Actually, Nick, there might be something in this vouchers for breastfeeding thing

Nick Clegg was asked yesterday, on his LBC phone in, what he thought about the plan to give women in deprived areas £200 in High Street shopping vouchers. This was one of these questions which he had to answer by instinct because he didn't know the detail and to give him credit, he said a lot of the right things. He talked about how no mum should feel pressured to breastfeed, but those who do should get the support they need. Whether he knows on a practical level what that actually means, though, is not clear.

He was unambiguous about one thing, though

Needless to say, it's not going to be Government policy to pay mothers to breastfeed.

I actually think that the benefits of breastfeeding, particularly in deprived areas, are so clear that it is worth trying anything that works.  Given Nick Clegg's commitment to tackling inequality, too, he might be very interested to find that research shows that a poor breastfed baby has better long term health chances than an affluent formula fed baby. If I had to pick just one of my many ramblings on various subjects for him to read, it would be this from last year following the UNICEF report that showed that the NHS could save £40 million a year by supporting breastfeeding and in particular this quote from research:

Breast fed children from lower socio-economic groups had better outcomes than formula fed children from more affluent families.

However, when resources are tight, I think that there are three very practical things  that come ahead of the vouchers scheme. I was on Radio Scotland's Call Kaye on Wednesday talking about them, and you can listen here to "Caron from Bathgate" at about 45 minutes in.

Good quality support

When I hit trouble early in my breastfeeding career, it was the specific support I received from La Leche League that sorted me out. I could so easily have given up because my local midwife and health visitor, lovely though they were, just didn't have the detailed information I needed to get through. Nor could they come out and sit in my house like LLL's Louise did. When I started supporting women myself, I found that some health professionals didn't know things I considered to be basic. Things are better now, but women often still can't access the help that they need.

Groups

Guilt seems to go and in hand with motherhood. When you're tired and upset and things aren't going well, you can blame yourself and think that you are the only one in the world who's going through it. You worry constantly that you are failing your baby. Attending a support group means that you meet others who are going through the same thing. Some will still be struggling with it. That group dynamic, led by someone who has some good evidence based solutions to offer in an informal and friendly environment, can do wonders.

Classes

Ante-matal breastfeeding classes are extremely useful in informing and preparing parents for what they might expect. Like all problems, the sooner you recognise it and intervene, the easier it is to resolve. If you can give people an idea of how to know if the baby is getting enough milk - and there are some very graphic leaflets around showing you exactly the size and colour of the emissions necessary to indicate that - they are more likely to call you in earlier.

I'd take it further, though. I've come across so many women whose families have undermined their breastfeeding. If their baby doesn't sleep, or cries a lot, breastfeeding gets the blame. They are told, often with the best of intentions,  that their milk isn't good enough or that the baby is hungry. I think there needs to be an ad campaign, or a class targeted at grannies to update them on current research, evidence and effective ways to support the new mother in their family.

Culture

Our culture has some very strange ideas about what breasts are for and how they should be portrayed. It equally has some very strange ideas about how babies behave and what they need. The baby that sleeps for four hours and only wakes up to be fed exists only between the wishful thinking pages of a text book. It's going to take a long time to achieve that and it will take getting many more mothers to breastfeed before we accept it as normal. That's why the vouchers scheme might be worth a shot. I'm looking forward to seeing how the pilot turns out. There is a very strong argument for putting as much money into encouraging breastfeeding as it takes to transform the health of our most disadvantaged babies.

Jim Hume MSP launches consultation on measure to ban smoking in vehicles with children present

Liberal Democrat MSP for the South of Scotland Jim Hume this week launched a consultation on his Members' Bill which would see smoking banned in vehicles where children are present. When I initially flagged this up on Liberal Democrat Voice a few weeks ago, there was a mixed reaction to the proposals.

Jim says in the foreword to his consultation document:

Recent research has shown that 17% of 11-16 year olds in the UK are exposed to second-hand smoke more than once a week while in a car with a further 30% indicating exposure once a week or less. These are shocking figures. I believe we can improve on the ban on smoking in public places and places of work, further protecting our children.

Research has found that second-hand tobacco smoke in cars has serious negative health impacts for children, including Sudden Infant Death Syndrome, coughing, wheezing, asthma and respiratory tract infections such as bronchitis and pneumonia. Not to mention the known risk of lung cancer from second hand smoke and the fact those exposed to second hand smoke as children are more likely to take up smoking themselves in later life.

