Welcome to the March edition of our newsletter – contents below.
ICYMI we wanted to highlight that we’re now on Blue Sky (which works the same way as X/Twitter) as @1stepsnutrition.bsky.social and also Instagram @1stepsnutritiontrust, so if you’re a lover of social media please consider following us there, and/or on Facebook and LinkedIn.
Professor Tim Lang led on producing this report “Just in Case: narrowing the civil food resilience gap”, commissioned and published by the UK National Preparedness Commission to establish how well prepared the UK is for a range of different food system shocks, including military weaponisation, economic, political, health, environmental and societal. While retaining a UK focus, the report draws on experiences and data gathered from 10 different countries across the globe. Firm conclusions and clear recommendations are made not only for the UK Government, but also for researchers and civil society so we can collectively bolster our national food resilience.
Early Years Nutrition Winners and Losers at Sustain’s Children’s Food Summit
On 25 February, Sustain hosted their second ever ‘Children’s Food Summit’, as part of their Children’s Food Campaign, with fantastic engagement and attendance from Children’s Food Campaign members and supporters from across civil society and Government. A part of the event involved awards for different categories, including Early Years Nutrition Champion and ‘Yucky’ awards for commercial villains. We at First Steps partnered on the champion award, seeking public and peer organisation nominations and adding our own suggestions in to the mix. We also helped judge the awards (with the exception of the one we supported to avoid any conflict of interest). Amazingly, many of the winners across awards categories were for organisations and individuals working to support eating well in pregnancy, infancy and early childhood (see below). Interestingly, yucky awards were dominated by unnecessary and inappropriate commercial infant and toddler foods (read more from Sustain on this here: KFC plus infant and toddler food brands come under fire at 2025 Children's Food Awards). This goes to show how the importance of early years nutrition, and the commercial challenges to eating well in these critical stages of life, have really come into the spotlight in the last couple of years. Here’s hoping this will help galvanise positive changes in the foreseeable future.
Congratulations to all the early years nutrition award winners and finalists, both yummy and yucky:
Political Leadership in Championing Children's Healthy Food Winner: Carolyn Wilson and the early years team, Scottish Government
Championing Equality, Diversity and Inclusion in Children's Food Winner: Leicester Mammas (pictured)
World Pulses Day, organised by the Food and Agriculture Organization for the United Nations, was on 10 February this year. It aims to increase awareness of the importance of pulses, such as beans, lentils, and peas, for their nutritional value in our diets, improving planetary health and food security worldwide.
Eating well in the first two years is important to ensure optimal nutrition for growth and development and the development of healthy food preferences. A healthy diet in the early years is one providing a wide variety of nutritious, minimally processed foods. Pulses are nutrient dense and are great sources of protein, iron, zinc, calcium, riboflavin (Vitamin B2) and fibre. Pulses can be offered from 6 months, among other first foods and as part of an increasingly varied diet. For infants and young children in families following a vegan dietary pattern, pulses form an important part of making sure that these children eat enough protein for their growth and development. You can access practical guidance on how to provide a nutritious diet for young children in vegan families in our Eating Well guide ‘Eating Well: Vegan infants and under 5s’, here.
Example of different ways to serve red lentils, a commonly used pulse, as part of introducing a wide variety of textures during the complementary feeding period.
A wide variety of pulses are also used in traditional South Asian dishes, and it is important to acknowledge how these dishes can be adapted for young children’s diets. You can read more on how to use pulses in South Asian cooking for infants and young children in our blog that we wrote in collaboration with Eating Better here, and in our South Asian Eating Well guide on feeding children aged 6 to 24 months, available in both English and Bengali, here.
NEW data: Oral health survey of 5-year-old children in England
This England-wide survey, which happens every two years, reports on data collected in the school year 2023/2024. The results show a small decrease in obvious dentinal decay since the last survey, at 22.4% down from 23.7%. Among the 22.4%, each child had on average 3.5 teeth with decay experience (at age 5 years, children normally have 20 primary teeth).
