Welcome to the December edition of our newsletter. We hope you have a good Christmas and 2025 gets off to a good start. Our next newsletter will be in early February.
New investigation: Campaigners call for end to food and drink industry’s infiltration of UK children’s education
Hot off the press today (Thursday 5 December), the BMJ have published this investigative report highlighting stealth marketing by the food and drink industry – including baby food brands - through education initiatives in nurseries and schools.
We signed a joint letter to the secretaries of state for education and health and social care calling for an end to this harmful marketing by companies marketing unhealthy foods which do not align with public health recommendations for children.
Our Director Vicky wrote this Op-Ed to accompany the report, highlighting the urgent need to address the composition and marketing of commercial baby and toddler foods.
On 27 November, the chief medical officers, chief nursing officers and chief midwifery officers published this correspondence to all health professionals. It urges them to continue advising women to take 400 micrograms of folic acid daily if they could become pregnant, and in the first 12 weeks of pregnancy to prevent neural tube defects. The context is that the government has mandated fortification of non-wholemeal flour with folic acid, and a concern that this might lead some women in to thinking this mean they no longer have to take a supplement, which is not the case.
News: Little Freddie baby food pouches misleading customers over sugar levels
The Grocer reported on data from independent laboratory tests that indicate that the brand Little Freddie are presenting misleading sugar levels on packs of fruit pouches marketed for babies from 6 months of age. It found that some contained almost double the amount of sugar listed in the nutritional information on pack. The products tested contained on average, 40 percent higher sugar levels than declared, and 11 percent over the upper tolerance limit provided by food labelling regulations.
The pouches with the largest discrepancies were the Banana & Raspberry Coconut Yoghurt pouch, Peaches & Raspberries, Pink Lady Apple Yoghurt, and Coconut & Summer Berries yoghurt. These products’ labels suggest that their sugar levels are lower than equivalent products produced by other brands (between 5.3 – 6.9g sugar per 100g), when the laboratory tests found that they found between 9.7g – 10.4g sugar per 100g.
These findings are concerning for infants and young children as high sugar intake in the early years are linked to poor oral health and can lead to the development of sweet taste preferences and contribute to overweight in later childhood.
The investigation also highlights the urgent need for the Government to publish, and make mandatory, their “Voluntary industry guidelines for commercial baby foods and drinks aimed at children aged up to 36 months”. Regulations are essential to protect parents from misleading marketing and claims that portray commercial baby foods as healthy, despite contradicting public health recommendations.
From 6 to 12 months, public health guidance recommends introducing babies to a variety of minimally processed or unprocessed foods with diverse tastes and textures. However, many baby food products, particularly pouches, are less nutrient-dense, sweeter, and have a different consistency compared to home-prepared alternatives.
Our Eating Well guides offer practical advice on meeting infants' (under 1 year) and young children’s (1 to under-5 years) nutrient needs in a cost-effective way while minimising the use of highly processed products. You can download or purchase hard copies here. Read the full article here.
Spotlight: High free sugars in kids flavoured yoghurts
A study published in October this year (and included in our November newsletter) found that UPFs (Ultra-Processed Foods) account for 47 percent of toddlers' total energy intakes, and flavoured yoghurts were one the most commonly consumed groups of UPFs. These are generally perceived as healthy but often have high levels of free sugars despite carrying ‘no added sugar’ claims.
We compared the price and sugar contents of Tesco’s Greek style and natural yoghurts (which can be classified as minimally processed foods) with six flavoured yoghurts marketed to children from 6 months available at Tesco. We chose one product from each of the six leading brands.
Sugar content
We found that all flavoured yoghurts had more sugars than Tesco’s Greek style yoghurt. Yeo Valley’s flavoured Greek yoghurt pouches had the smallest difference, of 1.2g/100g more, it also had 0.5g less sugar than Tesco’s natural yoghurt. However, 4/6 products had around double or more sugars compared with Tesco’s Greek style yoghurt per 100g: Peppa pig by Yoplait (9.3g), Petit Filous (9.4g), Ella’s Kitchen (9.5g), and Kiddylicious (11g). The same four had at least 3.4g more sugar per 100g than Tesco’s natural yoghurt.