Some children have no option but to go into a smoke filled car en route to the school, shops or their sport. I believe we have a moral duty to protect those children from second hand smoke, which will allow children to have the freedom to get the best start in life and go on to lead healthy lives themselves. I believe we need to remove the danger of smoke filled cars and ban smoking in cars when children are present. That is why I am consulting on the intention to bring in a Member’s Bill which will prohibit tobacco smoking in cars when children are present.

Penalty

The penalty Jim is proposing is similar to that for using a mobile phone while driving - an on the spot fine of £60. There would be no penalty points on a driving licence, though, as you wouldn't have to be driving to be in breach of this offence.

This might ease the concerns of some that a social services investigation would ensue on conviction.

Medical evidence

The document contains 9 pages of hard hitting, credible medical evidence outlining the case for change. In some ways, I think that some of that should be used to create a public awareness campaign on the dangers children face if you smoke in a car near them. If Jim's measure leads to that, surely it will be a big step forward.

Scots have until 30th August to respond to the consultation, which asks 11 questions. One issue that immediately comes to mind is how to raise awareness in other parts of the UK so that visitors to Scotland are aware. You can read the whole document and find out how to respond here.

Banning smoking in cars where children are present: what do you think?

North of the Border, the war on smoking continues. Today, larger shops are no longer allowed to display cigarettes. Now, Scottish Liberal Democrat MSP and health spokesperson Jim Hume is introducing a Member's Bill in the Scottish Parliament which will ban smoking in cars where children are present. His proposal will be put out to public consultation from 28th May. Talking about his plan over the weekend, he said:

The tobacco display ban is another welcome step in changing Scotland’s relationship with smoking which began with the ban in smoking in public places. But more can be done in our journey towards a healthier Scotland.
Passive smoking is entirely avoidable a

nd a private vehicle is one of the few places a child can still be legally exposed to tobacco smoke. That is why I am seeking a change in the law to safeguard the rights of children in Scotland and to give them a better start in life. My consultation to ban smoking tobacco in vehicles while children are present will be launched on the 28th May.

I stand alongside the British Heart Foundation, British Lung Foundation, Children in Scotland and ASH Scotland, amongst many others, in seeking a change to the law and hope that people and organisations from across Scotland can take part in this important consultation.

It doesn’t seem fair that any child should have to be trapped in a car which is filled with smoke. When you consider the real implications this can have for a child’s immediate and future health, it is clear we need to do what we can to protect children and give them the best start in life.

I have written several times about this issue over the year. In 2011, when Labour came up with this proposal, I said:

I think that the smoking ban introduced in 2006 by the Liberal Democrat/Labour coalition is one of the best pieces of legislation ever, because it strikes the right balance between freedom to smoke, and freedom to breathe air free from the poisons in cigarette smoke.   That covers public space, though. What about private space?  If we ban smoking in cars, surely there’s an argument to ban it in houses? And alcohol is harmful too – we know about the effects of growing up with parents who abuse alcohol. Do we ban drinking in a house where there are under 18s? What about obesity? Do we give the state the right to go through people’s food cupboards and fine per chocolate bar or crisp packet because obesity is such a problem and is going to cost us a fortune in the future?  If the issue is with the proven risks of cigarette smoke in a very confined space, you don’t get much more confined than a womb. Do we ban smoking in pregnancy? Even if we thought that was a good idea, which I don’t, how on earth do you enforce that?

My view hasn't changed since then and in fact I spoke to someone last week who said that a conviction of this nature might well end up with parents being automatically investigated by social services which might stretch already insufficient resources even further.

Having said all of that, I have a great deal of sympathy with the arguments in favour of such a measure and I do think that smoking around children at all is horribly inconsiderate and takes unacceptable risks with their future health. This is one of those issues where you can make a liberal argument from either perspective.

It is undoubtedly a good thing that this is being debated. At least some of the risks and dangers of the practice will be discussed openly and may encourage people to change their behaviour.  I wondered what LDV readers thought of the idea. Let us know in the comments below.

The proof that drinking will make me ugly

You may have seen my post a couple of days ago in which I expressed my concern about the new Scottish Government campaign aimed at getting women to reduce their alcohol consumption because too much wine makes them ugly. The intervening two days have not made me any happier with this tactic.

