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Executive Summary and Recommendations
The Australian Breastfeeding Association is one of the largest women's' self-help groups in Australia with over 12,000 Members. The Association aims to empower women to successfully breastfeed their babies.
This Budget Submission includes a comprehensive Five Year Plan for Australia to Protect and Promote the Initiation and Increased Duration of Breastfeeding which aims to protect and promote the Initiation and Increased duration of breastfeeding in Australia, and therefore improve the health status of Australia's future population. Research indicates that increasing the rate and duration of breastfeeding in Australia has the potential to save over $7 million per year in Government health expenditure.
Individual households spend over $105.5 million on buying formula and the cost to the education system of formula fed preterm infants is $2.7 million per year and $31.2 million for the life of these babies.
In addition, the Association recommends that lactation aids be included as GST free goods as they are used to provide breastmilk for vulnerable babies.
Recommendations for the 2000 - 2001 Budget
- That funding be allocated to implement the attached Five Year Plan for Australia to Protect and Promote the Initiation and Increased Duration of Breastfeeding.
- That lactation aids including: breastpumps; nipple shields; breast shells; and supply lines be declared GST free goods.
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The Australian Breastfeeding Association
The Australian Breastfeeding Association is one of the largest women's' self-help groups in Australia with over 12,000 subscribers. The Association aims to empower women to successfully breastfeed their babies.
The Association provides breastfeeding information and help to all parents through free telephone counselling services provided by 1500 trained volunteer Breastfeeding Counsellors working from their homes. Each year our Counsellors handle 276 000 counselling contacts from mothers, most of whom are not Members. This is a saving of $2.2 million to the health system.
Recognising the importance of education, the Association also organises 90,000 community education events each year. These include Group meetings for mothers, talks to schools, education sessions with health professionals and students and antenatal and postnatal classes.
Over the past 36 years the Association has developed many resources for supporting women in their choice to breastfeed. In an effort to reach all mothers, ABA has developed resources aimed at mothers in the paid workforce, teenage mothers, isolated mothers, and mothers from linguistically and culturally diverse backgrounds.
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Breastfeeding in Australia
The Australian Government has consistently recognised the value of breastfeeding to the health and well-being of the Australian community. The Australian Dietary Guidelines for Children and Adolescents and National Better Health Targets for 2000 reflect this fact.
The first dietary guideline for Children and Adolescents is "Encourage and support breastfeeding" 1 The Government has set a target of 80% of infants are to be exclusively breastfed at three months and 60% exclusively breastfed at six months.
It is difficult to accurately assess the breastfeeding rates throughout Australia, as there is no national collection of the statistics. However, from various State based research it would appear that we are some way from reaching the targets set - 84% of babies are breastfed on hospital discharge, 61% breastfed at three months and 49% at six months. 2
However, Australian breastfeeding rates appear to have remained static for the last 12 years and there is some concern that they may follow overseas trends and start to decline. Breastfeeding, rather than formula feeding, promotes good health and dramatically lowers the incidence of a number of illnesses, so saving health care costs.
Increasing the breastfeeding rates in Australia has the potential to improve the health status of Australia's future population and thus make significant savings to the Government health expenditure.
The Government made a start in the area of breastfeeding by committing $2 million between 1996 - 1998 to the National Breastfeeding Strategy. A number of projects have been undertaken with this money and it is important that the area continues to receive significant funding so the impetus is not lost.
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Breastfeeding Issues to be Addressed
The Association recommends that the following breastfeeding issues be addressed by the Government as a matter of priority. The attached Five Year Plan for Australia to Protect and Promote the Initiation and Increased Duration of Breastfeeding outlines the recommended initiatives to be implemented to address these issues.
While the initiation rates in Australia are reasonable the failure to continue to breastfeed is marked. 84.6% are breastfeeding when they are discharged from hospital, only 61.2% are feeding at 10 weeks and 48.4% at 24 weeks.3 There is a very steep decline in the number of breastfed infants between 2 and 6 weeks.
Breastfeeding rates among some groups are very low, for example, teenage mothers and mothers from linguistically and culturally diverse backgrounds. A number of strategies have begun to target these groups but more needs to be done.
Although many in the community recognise the benefits of breastfeeding, the superiority of breastmilk over substitutes and the benefits of exclusive breastfeeding are still not widely acknowledged.
The value of breastmilk is not recognised in the National Food Accounts; consequently breastfeeding is not given recognition for its economic value or importance in the community. The current structure of the National Food Accounts shows an improvement in economic value with decreases in breastfeeding, as cow's milk is included in the accounts while breastmilk is not.
Nationally there is no breastfeeding coordinator or national body overseeing the promotion and protection of breastfeeding. Policies and implementation varies from State to State and policies between Government departments are not always in harmony, for example, promoting breastfeeding versus no support for lactation breaks.
There is no ongoing routine national collection of breastfeeding statistics.
Very few hospitals have gained the World Health Organisation's Baby Friendly Hospital Initiative accreditation. 4
There is no consistent education for health professionals in the area of lactation and many professional bodies do not consider breastfeeding as an important area for on-going education or accreditation.
Legislation in Australia is not particularly supportive of breastfeeding. There is no legislation to give mothers in the paid workforce the legal right to breastfeeding breaks as set down by the ILO Convention No 103 (Maternity Protection), nor are there uniform national laws entrenching the legal right of mothers to breastfeed their baby in public places.
All women are not entitled to adequate paid maternity leave for at least the 12 weeks that it takes to establish breastfeeding properly.
Recommendation
That funding be allocated to implement the attached Five Year Plan for Australia to Protect and Promote the Initiation and Increased Duration of Breastfeeding.
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Goods and Services Tax Issues to be Addressed
The Association is concerned about the imposition of a goods and services tax on lactation aids and seeks to include such aids as an amendment to Schedule 3, Medical Aids and Appliances to A New Tax System (Goods and Services Tax) Act 1999. Alternatively, that the Minister for Health make a determination under Section 38(47).
The Association believes that such a tax on lactation aids is not in the public interest. Some babies are unable to suckle, through separation, illness or disability, or even inexperience. Breast pumps, nipple shields, breast shells and supply lines can make all the difference to whether the baby can be breastfed or not. In essence, breastmilk is the ultimate therapeutic good.
A GST on lactation aids is a tax on the food of vulnerable infants. Sometimes a mother needs help to produce the milk her baby needs. Taxing the aids for successful breastfeeding in these circumstances is counterproductive for public health. There is ample evidence that mothers' milk reduces risks of various illnesses as compared to formula fed babies. Babies missing out on mothers' milk means higher doctors' bills and hospital costs.
Recommendation:
That lactation aids including: breastpumps; nipple shields; breast shells; and supply lines be declared GST free goods.
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References:
- Australian Dietary Guidelines for Children and Adolescents, NHMRC, 1995
- Scott JA, Binns CW, Aroni RA, Infant Feeding practices in Perth and Melbourne - Report 1, 1995 p72
- Scott, Binns & Aroni, Infant Feeding Practices in Perth and Melbourne - 1993, Report 2, 1997
- There are 17 hospitals Australia wide currently with this accreditation
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