved and cared for baby will thrive Bob Doris If we're given weight just reflecting on your comments there would you agree with me the most important thing is that mum and baby are happy and healthy and yes breastfeeding might be the most appropriate pathway but given the mental health vulnerabilities of some families happy and healthy and well fed first and breastfeeding is a bonus but it's that happy and healthy of the heart of everything I absolutely would agree and that is the most important thing that we have a happy healthy baby remember you can breastfeed but do it express it and put it in a bottle that's okay as well there is no wrong way as long as your baby is happy and healthy Tess White spoke of how the first feeds are helped by our midwives but they are being increasingly called away from this essential time supporting infant feeding to cover acute care health visitors are also essential to not just breastfeeding but general health and well being of mums and babies visitors are becoming increasingly rare as cash strap councils are choosing not to replace retiring health visitors leaving mums and babies in Scotland to suffer and Tess White went on to prove this in Angus where some will not be seen for a year and whilst I am unable to breastfeed skin to skin contact with my newborn promotes a dad's bond as did bottle feeding and apparently changing their nappies Carol Mocken a Rachel Hamilton both spoke of wonderful legislation to feeding children under 2 and I would challenge the minister in this debate to give us reassurance that she will look to promote this Stephanie Callaghan is right when she says that breast milk contains magical properties that Alex Cole Hamilton went on to describe and the benefits of breastfeeding to mums, babies and the family budget and this is important as Rachel Hamilton told us positivity can quickly lead to frustration and upset as it's not always straightforward and the support of health visitors keeps mums breastfeeding and we know how difficult it is to find a health visitor to Rachel Hamilton as a doctor I would say cold cabbage leaves have a place as does cream and antibiotic so perhaps it's for others to speak to their doctor before their grocers while we should encourage and support breastfeeding we should not stigmatise mothers who cannot for health reasons or even societal reasons do so the Scottish Government must address the huge pressures upon our midwifery and health visitor services we are losing skilled midwifery staff because many are worried they cannot deliver the required quality of care recruitment and retention workforce planning require urgent attention if we are to foster support and an environment for breastfeeding midwives and health visitors play a pivotal role in educating and assisting new mothers promoting successful breastfeeding practices and supporting mothers who face breastfeeding challenges I too would like to thank members for their contributions on this important debate and the tone and I think one of the key things we've talked a lot about promoting and telling stories and I really appreciate the stories that we've heard from right across the chamber and I'm sure mothers, new mothers will appreciate that as well so thank you both for that thank you both for sharing and everyone else that did as I said in my opening improving the health of all babies and young children is one of the driving forces for my on-going commitment to support breastfeeding we must continue to build on the good progress in Scotland so far and continue to reduce early inequalities that harm generations and as Alec Cole-Hamilton said support not pressure if I can turn to the two amendments I was at Tess White's amendment which we will be accepting I think it's important to note that we hugely value our midwifery workforce and the high quality care they offer across Scotland health visiting remains a universal service and teams across Scotland work hard to deliver this entitlement latest published data shows the vast majority of eligible children are receiving health visitor contacts between 10 days and 5 years of age and we continue to work closely with health boards to monitor the delivery of the universal health visiting pathway and to best ensure young families get the support they need if I may turn to the points that Michael Marra made Scottish Government officials are meeting with health boards the Tayside meeting is in early March and we're also meeting with all Scottish executive nurse directors to discuss outcomes from the evaluation of the pathway and I'd like to thank Michael Marra for raising and sharing his constituents experience which my officials have noted Child health reviews are routinely published in national statistics we do not publish all visits that's held at the board level monitoring was done during Covid to prioritise early visits to health reviews as I have said we continue to work with boards I'd like to touch on Carol Mockins amendment and I'm sorry that we can't support that however I do recognise her nudge there was a lot of discussion about peer support for infant feeding I would be keen to understand the thinking as to why the Government couldn't support the amendment in Carol Mockins name on behalf of the Labour Party surely this is a pathway that is supported it's in your own policy we're looking to have those statistics published it would be great if the minister could provide those to members and put those statistics in spice but if this is something the SNP said that they are committed to why can't he then say guarantee that this can be something that people can expect as a right across Scotland Minister I thank Michael Marra for his intervention there I'm clear that the Scottish Government has invested £40 million to recruit additional 500 health visitors and following this investment their numbers have remained largely stable but we continue to work as I've said closely with health boards to monitor the delivery of the universal healthways visiting pathway to best ensure young families get the support they need I'd just like to make progress there was a lot of discussion around peer support I think that that is absolutely essential and as part of our quality improvement programme an additional investment of over £9 million over five years we've provided over £1.6 million to third sector peer support charities to increase research and deliver on the national breastfeeding helpline I understand that breastbuddies programme in Angus received funding in the last year and this is driving increases in that area so that shows the importance of that third sector peer support Rachael Hamilton referenced breastfeeding in the borders and again I would like to thank them for the work that they are doing we also contribute funding towards the national breastfeeding helpline which provides support via phones and closed social media groups