It's bad enough when newspapers and celebrity magazines ridicule people who don't conform to a certain standard of beauty - you'd think it was a crime even going out without make-up, for example. There's a multi squillion cosmetics and beauty industry persuading women that their natural state is far from desirable. If that was the case, how on earth we managed to reproduce before there were the likes of Clarins and Revlon I don't know. For the state to latch on to that sort of poisonous culture, though, is totally reprehensible.

I hadn't been able to download the iPhone app when I wrote my original post. I have now and it only adds to my concerns. Facebook is full of teenagers rating each other for looks, a practice I find extremely worrying. Now, the Government has provided a handy app which distorts someone's features. The potential for its use in bullying is clear. I know it's not the only app which does that, but it's one which comes from the Government and that makes me feel very uneasy.

The app itself shows a mirror surrounded by lights and invites you to choose or take a photo. You then position it on the outline and it shows you what you might look like if you have 1-6, 6-10 and 10+ glasses of wine a week. Here are mine. I'll leave it to you to guess which is the real and which is the distorted image.

One thing that worries me is that there's nothing within the app to signpost you to where you can get help information about alcohol consumption, or the key messages of the campaign. If you push the words Drinking Mirror, you do end up getting taken to the website, but you'd have to know to do that.

This campaign is aimed at women like me who like the odd glass of merlot at the end of the day. Frankly, what most women like me want is extra energy cos we all have so much to do. I know that I have more energy when I avoid alcohol and I wonder if that wouldn't be a better focal point for such a venture.

Alex Neil, don't you dare tell me I'm not a pretty sight

The Scottish Government has launched a campaign today called "Drop a glass size", aimed at women to get them to cut their alcohol consumption. The theory is sound enough. Wine glasses come in all shapes and sizes and, of course, if you use a smaller glass, and have the same number of glasses a week, you'll consume less alcohol, which is a good thing.

The method, though, oh dear. Why should we stop drinking? Because it ruins our looks, apparently. Are women not already under enough pressure to look good, to conform to often unattainable standards of beauty? If we're not thin enough with perfect hair, curves, teeth and nails, then we are objects of ridicule screams every tabloid and women's magazine. I mean, how I have the temerity to go out in public, given that I conform to none of it, I don't know. It's enough to drive you to drink....

They've launched an app, the drinking mirror,  too, for your smartphone or tablet which shows you a picture of what the drink will do to you if you don't stop...I can't see how you get it on an iPhone. It's not coming up on search in the App Store and there's no link so I can't see what a dreadful sight I'd look yet. This is the blurb that comes with the app:

Is alcohol ageing you? Deeper wrinkles, red cheeks and weight gain... some of the visible effects of regularly drinking too much are not a pretty sight.

Download the FREE Drinking Mirror iPhone or Android App below and see how dropping a glass size could help you look fabulous.

Do you know what ages women? Age. The passage of time. The appearance of wrinkles and weight gain at least happens as you get older. But women aren't allowed to do that. No, they have to conform.

If they want women to cut drinking, why not base their arguments around something women actually want, not what they feel pressurised to do. I'm thinking of more energy. I know for a fact that I feel more energetic if I haven't had any alcohol than if I have. There isn't a woman in Scotland, I bet, who wouldn't want to feel less knackered and if cutting alcohol consumption can help with that, then it's a guilt free, pressure free way of persuading them to do that.

I get that basing the campaign on appearance may be an effective way of getting into women's psyche. But surely that isn't a good thing. I am annoyed with Alex Neil for signing off on this. Cutting alcohol consumption is always a good thing to do, but I feel insulted and patronised by the ethos of this campaign.

Nobody would ever get run over if we banned crossing roads.........

To a liberal the idea of banning anything is instinctively something that has to be scrutinised within an inch of its life. To us, the state has to have a compelling reason to interfere in someone's private life and people should generally be free to go about their business as they choose so long as they are not infringing the rights of others.

And, so, just because doctors call for a ban on all smoking in private cars, this does not mean that one should be enacted, in much the same way as when the Police said they needed to detain terrorist suspects for 90 days, liberal voices ensured that this did not happen.

The BMA's line is that the toxicity of the environment inside a smoky car can be 23 times that in a smoky bar. Adults can make their own minds up about whether they take that risk. I don't think that I would regularly get into a car where someone was smoking. The state has no place to interfere in those decisions. If it did, then by the same logic, Government officials could be employed to go through your trolley at the supermarket and chuck out everything that's bad for you. If you ban people from smoking in their own private surroundings, and cars are part of that, where will the assault on liberty end?

