Alex Somlyay (Fairfax, Liberal Party) Share this | Link to this | Hansard source

It gave me great pleasure on 9 August to table the report of the House of Representatives Standing Committee on Health and Ageing inquiry into the health benefits of breastfeeding. Due to the pressure of the business of the House I was not able to speak to the report at the time; nevertheless, the committee felt that we should table the report because it was World Breastfeeding Week.

The report is entitled The best start—report of the inquiry into the health benefits of breastfeeding, and the committee is clear in its belief that breastfeeding really does provide the best start for the youngest and most vulnerable of our community members. The genesis of the report came during the committee’s inquiry into health funding, when a submission was received on the health benefits of breastfeeding. The evidence pointed to the fact that breastfeeding babies would have long-term financial benefits for the health budget in the out years. We could not consider the submission at that late stage but we agreed to have a short, sharp inquiry later into the health benefits of breastfeeding, following the completion of the health funding inquiry.

When we first started the inquiry into the health benefits of breastfeeding, the committee noted the amount of guilt and emotion that surrounds the subject. Initially, most of the submissions were from breastfeeding mothers, so the committee actively sought submissions from mothers who had chosen to bottle-feed, to give us another perspective. The committee were very sensitive at all times to the problem of making mothers feel guilty if they had made the decision not to breastfeed. Mothers making the decision either to breastfeed or to formula-feed their babies need the best available information, and the committee recognised this need for additional support and information.

The health benefits of breastfeeding are numerous and are backed up with evidence. Breastfeeding protects babies against common infections such as those of the gut and the respiratory tract. It lowers the risk of ear infections and allergies and asthma may also be prevented, because the special properties of breastmilk help to give the baby a stronger immune system. The impact of breastfeeding upon chronic disease is also important. Evidence suggests that there is a link between breastfeeding and weight gain in later life. The good early nutrition provided by breastmilk could lessen the risk of obesity in childhood and adulthood. Research is continuing on the links between breastfeeding and other chronic diseases such as type 2 diabetes and heart disease. The health benefits of breastfeeding are not limited to the baby alone. Breastfeeding also helps the mother to recover more quickly from childbirth and lowers the risk of breast cancer.

The most recent national health survey found that 83 per cent of women initiated breastfeeding when they were discharged from hospital, that several weeks later many women had stopped breastfeeding and that by six months only 48 per cent of babies were receiving any breastmilk. The dietary guidelines for children and adolescents in Australia say that the goal of having 80 per cent of women exclusively breastfeeding for six months ‘is achievable’. The committee found that women want to breastfeed, health professionals want women to breastfeed and babies want to be breastfed, but somewhere along the way something has changed with breastfeeding and it has become a complex activity for many women.

So what goes wrong? In the early days after they had given birth, many women found that breastfeeding was a lot more painful and complex than they had expected. They got lots of conflicting advice from different nurses and midwives and found themselves discharged from hospital within a couple of days, trying to learn how to breastfeed at home by themselves. When mothers take their babies to the maternal and child health service they may be told that their baby is not gaining enough weight and that they should give the baby some formula. When mothers go to a shopping centre and try to breastfeed in public they are told to go and do that somewhere in private or told that what they are doing is disgusting. Even at home mothers can be told by their family that if they give their baby some formula it will sleep through the night, which will be better for everyone. At every point along the way it seems our mothers are not given enough support to breastfeed.