While the decline is good, this prevalence is shockingly high and masks disparities at both regional and local authority levels. Prevalence for enamel and/or dentinal decay is also higher at 26.9%, with regional ranges from 23.3% in the East of England to 36.8% in the North West.
Children living in the most deprived areas of the country were more than twice as likely to have experienced dentinal decay (32.2%) as those living in the least deprived areas (13.6%). There were also disparities in the percentage of those who had experienced dentinal decay by ethnic group, which was significantly higher in the Other ethnic group (45.4%) and the Asian or Asian British ethnic group (37.7%).
The report highlights that most dental decay is preventable, by limiting sugary foods and drinks. Our guide “Eating well: the first year” covers how to look after baby teeth, providing advice aligned with NHS and NICE guidelines. Chapter 10 of this 2014 Government toolkit also has a specific section on early years diets: Delivering better oral health: an evidence-based toolkit for prevention.
Practice tips for preventing dental decay:
Promote and support breastfeeding
Advise introduction of a beaker/open cup from 6 months, and to stop using a bottle after 12 months
Advise to give only breastmilk, first infant formula, or water in the first year (water to drink after 6 months of age) and only breastmilk, water and cows’ milk up to the age of 5 (or a suitable, fortified and unsweetened/zero sugar plant-based milk alternative for dairy free diets)
Advise avoidance of all formula milks, including growing up and toddler milks after the age of 1 year
Advise avoiding sugary foods and drinks – noting this includes most commercial baby foods, even though they are marketed as healthy choices!
Advise to brush baby’s teeth twice a day every day as soon as they appear, using a smear of fluoridated toothpaste
New Report: Dietary Intake in Scotland’s Children (DISH) research
Food Standards Scotland has published a report in collaboration with the University of Edinburgh with information on dietary intakes of 1,700 children aged 2-15 years in Scotland in 2024. For children aged 2-4 years, just 27% met their energy density goals and 13% had the appropriate amount of saturated fat in their diets. Concerningly, just 14% met the goal of less than 5% of energy intakes being attributed to free sugars, with the average being 9%. Most 2–4-year-olds did not have enough fibre in their diet (68%), and significantly less young children in the most deprived areas met their fibre intake goals than in the least deprived areas. Young children in the most deprived areas also consumed significantly less fruit and vegetables than those in the least deprived areas in all age categories. Additionally, confectionary, sweet biscuits, crisps and savoury snacks, cakes, sweet pastries, sugary drinks, puddings, ice cream, and dairy desserts made up 14% of 2–4-year old’s energy intakes and a third of their free sugar intakes. As well as the nutrient imbalance these foods create in young children’s diets, this is concerning because many of these foods are ultra processed (UPF). To read more about why a UPF-rich diet is a concern in early childhood, read our 2023 report here.
The DISH findings suggest poor diets are still a major challenge for Scottish children, especially for those most vulnerable, living with food security or in the most deprived areas. We support the call for collective effort from policymakers, the food industry, schools, and communities to support healthier diets by improving the food environment. Improving the food environment in Scotland could help rebalance children’s diets towards the nutrient-dense, less processed/whole foods necessary to meet dietary requirements.
Early years diets are important for children to develop healthy eating preferences as well as to meet their nutrition needs for optimal growth and development and prevent disease. Our ‘Eating Well’ guides provide practical advice on how to meet nutrient requirements during pregnancy, while breastfeeding and for infants and young children under 5, cost effectively and based on unprocessed and minimally processed foods. You can download or buy hard copies here.
For parents using formula, First Infant Formula is the only formula their babies will need in the first year of life. It doesn’t matter which brand they use as they are all very similar. The NHS provides some information on formula feeding your baby and types of formula milk. However, and not surprisingly, formula companies still seek to convince parents/carers that their high-priced products are superior to other, lower cost, alternatives.