But what about the risks to children? Believe me, my opinion of anyone who, knowing what we know about its harmful effects, exposes children to their cigarette smoke is right down there with bankers and  companies who inappropriately market infant formula in my estimation. Again, though, where do we draw the line? I wrote about this very issue earlier this year when Labour touted making smoking in cars with children a crime.

I said at the time:

There comes a point when the state has to recognise that it can’t do everything.  Smoking in cars when you’re taking your kid to school when the evidence exists that this causes harm is an inconsiderate, horrible thing to do that will probably affect their future health. 

There’s all sorts of things parents do, though, which store up future problems for their children. That’s why poet Philip Larkin famously said “They f*** you up, your mum and dad.”  Evidence suggests that the regime orientated parenting methods such as leaving babies to cry and trying to regulate their instinctive behaviour can cause much more harm than good for future mental wellbeing.  We have a situation where 1 in 4 adults will have mental health problems at some point in their lives. Do we ban these methods in the hope of improving mental health?  I can imagine the outcry if a Government tried. 

What I think would me more helpful, though, is an attempt by Governments and politicians to put the needs of children front and centre, to try to change the culture to make us a much more child friendly place.  We don’t actually seem to like kids very much here – we ghettoise them, try to confine them to soft play areas so that adults can get on with their own socialising. Then we complain when they hang around with each other as teenagers.  Maybe we should be thinking about how we can best integrate them into our lives and accept and enjoy them in every environment. Then it might not be so easy to dismiss the effects on them of lighting up in a small metal box.

I suspect the BMA's agenda is actually to gain a ban where children is concerned by making it look like a compromise on this proposal, but I think that even this would be too far.

I'm pleased to see that the Scottish Government is being quite sensible in response to the BMA's proposal, which I presume is down to Nicola Sturgeon. They say that:

"While we have no plans to extend the smoke-free laws to private cars, the Scottish government is conscious that private cars are now one of the main places for exposure of children to second-hand smoke.

"In developing our refreshed national tobacco control strategy for publication next year we will consider with our health improvement partners what further steps might be taken to protect children from the risks posed by second-hand smoke."

I think Nicola should sit down with Angela Constance, the Children's Minister, the Children's Commissioner, representatives of children's charities and maybe even some children themselves and work out how best to make Scotland a more child friendly culture. That to me is the most sensible way forward. Changing culture takes time, but think back to the when I was a child when nobody wore seatbelts in cars and drink driving wasn't exactly encouraged, but it wasn't frowned upon either.

South of the border, they should do the same sort of thing. A sort of ongoing children's summit, if you like.

 If the Government tried to ban everything that was risky, then we'd literally never go out - and staying cooped up at home isn't exactly healthy either. There are some things you shouldn't legislate for. Personal freedom is precious and we must guard it carefully.

BBC reports flawed breastfeeding report as Holy Writ alongside new Vitamin D guidance

The BBC is reporting that the Scottish Government has issued some new advice to pregnant mothers, that they should take Vitamin D supplements. Much as I'm not keen on synthetic vitamins, I can't really argue with this one. We used to spend so much time outside in sunlight, but with modern busy lives, children often spend their early years being driven to nursery, spending all day there and then going straight home. There's not so much of the spending all day outside in the pram, either in the garden, or going for long walks, soaking up the sun's rays, and when we do, we sensibly slap on the sunscreen. Even La Leche League has conceded on the Vitamin D issue so I reckon this is a sensible move.

The thing that's made me absolutely mad is not what the Scottish Government has said, but the way the BBC has reported that there is no change to the age at which children are recommended to be weaned:

The policy was drawn up before evidence that babies should be given solid food before the age of six months was published in last week's British Medical Journal.

The BBC are treating a report by 4 people, 3 of whom have connections with the baby food industry, as Holy Writ even though it is not based on a shred of new evidence, just them putting their spin on older research. I wrote about this in more detail last week. Honestly, journalists are all over politicians at the slightest sniff of a conflict of interest, yet they print this sort of stuff unchallenged. I am not impressed.

Moving on, the new Scottish guidance suggests that the introduction of lumpy foods too late can cause a baby to be fussy eaters and can exhibit strong dislikes even at 7 years old. There's a bit of chicken and egg about this, I think. Anna would have nothing to do with lumpy foods, despite being offered them on a daily basis from before 6 months, until she was a fair bit over a year. And she is quite a fussy eater. Looks like an open and shut case, but is it?