Price
All flavoured yoghurts were more expensive per serving than Tesco’s Greek and natural yoghurts, which were both 22p per 100g. The flavoured yoghurts sold in pots were around double the cost of Tesco’s Greek/natural yoghurts, at 49p per 85g pot (Petit Filous), and 60p for two 45g pots (Peppa Pig by Yoplait). Kiddylicious and Ella’s Kitchen flavoured yoghurt pouches cost £1.20 (100g, and 90g respectively), more than 5 times the cost of Tesco’s Greek/natural yoghurts.
Pictured: Greek yoghurt with mixed berries, breakfast for a 7-9 month old, page 58, Eating Well the first year
In their 2023 guideline on feeding young children aged 1-5 years, SACN recommends unsweetened yoghurt. This can be served with stewed fruit as an alternative to buying flavoured children’s yoghurts, which as shown are often high in free sugars and far more expensive than less processed natural and Greek yoghurt alternatives. You can find recipes in our Eating Well guides, here.
New editorial: Plant-Based and Dairy-Free Drinks: An Emerging Health Hazard for Young Children
We wrote this editorial on the health risks associated with plant-based and dairy-free drinks based on our report Drinks for young children marketed as ‘growing up’ and ‘toddler’ milks and drinks. The focus is on plant-based “growing-up” milks (GUM), reflecting their increased availability, shifting consumer preferences from cows’ milk to plant-based alternatives, and the widespread overdiagnosis of milk allergies in infants, leading to the use of specialised low-allergy formula products.
Although manufacturers promote GUM as vital sources of nutrients such as vitamin D, calcium, and iron for young children, there are clear health risks associated with many plant-based GUM due to their high free sugar content, which is linked to dental decay, overweight, and obesity.
Plant-based GUM are among those with the highest sugar content. According to the UK Department of Health and Social Care's recommended sugar limit of 5 percent of total energy intake, consuming just 140ml of plant-based GUM or 100ml of specialised low-allergy GUM can exceed the daily sugar limit for a 1- to 2-year-old. In comparison, it takes 260ml of dairy-based GUM to surpass the same limit.
The absence of labelling regulations allows GUM manufacturers to make misleading nutrition claims, giving the impression that these products are low in sugar. As a result, many parents and caregivers remain unaware of the high free sugar content in plant-based GUM. For instance, oat milks can be marketed as having "no added sugars," even though their free sugar content originates from oat processing, which can lead to higher sugar levels than standard cows’ milk-based GUM.
This underscores the urgent need for marketing regulations to better enable parents and caregivers to make informed decisions about their children’s diets in line with public health guidelines. Current NHS advicefor young children states that unsweetened, calcium-fortified milk alternatives such as soya, almond, and oat drinks (excluding rice drinks) can be given from the age one as part of a healthy, balanced diet. If choosing oat drinks, our view is that families should choose a ‘no sugar’ option, as unsweetened oat drinks still contain free sugars, unlike unsweetened soya or almond options.
Additionally, health professionals should support mothers who wish to continue breastfeeding their toddlers.
New Paper: Exposure to sugar rationing in the first 1,000 days of life protected against chronic disease
Research published in October 2024 in Science by Tadeja Gracner and colleagues examined the impact of sugar rationing on type 2 diabetes and hypertension in the first 1,000 days of life. The study was a quasi-experimental design that analysed UK Biobank data from over 60,000 adults aged 51-66 conceived either during rationing (between October 1951 and June 1954) or after rationing (between July 1954 and March 1956). Adults born during rationing were exposed to sugar levels within dietary guidelines which recommend <40g sugar per day and no added sugar under the age of 2. Following rationing, sugar intakes almost doubled to around 80g per day.
The data shows that nearly 4,000 participants were diagnosed with diabetes, and almost 20,000 with hypertension. The risk of developing these diseases increased with age, and at a much faster rate for those who experienced minimal or no exposure to rationing; early-life rationing delayed the onset of diabetes by 4 years and hypertension by 2 years. It found that 92.2 percent of adults who were exposed to sugar rationing early in life were likely to be living without Type 2 Diabetes (a risk reduction of about 35 percent), and 65.4 percent without hypertension (a risk reduction of about 20 percent). Furthermore, participants exposed to rationing in utero and beyond the first year observed a 30 percent decrease in obesity. These findings reflect those of animal studies which found high-sugar diets during pregnancy can increase hypertension and type 2 diabetes risk factors.
