Childhood Obesity Strategy

Alison Thewliss (Glasgow Central) (SNP): I am glad to be able to speak in this debate and hope that what I say will provide a different kind of insight into the debate on childhood obesity.

I am a great enthusiast for breastfeeding. Breast milk has many exceptional qualities, the most obvious being that it is exactly the right thing for infants to be eating. In the beginning, there is the double cream of breast milk, colostrum, which appears before a baby is even born in preparation for those first feeds. The milk that comes thereafter changes and adapts over time as the baby’s needs change. Breast milk has everything that a baby needs and, taken directly from source, it has the advantage of being at the correct temperature. It is easily absorbed by the infant gut. It is a miracle of nature.

What breastfeeding contributes to this debate is the impact that it can have on reducing childhood obesity. An excellent study was pulled together by UNICEF a few years ago called, “Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK”. The report analysed data from many studies to ensure that there was a sound scientific basis for the claims that it made. Although I accept that giving precise figures and modelling on this is difficult, the UNICEF report estimates that:

“A modest increase in breastfeeding rates could result in a reduction in childhood obesity by circa 5%. If this was the case, the number of obese young children would fall by approximately 16,300, and annual health-care expenditures would reduce by circa £1.63 million.”

That would be no mean contribution. Breastfeeding starts babies off on the right track and, with the accompanying health benefits, such an increase could result in a generation of healthier babies and young people.

The Government should bear that in mind and ensure that services to promote, protect and support breastfeeding are well maintained. This is too important to be left to the good will of the wonderful network of voluntary organisations across the country. It needs to be an identified priority of this Government. The newly formed all-party parliamentary group on infant feeding and inequalities, which I established this week with colleagues from across the House, aims to examine the matter further. We will consider the issues of inequality, because there are multiple deprivation issues, with lower rates of breastfeeding in deprived communities.

What is less well known about infant formula is the specific contents of that product. It takes a complex chemical process to produce formula that involves either dry blending or wet mixing and spray drying, in which cow’s milk is treated with added lactose or other carbohydrates, vegetable and other oils, vitamins and minerals. According to the First Steps Nutrition Trust, the current regulations require infant formula and follow-on formula to have an energy content of between 60 kcal and 70 kcal per 100 ml. Those figures are based on the energy content of breast milk, but, as I mentioned earlier, breast milk composition changes in response to the baby as it grows. Breast milk also has more unsaturated fats than cow’s milk and the fats in infant formula tend to come from the vegetable oil. If anyone has an interest in finding out more about this, I recommend that they seek out the “Infant milks in the UK” report that is produced by the First Steps Nutrition Trust. The level of detail is fascinating.

There are differences between the growth curves of breastfed and formula-fed babies, with the formula-fed babies gaining more weight in the first year. Some studies suggest that that may, in part, contribute to childhood obesity. Pressure is also put on mothers to ensure that their baby is gaining the correct amount of weight. We should consider how formula milk is delivered. I have heard many people describe how many millilitres of formula their baby has drunk at any given time, comparing and contrasting this with others. There is an expectation of how much is normal.

There is a risk in the making up of formula milk, because one must ensure that the correct dosage of powder is dissolved in the water. If this is not done accurately, there is a risk of babies being overfed or, indeed, underfed. The risk of that is far lower for breastfed babies, although I admit that I could only really tell how much breast milk my babies had by the amount that they both threw up all over me. There is not really any other way of telling.

Mrs Hodgson: I agree with everything the hon. Lady has said so far. As she knows, I took part in the debate that she led in Westminster Hall on this issue. The point that she is making is very important. I was an evangelical breastfeeder myself and still encourage everyone to do it in every which way they can. She makes the point that breastfed babies feed on demand, so they take as much or as little as they need, whereas when babies are bottle fed, there is an obsession with whether they have taken half a bottle, 8 ml or whatever. Parents inadvertently force-feed their baby the amount they think they should have, rather than what the baby needs, so babies get used to being full. As we all know, that is not necessarily good and can lead to the bad habits in adulthood that I spoke about earlier.