I have always resolved never to make food a battleground. I will take no guilt on this, as I believe it's my job as her mother to offer her healthy, nutritious food several times a day, and it is her job to eat it. If she doesn't want to, I'm not going to force her. Yes, she has strong food preferences, but as she grows older, the range of things she'll eat is getting bigger. This is a child who wouldn't touch an apple or a banana if her life depended on it, but who will  happily down grapefruit, brocoli and mushrooms. My point is that the refusal of lumps may have been an indication that she was already a fussy eater. Her diet has caused me stress over the years, but she's healthy and a perfect weight for her height and age so we're doing something right somewhere..

My health visitor, who was lovely, and often right, told me when I mentioned the lumpy food issue that I'd have to sort that or she might have speech problems. At that point, at the age of around a year, Anna had a vocabulary of over 100 words, so I took that particular bit of advice with a pinch of salt.

I tried so many things to try to get her to eat lumps and finger food in those days, but she was seriously having none of it, but, like everything else, it all sorted itself out in the end. I find the fact that it's been confirmed that there is a relationship between lump refusal and fussy eating interesting, but not really surprising and I'm not really sure what parents in the same position as I was are supposed to do.

Dark Chocolate can be healthy.....

It's a bit dreich and dismal this morning, and it's the last day of the school holidays and our Summer of Fun must come to an end.

However, I do take a wee bit of comfort in the research from Sweden that dark chocolate, eaten in, to be honest, fairly miniscule quantities, can help prevent heart failure in older women.

As ever, there's a dietitian on hand to tell you that no, you can't have your sweet treats and should look for the same chemicals in nice vegetables instead, just for the sake of balanced reporting.

I know I have a lot to learn about the art of moderation where food is concerned, but I really do think that's the way to go. I know from bitter experience that denying all treats just leads to diet disaster. Effectively the research gives you carte blanche to eat a couple of squares of dark chocolate a week, no more. Surely nobody's going to deny us that small pleasure?

Lib Dem Finnie calls for probe into hospital malnutrition deaths

Scottish Liberal Democrat Health Spokesperson Ross Finnie has called for ministers to investigate whether malnutrition in hospital patients is being properly diagnosed after official figures sought by the Liberal Democrats showed that this was the cause of death for 450 people in hospital over the last five years.

Ross Finnie said:

"It is alarming that anyone in Scotland is dying of malnutrition in this day and age.

"Most victims are elderly people, many of whom have conditions that make eating difficult or need help with their meals.

"These figures raise the serious concern that in some hospitals, malnutrition is not being properly diagnosed.

"Ministers must investigate this issue as a matter of urgency."

I think he's right to ask the Government to make sure that there are procedures in place to check that patients, particularly the elderly, are eating as well as they can, and helping them if they can't, for example, feed themselves.

Drink Beer for Healthy Bones, Girls

In the days of yore, when I was a student, if I strayed too far into normal pubs and away from the usual student hangouts, I was looked upon with great suspicion if I tried to order a pint. I remember being told at least once that they didn't serve pints to women. Needless to say, I left. Even when we lived in Nottinghamshire, ordering a pint of real ale and being female had its incompatibilities.

Anyway, I was amused to see this story which suggests that moderate consumption of beer can actually protect women from Osteoporosis. However, you get the best results if you're naughty and consume more per week than the Government thinks is safe - around a pint a day on top of the two units you are allowed to be exact.

The Osteoporosis Society was at best bemused by the research and was at pains to warn us not to drink too much:

"While low quantities of alcohol may appear to have bone density benefits, higher intakes have been shown to decrease bone strength, with an alcohol intake of more than two units per day actually increasing the risk of breaking a bone.

"There are also many other health concerns linked with alcohol which cannot be ignored."

The good thing about the research is that they think that plant hormones present in beer may have something to do with improving bone health and these will no doubt be studied more and might lead to something which helps reduce the misery of Osteoporosis.

In the meantime, mine's a pint of St Peter's Well....

Prescription Relief

The Liberal Democrat pledge on prescription charges is set to bring relief to anybody who currently has to pay large amounts of money for prescribed drugs for chronic conditions not covered by current exemptions. The plans mean that the maximum anyone will pay will be one prescription charge per month. Everything above that will be free to all, and those people currently exempt will pay nothing at all.

I have been in contact with a fair number of people through my work whose lives have been blighted by illness and who currently have to find the money to find essential prescribed drugs. This move would make life easier for them.

Coupled with that is a pledge to give pharmacists greater powers to prescribe so that GP's time is freed up to concentrate on those who really need it.