The committee considers that the Commonwealth government needs to develop a national strategy to promote and support breastfeeding. The rates of breastfeeding in Australia need to be monitored more accurately, especially in remote and Indigenous communities. There needs to be more research in Australia into the health benefits of breastfeeding and into the best ways to promote and support breastfeeding. The committee was told that partners are a big influence on a breastfeeding mother, so they need to be included in breastfeeding education. Maybe there could be special programs for them, like the Talking Dads program at Melbourne’s Royal Women’s Hospital. A key recommendation of the committee is that more needs to be done to educate the community on the benefits of breastfeeding and on how the community can support breastfeeding mothers. The committee found that there was still a strong belief in the community that infant formula was as good as breastmilk. This is not true, and the community should be helping breastfeeding mothers rather than telling them to use formula. However, we recognise that it is important to support mothers who for whatever reason choose not to or cannot breastfeed. These mothers need to be able to access information from health professionals, and this information needs to be accurate and informative. The committee considers donor breastmilk banks could be critical in saving the lives of sick and premature babies and found that there were many women in the community who would happily donate their excess breastmilk. The committee visited the Mothers Milk Bank at John Flynn Private Hospital Medical Centre on the Gold Coast and heard from several parents how the donor milk had contributed to saving the lives of their children. The committee observed the work of the Australian Breastfeeding Association in the community and believes they do a great deal for breastfeeding. The committee was so impressed with the support the ABA provides to mothers that it has recommended that a national, toll-free, 24-hour number helpline be funded.

Returning to work and breastfeeding are two things that are often difficult to combine. Employers can greatly assist women to continue breastfeeding while working by providing lactation breaks and a room with appropriate facilities and just by being encouraging. We should provide leadership here at Parliament House, and to this end the committee has recommended:

That the Speaker of the House of Representatives and the President of the Senate take the appropriate measures to enable the formal accreditation by the Australian Breastfeeding Association of Parliament House as a Breastfeeding Friendly Workplace.

The health system has taken steps to improve how it supports breastfeeding, with the Baby Friendly Hospital Initiative. The committee considers that this initiative should be implemented in all maternity hospitals and has recommended accordingly. The committee considers that any strategy to improve rates of breastfeeding in Australia needs to provide protection for breastfeeding as well as support and advice to expectant and new mothers. The committee has taken the decisive step of recommending that the World Health Organisation International Code of Marketing of Breastmilk Substitutes, better known as the WHO code, be implemented in Australia, because the committee considers that mothers need the best information they can get when making a decision on how to feed their baby. I have often said during the course of the inquiry that this is not a witch-hunt against manufacturers. The committee welcomed evidence from the infant formula manufacturers. It acknowledged that, when breastmilk in any form is not available, the only suitable alternative nutrition for infants is infant formula. The committee also reaffirms its support to all mothers.

Compiling such a comprehensive report relies on the assistance of many people. The committee would like to thank the many individuals and organisations who assisted by making a submission or giving evidence at a hearing. Their expertise and experience are greatly valued and it laid a strong foundation for our deliberations. We would also like to acknowledge those who spoke from the heart and told us of their experience about breastfeeding. It was clear that for many women breastfeeding was very difficult, and it is a topic that still fills them with emotion. For others, we could see how fulfilling they found breastfeeding to be.

The committee was fortunate to hear directly from several well-respected organisations and groups who promote and support breastfeeding in the community. We thank the Australian Breastfeeding Association, the National Health and Medical Research Council, the Uniting Church in Australia and the Baby Friendly Health Initiative. There were more groups than I have time to mention, but the committee would like to extend its appreciation for their participation.

The committee also thanks the members of the Gulf communities in Queensland at Pormpuraaw and Kowanyama in remote Far North Queensland. We visited these communities as part of the inquiry and were very appreciative of the time that they gave to the committee. I would also like to place on record our thanks to the hardworking secretariat staff, under the guidance of James Catchpole. James is in the clerk’s chair at the moment. As usual, James has ensured that his team has provided first-class support. I especially want to mention Pauline Brown, who had carriage of this inquiry. It was Pauline’s very first inquiry, and I do not think I have ever seen in my 17 years in parliament a more conscientious officer. Pauline went through a baptism of fire and came out very well indeed. I would also like to thank Lauren and Meg for their expert assistance. I must thank my fellow committee members for the assistance they provided in the course of the inquiry—in particular, deputy chair Steve Georganas, and the previous deputy chair, Jill Hall. I commend the report to the House.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

I would like to begin by thanking all members of the House of Representatives Standing Committee on Health and Ageing, especially the chair, Alex Somlyay, the member for Fairfax, for his great chairing of the meetings of this inquiry. I would like to thank the secretariat—Mr James Catchpole, the secretary, Ms Pauline Brown, and Meg Byrne and Lauren Walker—for all their assistance in making this committee work and run so smoothly. I would also like to thank all the individuals who lodged submissions with the committee and the witnesses who attended the hearings for being part of the inquiry into the benefits of breastfeeding. The inquiry and its subsequent report would not have been possible without the assistance and input of all these people.