we there is a lot of publicity as well of on breastfeeding legislation and that's included in ready steady baby and on parent club and joining instructions for that or email information is found in the baby box and also to celebrate the breastfeeding act's 10 year anniversary we had a breastfeeding week and perhaps there's an opportunity to do one in 2025 or on its 21st anniversary in 26 and nine years ago we agreed not to sunset the legislation this last summer I attended a breastfeeding picnic outside Parliament and there was great publicity from that not to mention the knitted breastfeeding boob that I have in my office and as MSPs we should really sign up as Claire Hawhey suggested to being breast friendly workplaces in our constituency offices and if I may also just mention Inverclyde where a mural on a gable end became a talking point in the community it was a breastfeeding mermaid so there is a lot of publicity happening I was very pleased that Claire Hawhey and also my colleague Marie Todd were so involved in an instrumental in the baby box and Claire Hawhey clearly outlined everything that is content everything that is in it referencing Stephanie Callahan's question and I'm very happy to work with my colleague Natalie Dawn discussing what we can do about the current contents I'd like to too touch on Alec Cole Hamilton's point about recognising the role of partners and fathers we worked with fathers the fathers network Scotland to put content for dads on parent club and we did a social media campaign on the role of partners which was promoted and accessed widely I think that's a very key thing to talk about Claire Baker touched on the costs around yes of course Alec Cole Hamilton I'm very grateful for her picking up my remarks about the role of partners and fathers when we were expecting our first child and we were attending national childbirth trust classes there was an entire class dedicated to just the dads on how to support partners who are having difficulties securing a latch with their baby against the nipple and indeed supporting them through difficulties around breastfeeding is there a way the government could help expand that kind of intervention to other groups Minister I thank Mr Cole Hamilton for his intervention and would suggest that a lot of work being done in this area and also the leaflets off to a good start and various other ones support that and it's something like yesterday when I met two midwives within Argyll and Bute that they talked about as well I want to restate that all infant formula is nutritionally equivalent and price is not an indicator of quality and I agree with Claire Baker's point that the reductions are very welcome pity they didn't happen sooner but I think further reductions are needed perhaps including consideration of a price cap formula is a vital product in the first year of life profits should not be cut over health I think both Gillian Mackay and Claire Baker talked about the social determinants of health and Rona Mackay and various others talked about the best start foods and payments that the Scottish Government has introduced and I think we should recognise that best start foods provides a weekly payment that is more generous than the rest of the UK and we will increase best start foods to a minimum of £5.30 a week from April 1 subject parliamentary approval Gillian Mackay I thank the minister for taking the intervention in my speech I mentioned that many of the factors to improve best speeding rates outside of her portfolio I wonder if she would take into conversations with other ministers and cabinet secretaries the need for them to look at how workplaces and others enhance their support for breastfeeding minister I thank Gillian Mackay for reminding me that I think I suffer from Carol Mockins they are not writing everything down quickly enough but yes very welcome to speak to colleagues about this I think basically quoting Fulton McGregor we cannot act in a vacuum we must learn from women who have felt unsupported or unheard and share that across sectors including maternity, neonatal and in the community failing to learn can impact on mothers mental health and confidence to breastfeed in the future and as Karen Adam said each individual breastfeeding journey is different and flexibility and support is tailored to need is so important clinical and support staff receive training on the baby friendly standards both during periods of formal education and in practice we must make sure that this is of the highest quality as embedded in holistic care the UNCRC will afford us more recognition across sectors that the needs of babies and young children must be fully considered in all that we do this includes receiving adequate nutrition and supporting their parents to provide this just to finish I recognise that even where a mum wants to breastfeed her baby that is not always easy especially in the early days and without the right support it can be hard to meet individual breastfeeding goals we have some excellent support across Scotland which I've already highlighted as have others in this debate this includes our parent club website local infant feeding teams the national helpline specialist and peer support we need to listen to mums and new parents to learn how to continuously improve their offers to better meet their needs I want every new mum in Scotland to feel that they have a real choice in how they feed their baby and I want breastfeeding to be that easiest choice I'm delighted to have had this opportunity to commit this motion and also hear from across the chamber people's thoughts and views thanks that concludes the debate on celebrating and supporting breastfeeding in Scotland and it is now time to move on to the next item of business I am minded to accept a motion without notice under rule 11.2.4 of standing orders that decision time be brought forward to now I would invite the minister for parliamentary business to move the motion thank you the question is that decision time be brought forward to now are we all agreed thank you we are agreed there are in fact three questions to be put as a result of today's business the first question is that amendment 11935.2 in the name of Tess White which seeks to amend motion 11935 in the name of Jenny Minto on celebrating and supporting breastfeeding in Scotland be agreed are we all agreed are we all agreed the Parliament is agreed and therefore the amendment is agreed the next question to be put I'm sorry Mr Fraser is there some thank you the next question is that amendment 11935.1 in the name of Carol Mochan which seeks to amend motion 11935 in the name of Jenny Minto on celebrating and supporting breastfeeding in Scotland be agreed are we all agreed the Parliament is not agreed and therefore we will move to a vote there will be a short suspension to allow members to access the digital voting system thank you