In response to rising infant formula costs (and our advocacy), the Competition and Markets Authority’s (CMA) carried out a study of the infant and follow-on formula market and exposed brand profiteering via unjustifiable price hikes. The CMA has recently recommended a series of robust interventions to strengthen and properly implement existing marketing rules for formula, as well as to better support families in informed decision making around product choice (see BFLG news below). Unfortunately, since the CMA started investigating formula prices, companies have doubled down on their marketing and insistence that their products are superior to others. We decided to create our own, conflict of interest free infographics to set the record straight. See below our infographics compared to industry’s misleading marketing tactics.
In this first example of current marketing, Aptamil claims that Aptamil and Aptamil Advanced are better than ‘First Infant Milk Minimum Requirements’ when in fact the nutritional requirements are strictly regulated and cannot be bettered with the addition of extra or ‘special’ ingredients.
Our infographic highlights that all first infant formula meet strict nutritional requirements and that they are all equally suitable for babies’ growth and development. You can download this infographichere.
In this second example of current marketing, Kendamil compares its new lower cost Bonya formula with other low cost infant formulas to suggest theirs is better. They use ingredient claims such as ‘contains milk fats’ and ‘no fish oil’ which suggests these products are better quality when they make no difference to health and nutrition outcomes or product safety.
Our infographic highlights all the key nutrients that are included in infant formula in the UK, and the minimal differences between ‘premium’ branded formula products, and lower cost brands as well as supermarket own-brand alternatives. You can download this infographic here.
We encourage you to share these infographics on your social media and within your network. For further supplementary information for parents and carers who use formula, see below. This core reference provides an overview on infant formula for healthcare professionals.
New: Summary sheet of information for families who use formula
At the request of a midwife, we have created a one-page handout that lists and provides links to the different parent-facing resources we provide on formula. These are intended for use by midwives and health visitors supporting post-partum families who are using formula. These resources are in line with and complement NHS guidance. You can find the handout on our website here.
We have had an increasing number of queries about ‘Sprout’ an Australian, vegan infant formula made from rice starch and rice and pea protein.
In addition, ‘Arize’ is a new specialised formula based on hydrolysed rice protein which has recently come on to the UK market, positioned as an alternative to extensively hydrolysed formulas for infants with cows’ milk allergy.
Two key points:
1. ‘Sprout’ does NOT meet UK/European regulations for infant formula composition in a number of ways, which means we would not endorse its use.
2. ‘Arize’ is an FSMP and should only be used under medical supervision.
You can find out more about both products in our new FAQ ‘what rice-based formula milks are available and are they recommended?’ here.
Competition and Markets Authority infant and follow-on formula Market Study final report
On Friday 14 February 2025, the Competition and Markets Authority published its much-anticipated final infant and follow-on formula market study report. We welcome the report and fully support the proposed set of recommendations, many of which we have been advocating for some time. The final documents include an 8-page overview of the findings, 34-page Executive Summary and comprehensive 185-page Final report, together with 6 Appendices, a qualitative research report and 35 submissions published in response to the CMA’s interim report (including ours).
The following figure (available here) summarises the 11 recommendations from the CMA’s final report:
First Steps Nutrition Trust and the Baby Feeding Law Group UK issued a press release with feedback on the morning of 14 February, together with quotes from Jess Brown-Fuller MP (Chair of the All Party Parliamentary Group on Infant Feeding), Baroness Walmsley (Chair of the House of Lords all party inquiry entitled ‘Recipe for health: a plan to fix our broken food system’), Alison Morton, CEO of the Institute for Health Visiting (iHV) and Dr Chris van Tulleken, doctor, author and broadcaster. Our Senior Nutritionist, Dr Katie Pereira-Kotze was also on BBC Breakfast at 08:30 the morning the report was launched, see here. On 21 February, the Food Foundation shared this helpful short podcast: "CMA formula update" and on the same day The Grocer published this feature about the report: "Can the CMA save parents from infant formula confusion?"
We are currently finalising a comprehensive response to the CMA’s final report, incorporating inputs from the members of the BFLG-UK, and this will be available in due course on the BFLG website here.