It was good to see that the inquiry generated nearly 500 submissions—in fact, a total of 497 submissions. There was a great amount of public interest. There was a flood of submissions to the health and ageing committee. At some of our hearings, there was standing room only for people who came to watch the proceedings.

The report, titled The best start—report of the inquiry into the health benefits of breastfeeding, found that many different factors may influence a mother’s decision to provide breast milk or to use formula for her newborn child. It found that a mother’s decision to use one feeding method over another may be related to cultural background, the mother’s health or a personal preference. Whichever decision a mother comes to, they should be supported by the Australian community and Australia’s health system because it is the responsibility of every new mother to assess her own personal circumstances when making a decision about whether to breastfeed or to use a formula. It is our role to ensure that the services are in place so that Australian mums have the information they need to make an informed decision.

Breastfeeding has been practised for centuries. Breastfeeding is very natural; it is one of the most natural occurrences that takes place in a woman’s life. Somehow, we in the Western world have made it very clinical over a couple of generations. The key to promoting breastfeeding is in educating our society to better understand what it means to breastfeed. Education about breastfeeding and how to breastfeed is very much needed for a new mother in pregnancy and soon after the birth of her child so that she is aware of the short- and long-term health benefits and has all the information in front of her to make an informed choice on whether she breastfeeds or not. There should be a concerted effort to change the attitude of society so that, once again, breastfeeding becomes a very natural, normal thing that takes place in a woman’s life.

How do we change an entire society’s view of this issue? That is the big question. We have somehow, as I said earlier, changed breastfeeding from something that was very natural for thousands of years, passed from mother to daughter, generation to generation, to something that is no longer the cultural norm.

The report of the inquiry into breastfeeding outlines the health and other benefits of breastfeeding, noting that breastfeeding protects against gastrointestinal and respiratory illnesses and ear infections, just to name a few. These illnesses have the ability to impact adversely on the health of a newborn baby. Breastfeeding has also been identified as a factor in contributing towards lowering obesity and the prevalence of chronic disease later on in life. Despite these benefits, many women who have the capacity to breastfeed are choosing not to breastfeed their child up to the recommended age of six months, let alone to the World Health Organisation’s ideal age of 12 months. Here in Australia, only 18 per cent of mothers are fully breastfeeding their child to the age of six months. To increase the number of mothers breastfeeding their babies up to six months, women need support and advice from health professionals.

The report found that the Commonwealth should take a greater role in promoting and educating Australians about breastfeeding and infant health. Poor nutrition in infancy has a significant impact on the future health of many Australians. An improvement in health in infancy would reduce the pressure on our health system. Implementing and supporting preventive measures such as breastfeeding in our health system has the capacity to ease the burden on Australia’s hospitals and medical facilities in the future.

We know that demands on our health services are set to rise in the future. We are now seeing an increasing number of children with chronic illnesses in the middle stages of their development. The prevalence of asthma in Australia is one of the highest in the world, affecting up to 14 per cent of Australian children. Breastfeeding may be used as a preventive measure to lower the number of children in Australia who develop respiratory illness later in life. Prevention, as we all know, is better than cure. Provision of comprehensive child and maternal health services, such as breastfeeding support services, will play a vital role in improving infant and child health.