Alison Thewliss: I absolutely agree with what my good friend says. Bottle feeding tends to be at a set time—“Is it time for the baby’s feed yet?”—rather than when the baby actually needs to be fed, whereas breastfed babies are fed little and often on demand, which is a slightly better habit to get into.

There is also a beneficial effect on breastfeeding mothers. As well as reducing the risk of cancer and diabetes, breastfeeding burns calories and helps to get mothers back to their pre-maternity weight — for me the prospect of burning an extra 400 to 500 calories just by breastfeeding my baby was very attractive, and it certainly helped me to fit back into the clothes that I wore before I had my children, both of whom were breastfed for two years.

I was interested in the findings of the Select Committee report, and I particularly note the points about marketing and sugar content in foods. I was a wee bit disappointed that it does not contain much discussion on baby foods and toddler milks, as there are significant issues in that area regarding the advertising and the content of the products. In evidence to the Committee, Dr Colin Michie of the Royal College of Paediatrics and Child Health stated:

“Follow-on formulas are not necessary for human beings, but it would not seem so if you watch television. The problem is we are all very convinced by the stories. There are other issues that have parallels for what was said earlier in that the milk companies sponsor education, training, events and an awful lot of professional activities, which again does exactly, to our minds, what we heard it does to infants’ minds: when we see brand names, we equate certain things with them. It is an insidious business that we know enough of to be very wary of.”

The artificial creation of a market for follow-on or toddler milks is of some concern, because those products are not subject to the same level of scrutiny as formulas for very young babies. Research gathered by the First Steps Nutrition Trust suggests that

“Growing-up milks and toddler milks contain almost twice as much sugar per 100 ml as cow’s milk, and some Aptamil and Cow & Gate growing-up milks and all SMA growing-up milks contain vanilla flavouring. It is unclear whether repeated exposure to sweet drinks in infancy and toddlerhood might contribute to the development of a preference for sweet drinks in later life.”

It is important to take cognisance of that and consider the issue as part of the obesity strategy.

Dr Wollaston: I thank the hon. Lady for her powerful contribution, and I completely agree with what she says. I also agree that the advertising of follow-on milks is a covert form of advertising infant formula. Does she feel that that should be completely banned?

Alison Thewliss: Absolutely, and a lot of the advertising is very—I supposed we could say cunning. Products are made to look the same on the shelves and to match the adverts for follow-on milks, rather than those for the younger infant formulas, and more needs to be done about that.

The sugars in follow-on milks are not always made clear on the packaging, and that should certainly be of concern to us in this House. Establishing a sugar habit at such an early age should be discouraged, and as was said earlier, that also has an impact on the teeth of a growing child. Baby Milk Action has campaigned tirelessly on the marketing of formula, and it has been involved in challenging those issues in the European Parliament. There are related issues concerning the marketing and composition of baby food, and about the jars and packets found in supermarkets, which are often marketed at babies under six months, contrary to World Health Organisation advice.

Pressure from groups such as Baby Milk Action, and actions by MEPs such as the Green MEP Keith Taylor, led yesterday to the European Parliament rejecting draft EU rules on baby food. If they had been approved, they would have allowed baby foods to contain high levels of sugar, and products to be labelled for use from four months of age, rather than from six months, which is the advice. As a result, the Commission has been forced back to the drawing board to bring the regulations in line with recommendations of the WHO and the World Health Assembly, and to fit better with the international code on such issues. I would like further debate on the composition of baby foods, how they are marketed, where they are placed in supermarkets, and what advice is given to parents. Again, the sugar content and the rationale behind waiting until six months before bringing babies on to solid foods is not always made clear to parents.

Advice on such matters has changed over the years and has sometimes been conflicting, and well-meaning advice from family members can cause doubt in the minds of new parents. People need to have the best advice on feeding. All agencies should be clear about the advice that they give out, and we must guard the most vulnerable babies in our society against the vested interests of wealthy baby food and formula companies that seek to exert influence on professionals and groups giving out that advice. I hope that these issues will be given due consideration in the debate on obesity, and that thought will be given to the contribution that breastfeeding can make to improving infant and maternal health.