In the meantime, we strongly recommend that all four governments urgently implement the package of recommendations put forward by the CMA, to ensure that all parents, however they feed their babies, can make informed infant feeding choices. We urge the Department of Health and Social Care (DHSC) to take the lead on providing the clear, impartial, accurate messaging required. There are some recommendations that can be implemented without regulatory change (including improved enforcement and the standardisation of infant formula labelling in health care settings). An important recommendation that we fully agree with but understand may take time (requiring public consultation) is the strengthening of labelling and advertising rules. We see this as an opportunity for the UK legislation to be more aligned with global guidance, to protect all infants, by ensuring safe and appropriate formula feeding together with the protection of breastfeeding. We will continue to urge caution that formula price promotions will never be appropriate due to the potential associated risks, especially to the most vulnerable families, and are not a credible solution to high prices, where companies have maintained high profit margins. Lastly, the recommendations from the CMA need to be accompanied by proportionate action to ensure universal access to breastfeeding for mothers who want to breastfeed as well as improvements to the Healthy Start scheme to support pregnant women, breastfeeding women, babies, and young children to meet their nutritional needs.
All Party Parliamentary Group on Infant Feeding update
The All-Party Parliamentary Group (APPG) for Infant Feeding has been reformed following the election last year and is now chaired by Jess Brown-Fuller, MP for Chichester. On 24 February 2025, Jess, together with the Chair for the APPG for Babies (Maya Ellis, MP) and the Chair for the Health APPG (Dr Simon Opher, MP), sent a letter to the Secretary of State for Health, asking that the Government implements the CMA market study recommendations (see above) as a matter of urgency.
On Tuesday 4 March, the first full meeting of this APPG took place, in a hybrid format with a face-to-face meeting at Portcullis House. There was a presentation from Rachel Smith from the Competition and Markets Authority who discussed the final report from the CMA on the infant formula and follow-on formula market study. Our Senior Nutritionist, Dr Katie Pereira-Kotze Katie shared the response from the BFLG-UK to the CMA recommendations, and this will be available in due course on the BFLG website here.
Nourishing our Future conference, Saturday 15 March 15, Essex
Anglia Ruskin University (ARU) and Essex County Council (ECC) Public Health are hosting this pioneering event dedicated to exploring and promoting healthy eating in early years settings. The event will take place on Saturday 15 March at ARU’s Chelmsford campus.
The Nourishing Our Future project is a research initiative led by ARU and commissioned by Essex County Council Public Health, that delves into the challenges and opportunities of fostering healthy eating habits in early years settings. By collaborating with educators, parents, and industry leaders, the project aims to create impactful resources and strategies that benefit children across the region and beyond. This project sought to understand the current food environment within early years settings in Essex and identify areas of need and realistic and effective opportunities for improvement. The conference will bring together local parents, early educators, researchers, experts, and policy leaders from the intersecting fields of early childhood education, nutrition, and public health. It seeks to exchange insights, highlight innovative practices, and develop real-world strategies for creating healthier food environments for young children.
The research findings will be presented, and there will be contributions from a range of actors including us at First Steps. Book to attend here.
World Breastfeeding Trends Initiative (WBTi) UK 2024 Report launch, Tuesday 25 March, London
The 2024 World Breastfeeding Trends Initiative (WBTi) UK Report, assessing breastfeeding policies, programmes and practices in the UK, will be launched on Tuesday 25 March 2025 from 6-8pm. This will happen through a hybrid event with limited in-person places (at Guy’s Hospital in London). Please RSVP to Patricia Wise at patricia@wise141.co.uk, indicating whether you would like to attend in-person or virtually.
House of Lords debate on the Government response to ‘Recipe for Health’, Friday 28 March, online
As reported in our February newsletter the formal response of Government to the House of Lords report ‘Recipe for Health’ published on Thursday 30 January was very disappointing, with no new meaningful commitments despite acknowledgement of the huge problem posed by persistent high levels of overweight and obesity. At 10am on Friday 28 March, the response will be debated in the House of Lords, and the debate can be watched on parliament TV. We will share links on our social media.