Knowing, as we do, the health benefits of breastfeeding, there should be a concerted effort by leaders within the Australian community to break down any inhibitors to breastfeeding within social and workplace settings. From the many various submissions to the inquiry there emerged examples where workplaces persuaded women not to breastfeed at work. Knowing the health benefits of breastfeeding, workplaces should endeavour to encourage women to breastfeed their newborns by creating work environments that are supportive and accepting of a mother’s decision whether or not to breastfeed. We saw some great examples when we visited the Westpac workplace in the city of Sydney, where they had rooms set up so that employees, mothers of infants, who wanted to breastfeed would be able to do so. That was a great example to many other employers. We need to set up these places to encourage mums to continue to breastfeed.

As I said, parents should be able to focus on their top priority straight after childbirth, their newborn baby, and we have to somehow make it easier for them. There are great psychological and physical health benefits for babies whose mothers spend time with them during the early months of their lives, including the internationally recognised benefits of breastfeeding.

In Australia, there are sometimes cultural inhibitors to breastfeeding, such as the stigmatisation of women who feed their babies in public. This creates a series of problems for mothers who want to breastfeed, as they feel they cannot feed in public; they are often driven indoors or out of sight, making it too difficult for them and therefore causing them to give up.

This is not the case in many other developing and even developed countries around the globe where there are support systems and open promotion of breastfeeding for newborns, making it more accessible and easier for mothers to do so. In some developed and developing countries where breastfeeding has become culturally acceptable, there is a noticeable reduction in child mortality rates. So it is important that breastfeeding is coupled with peer support. According to a witness in the inquiry, peer support is a proven way of normalising breastfeeding.

Breastfeeding rates declined rapidly to the point where in 1971 only about 20 per cent of babies were being breastfed to three months of age. Currently the rate of breastfeeding is up at 60 per cent. Australia is still getting over the normalisation of bottle feeding. Breastfeeding rates did decrease in the fifties, reaching a low point in the late sixties and early seventies. This was a result of a combination of the availability of infant formula and the promotion of the use of formula by the health system.

Since then, the breastfeeding rates have increased slowly. From the current available data, a conclusion may be drawn that mothers with newborn babies initially want to breastfeed soon after they give birth. The data shows that the rates for breastfeeding are initially extremely high while the mother is still hospitalised or recently out of hospital. However, the impact of a number of different factors such as demographics, psychological health, physical health, cultural and societal influences have led to many mothers stopping using breast milk to feed their child.

In order to ensure that we can continue to accurately monitor the use of breastfeeding across the nation, the inquiry also recommended that there be improvements in the methodology used to monitor breastfeeding. The recommendations included increasing the quality of data on breastfeeding and coming to a consensus on one definition for breastfeeding. With these changes we will be able to collate more accurate data and make well-informed comparisons between breastfeeding and infant health.

Representatives of the breastfeeding phone counselling services who appeared as witnesses to the inquiry estimated that they receive around 200,000 calls annually from new mothers who need support. From this data it appears that there is a high demand for support from new mums who are having difficulty feeding their child and are worried about whether they are giving their child the nutrients they require to lead healthy lives.

We also saw examples during the inquiry of particular marketing companies that target their products towards infants and toddlers, whether they be formula or other products. There were also claims from companies which manufacture fruit juice that their products included all the nutrients that children need for their daily intake. Some of these companies are using marketing tools that impact negatively on breastfeeding rates.

Many witnesses to the inquiry brought information forward about the importance of breast milk and how difficult it is to find a replacement that provides the same nutrients to children. However, not all mothers are in the situation where they are able to breastfeed and we should not isolate those people as being poor examples of motherhood. Again, it comes down to the choice of the mum.

It is understandable that formula companies are in the market to make a profit and that is why many of these companies encourage the use of breast milk substitutes and run sometimes very effective marketing campaigns. This is where health professionals need to be there to advise mums on the best course of action they should take in order to give their child the best possible care.