Although other foods, such as butter were rationed at similar time points, the differences in intakes pre- and post-rationing were far smaller, and there were no differences between individuals’ outcomes before and after rationing ended.
This study highlights the role of sugar intakes during pregnancy and infancy in long-term outcomes of diseases.
NHS advice states that babies do not need sugar and SACN advises that the average free sugars intake for children aged 1 year and older should not exceed 5 percent of their total dietary energy intake, and that foods high in free sugars should be limited in children aged 1 to 5 years.
We offer a range of ‘eating well’ guides providing practical guidance on how to meet nutrient requirements and eat according to public health recommendations between pregnancy and the age of 5 years, including practical advice which minimises sugar intakes. You can find our guides here.
Translated eating well guide: Eating Well 6 months to 2 years for South Asian children in Bengali
We are delighted to be able to share a version of this eating well guide in Bengali, translated by Lily Islam of the charity Women and Children First, with funding from the Access Foundation.
This resource was prepared in collaboration with the Nurture Early for Optimal Nutrition (NEON) programme. It summarises the importance of eating well between 6 and 24 months and shows how this can be achieved through providing nutritionally appropriate, affordable, culturally tailored South Asian age-appropriate recipes based on unprocessed and minimally processed foods.
There is currently no hard copy available of this resource but if you would like to have a printed copy of it, please express your interest by emailing admin@firststepsnutrition.org. If we receive enough requests, we may be able to do a print run.
Two new reports on food insecurity in the early years
“Reducing infant and maternal food insecurity in the UK”
The Independent Food Aid Network UK (IFAN UK) updated this briefing in mid- November, see here. They seek to shine a spotlight on families with young children, who are among the most vulnerable to food insecurity. This is incredibly concerning because of their specific nutrition needs to support growth and development and the lifelong implications of poor diets in the earliest years.
“It’s crucial to continue highlighting the scale and depth of infant food insecurity, but it’s more important than ever that parents and carers of infants can access adequate incomes and that this is the primary focus of policy makers. This cohort of people is presenting at food banks because they don't have enough money to afford essentials… In the here and now [there needs to be a] focus on developing and supporting emergency infant feeding pathways at local authority level. These need to prioritise income maximisation, autonomy, and dignity and choice regarding cash payments for the purchase of infant formula and to enable breastfeeding mothers to afford adequate nutrition”.
IFAN makes 6 recommendations as follows:
Collaborate to ensure parents and carers struggling to feed infants are supported through a cash first approach
Promote and invest in local advice services to help embed early cash first interventions
Bring social security payments and wages in line with the cost of living and ensure everyone can access a Living Income
Ensure the availability of crisis support via cash payments
Improve access to and adequacy of Healthy Start and Best Start schemes
Take a cash first approach when providing immediate support
We at First Steps Nutrition Trust endorse these recommendations, and the need to ensure that food security responses both protect and support breastfeeding and safe and appropriate formula feeding where needed.
“How can we reduce food poverty for under-fives?”
The Education Policy Institute published this report on 28 November, highlighting the issue of food poverty in the early years and making recommendations for action. It highlights the vulnerability of families with under 5s, the health harms of poor diets in this life stage and the root cause: poverty. It emphasises our inadequate benefits system, Healthy Start and food provision in early years settings.
The report recommends that the Government:
Ensure its forthcoming child poverty strategy includes a focus on food poverty experienced by young families. The Two Child Limit and the benefit cap should be abolished, and an ‘essentials guarantee’ instated to ensure that families on social security benefits have sufficient income to meet all basic needs.
Improve the Healthy Start scheme as per the recommendations of the Working Group
Work towards universal free meals in early years settings; improve the existing free early years meals programme, promoting awareness amongst parents and early years professionals, removing restrictive criteria and increasing the scope beyond maintained settings.
Fund and support local authorities to provide tailored solutions to food poverty based on local needs.