We need an education campaign about breastfeeding so that women can make informed decisions about what is best for their child. We know independent health professionals need to be available to provide the right information to mothers but without bias. As education among mums about breastfeeding increases, we will be able to be increasingly satisfied that they are making the right decisions and the right choices. So it has become clear as a result of this inquiry that new mums need to be more informed about breastfeeding and to be given the support that they require to provide the best nutritional care for their newborn.

Warren Entsch (Leichhardt, Liberal Party) Share this | Link to this | Hansard source

It certainly gives me pleasure to contribute to this debate, having the honour of being part of the committee that looked into the benefits of breastfeeding. It came about actually because, in a previous inquiry we were working on concerning the healthcare system, we had a very good submission from the Breastfeeding Association.

At the time, they raised concerns about needs that they believed they had in relation to raising awareness and support for breastfeeding mothers. We thought it would be an opportunity to have a short, sharp inquiry. When we announced that inquiry, I have to say that I was somewhat surprised at the huge amount of interest that it generated. There were a huge number of submissions—nearly 500 submissions came from right around the country. Reading through those submissions, you are somewhat surprised at the lack of understanding on this issue. You have preconceived views in relation to the availability of formulas, for example, and the activities of infant formula manufacturers in marketing their products.

We were interested in finding out what was happening in remote and regional areas, particularly in Indigenous communities. When we were seeking information to establish where we should be going in relation to Indigenous communities, we were somewhat surprised at the total lack of information that was available. I listened to much of the contribution by my friend and colleague Mr Georganas and concur completely with what he said. I will not repeat a lot of the information that he provided; I will focus on just a couple of areas. One was in relation to Indigenous health. I guess I started this inquiry with an assumption that Indigenous people in these remote communities would be provided with truckloads of formula and that breastfeeding rates would be quite low. It was very surprising. We had the opportunity of visiting a couple of remote communities in my electorate: Kowanyama and Pormpuraaw. We found that the incidence of breastfeeding in these communities was very high—up in the 90 per cent range. We are talking about breastfeeding for six months and extending that through to up to 12 months.

When we had the opportunity of visiting the local community store we found that the availability of formula was quite limited. I have to say that it was provided in a quite responsible way. I think that highlighted to us that there was a lack of information in this area. One of the recommendations was that we need to start to look at this matter closely. What is happening in these remote Indigenous communities is also happening very much in remote Australia generally. I think we need to get a lot more information on that.

The inquiry clearly highlighted the very significant benefits associated with breastfeeding, critically up to six months of age and necessary wherever possible up to 12 months of age, in the best interests of the child. We found that some of the public hospital programs were very good. People raised concerns about their preference or where they were encouraged, basically, to put their children onto formula for convenience sake or because they may have been experiencing difficulties in early breastfeeding. Nipple soreness and things like that caused problems and they were encouraged to go onto formula.

We actually had evidence from some mothers who were very, very disappointed that they were not given the opportunity to deal with some of the physical problems—the health problems—they had and helped to persevere with breastfeeding their children. In some cases they felt they had missed out tremendously by losing that opportunity when in fact they could have dealt with some of those problems. It may well have been difficult, but if they had had proper support they could have dealt with that and then continued breastfeeding their children. One of the recommendations is to have baby-friendly hospitals where we can ensure that there is the right type of support for nursing mums to ensure that they are able to maximise that opportunity.

At the same time, however, we have to recognise that there is a critical role for formula. Unfortunately, there are some mums who just cannot feed their children naturally through breastfeeding. We have to make sure that the formulas available are as good as possible and as close as can be to mothers milk. We have to also make sure that those mums who, through no choice of their own, are compelled to use alternative methods for feeding their infants are not seen as a lesser person for doing that. There were mums who felt very much that they were seen as a lesser person because they did not have the capacity to breastfeed. It is absolutely critical that we recognise that this does occur and that these mums are just as caring and just as nurturing as those that have the ability and the privilege to be able to breastfeed their children.

We also identified another need: breastfeeding-friendly workplace environments. Mr Deputy Speaker Quick, you would be interested to know that one of the recommendations was to look at how we could turn this place into such an environment. There is a recommendation for the Speaker to consider doing that because, as you are well aware, there are a number of our members who have had children while they have been in service here and it is important that they are able to fulfil their obligations not only to the parliament but also to their children.

It was probably one of the more interesting inquiries that I have been on, and probably one of the more enlightening. You assume that you understand these issues and then you listen to evidence from passionate people who are putting forward some very, very strong arguments. I enjoyed it immensely. I think there were 21 recommendations—I defer there to the chair, Mr Somlyay, who did an outstanding job in this inquiry. I see that our deputy chair at that time is here as well. It was probably one of the more enjoyable inquiries I have done.

I think it is important that, as recommended, the department provide funds to expand the Breastfeeding-Friendly Workplace Accreditation Program nationally. The other recommended initiative, which I thought was rather interesting and important, is that we are calling on the Treasurer to move to exempt lactation aids such as breast pumps, nipple shields and supply lines from GST. They are an essential part of enabling mums to continue breastfeeding.

I take this opportunity to thank the chairman and members of the committee for doing an outstanding job. To Pauline Brown I say: thank you very much indeed; it was great. Of course I thank other members of the secretariat. It was certainly one of the more rewarding inquiries that I have participated in. I hope that, as a result of the work that we have done in this report, we have clearly identified that breastfeeding a child up to the age of 12 months is by far the best way of being able to give kids the best chance in life. It has been confirmed that we are significantly behind many of our contemporaries. When we look at the European experience, particularly the Scandinavian example, we see that we are very much behind. We start off very well with breastfeeding in the first three months but we fall back significantly at six months and our rate is very low at 12 months. There is a lot of work to be done in this area; a lot can be done to raise awareness and deal with workplace relationships. We could also fund the Australian Breastfeeding Association to enable it to expand its current helpline, to make it a toll-free helpline so it can give young mums the information that they need to make breastfeeding happen. With that contribution, I commend the report to the House. I hope that the recommendations will be adopted in full by government.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I commence my contribution to the debate by recognising the fine role the Chair of the Standing Committee on Health and Ageing has played. I have truly enjoyed working with him on all the inquiries that the committee has undertaken. He is a fine chairman and I feel privileged to have been a member of a committee which he has chaired. I also recognise the fine work of the wonderful Pauline Brown, who is sitting over there with her head bent! Her research powers and her ability to put together a report are second to none. She has excellent skills. I think the parliament is very lucky to have in its employ someone of her calibre. I note the number of submissions that the committee received: 479 submissions is an enormous number of submissions for a committee to receive on any inquiry that it undertakes. It showed us that this is an issue about which there is a lot of passion and it is something people care very deeply about.

I would like to pick up on a couple of the recommendations and then spend the majority of my contribution looking at chapter 8, which relates to the impact of breastmilk substitutes, the MAIF agreement, Marketing in Australia of Infant Formula agreement, and the WHO code, the International Code of Marketing of Breat-milk Substitutes, which are the two different codes that control the supply of breastmilk substitutes. It is also very important to note recommendation 10, which the previous speaker, the member for Leichhardt, referred to. I should have said at the beginning of my speech that I enjoyed working with all members of the committee. Those who have spoken to date—and the member for Ballarat will be speaking a little later—were real contributors to this report. I now turn to recommendation No. 10:

That the Speaker of the House of Representatives and the President of the Senate take the appropriate measures to enable the formal accreditation by the Australian Breastfeeding Association of Parliament House as a Breastfeeding Friendly Workplace.

I raised this question with the Speaker on the last sitting day and asked him to report back to me on it. I was extremely disappointed with the reaction—not from my honourable friends opposite—from some of the government members, because it showed a total lack of understanding of this issue. This is about parliament being a role model for the rest of Australia. If we cannot put in place the right sorts of procedures then how can we ask employers in other areas to do so? I felt that that was a very important recommendation. I would ask government members to ensure that their ministers and other people who are responsible for decisions in this area know just how important it is. I notice that the member for Canning is coming back into the room. When I raised that question, he was one of the members who laughed. The recommendation is in relation to Parliament House becoming a recognised and accredited breastfeeding friendly workplace. There is a very important role for this parliament to play. But that is enough said on that.

I would now like to turn to chapter 8 of the report, which deals with an issue of very great importance and one which can make a real difference to improving the rates of breastfeeding in Australia. It also goes to the way that formula is marketed in Australia. Currently in Australia we have the MAIF code of practice, which is voluntarily agreed to by the manufacturers of infant formulas. The first weakness of that voluntary code of conduct is that not all manufacturers have to sign up to it. Those manufacturers that sign up to it commit to it and must abide by it, but if a manufacturer chooses not to sign up to that code of practice there is absolutely no reason why they cannot behave in whatever manner they would like to. I do not think that is good enough. It is very important that women get the correct information about breastfeeding. It is very important that women get the support that they need in relation to breastfeeding and that they are not misled by any side issues.

The MAIF code is administered by APMAIF, the Advisory Panel on the Marketing in Australia of Infant Formula. APMAIF looks at complaints that are lodged with it in relation to breaches of MAIF. Members may be very surprised to learn that APMAIF have not submitted a report to parliament since 2005. We had the CEO of APMAIF come and talk to our committee, and I think I can say without any reservation that every member of our committee felt that the penalty for a manufacturer that breached the code of practice would be something like being hit with a wet lettuce leaf. The representatives who came before the committee quite frankly did not understand what it was all about. If a breach occurred, the penalty was to be named in the report tabled in parliament. If the reports are not tabled in parliament, tell me—please help me understand—how that penalty amounts to anything whatsoever. When the representative from MAIF left the committee hearing, I thought he might have handed in his resignation because he could not in any way justify the action of that panel.

The WHO code, which Australia was one of the first countries to sign up to, was not adopted by the Australian parliament. In 1992 the MAIF code was agreed to. The WHO code is a minimum standard and it covers both the manufacturers and the retailers. I think the fact that the retailers are not covered by the MAIF code is of great concern. The retailers can display and promote infant formula in whatever way they choose, whilst under the WHO code in other countries that is not the case. The handing out of samples to medical professionals is another thing that infant formula manufacturers can do. In countries that are covered by the WHO code that is not the case. The WHO code applies to products such as breakfast cereals, infant meals and drinks, but those are not covered by the MAIF code. On most of these foods it is recommended that the infant is four to six months old. The standard is that babies should be exclusively fed by breastmilk or nonsolids until they are six months old. So just the labelling of these products breaches the best practice for caring for, feeding and providing nutrition to young babies.

The table set out on page 135 of the committee’s report details very poignantly the contrast between the international WHO code and the rather flawed code that we have in Australia. Our committee strongly recommended that we adopt the international WHO code. The chair played a very strong part in us doing that. I would have been a little more timid in the recommendation, even though I believed passionately that that was the way to go.

When we consider the issue of the WHO code and the MAIF agreement, if the government does not accept signing up to the WHO code, we at least have to have a fallback position. I think that the minimum fallback position is that, if formula manufacturers are to sell their products in Australia, they must be a signatory to the MAIF agreement. Even if you have one group of infant formula manufacturers that are, to some degree, trying to act responsibly—even if they do not go as far as I or our committee believe they should—we need to make sure that every single manufacturer signs up to that. The manufacturers are bound by the MAIF agreement but I truly believe that there needs to be some action taken to bring the retailers under the MAIF agreement. Otherwise, the area is not being covered properly.

I notice that the time for this debate is about to expire. I would refer members to the report. I believe there are a number of really worthwhile recommendations, like those addressing the GST on lactation aids, the baby-friendly hospitals and all those other issues that have been identified in this committee report. Once again, I thank the chair for the role that he has played in the development of this report.

Debate (on motion by Mr Randall) adjourned.