The report acknowledges the importance of breastfeeding for infant food security, and the recommendations made by other organisations to protect and support breastfeeding, including the Food Foundation in their report ‘Breaking Down the Barriers to Breastfeeding’ and Bremner and Co’s report, as shared below.
New report: Breastfeeding in focus: Insights from the sector
On 4 November, Bremner & Co published its new report sharing insights and recommendations for UK breastfeeding policy and practice. This work was commissioned by Impact on Urban Health who acknowledge that infant feeding is often overlooked in food policy. The research consisted of 28 semi-structured interviews, desk research and a media review of the UK’s top newspapers and their portrayal of breastfeeding. Interviewees included representatives from n=14 charities/NGOs/campaigners, n=5 local government of members of parliament, n=5 health sector, n=3 academia, and n=1 industry. Six key themes were uncovered as barriers to breastfeeding: policy, infrastructure, culture/media, demographics, place of work or study and the Commercial Milk Formula industry.
The recommendations presented are from those who engaged in the research. They are extensive and intersect policy, communications, advocacy, information provision, and breastfeeding support interventions. They include a government feeding strategy, more funding for breastfeeding support, strengthened existing breastfeeding policies, improved statutory maternity pay and policies, the inclusion of breastfeeding in education curriculums, and funding and support to charities who advocate for stronger legislation on the marketing of commercial milk formulas. It also outlines some practical interventions for supporting women to breastfeed in the community, from creating breastfeeding spaces to implementing more support in areas with high need due to high infant mortality rates, malnutrition or food insecurity.
We look forward to drawing on the insights and recommendations in this report in our practical work and advocacy.
New report: Nourishing Britain: a political manual for improving the nation’s health
This reportby Dr Dolly van Tulleken and Henry Dimbleby is billed as a manual for politicians with guidance on ‘how-to’ fix the food system. It draws on interviews with three former prime ministers, one deputy prime minister, ten former health secretaries, and six other former and serving politicians. They say:
“We wanted to understand the messy, behind the-scenes compromises, the logistical frustrations and psychological and cultural barriers that get in the way of improving the food system. And perhaps even more importantly, we wanted to know what it takes to lift those barriers, and push through meaningful change”.
It’s a fascinating read, and this caught our attention in Chapter 5, under ‘Ingredients for success’: ‘Deploy a compelling argument’: Prioritise children: This makes sense nutritionally, since a good diet early on can have life-long health benefits. But it also makes sense politically, because the wellbeing of children is a priority for voters.
We will continue to highlight the vital importance of nutrition in the early years for public health and prevention.
New editorial: Conflicts of interest: moving towards zero tolerance
On 19 November, Chris van Tulleken and colleagues published an opinion article in the British Medical Journal which calls for an end to conflicts of interest in scientific research. It draws upon the example of the tobacco industry – where public health messages were diluted despite research demonstrating that smoking, unequivocally, causes lung cancer. They explain how tobacco companies paid off doctors, academics, charities and policymakers resulting in delayed public health interventions and messages. A similar phenomenon is present with food, where those working to improve, research, or provide media coverage on, diet and health are funded by the food industry. Poor diet is a public health crisis, as it is now the leading cause of early death globally, ahead of smoking.
Conflicts of interest are often undisclosed, or an afterthought, in scientific journals. The authors calls for a complete reset stating that conflicts of interest lead to biases and impact healthcare practice, policies, and public health.
We support the recommendations to end conflict of interests by strengthening government action, zero tolerance for conflicting interests for healthcare professionals and their governing bodies/memberships, as well as stricter and clearer statements in scientific journals.
Last month, we announced the introduction of Lidl Lupilu infant formula and follow-on formula, and Kendamil Bonya infant formula and follow-on formula. We have updated our Infant Milks website with information on the composition and cost of these new products.
We are chasing Aldi for a definitive answer, but we think that the Mamia 900g infant formula has been discontinued. The 800g product is still listed online.
We publish a cost report summarising current costs of infant formula, follow-on formula and infant milks marketed as foods for special medical purposes marketed over the counter in the UK. We also publish a trends report which shows how the cost of powdered infant formula is changing over time, and how these costs impact on the cost of feeding a 10-week-old baby. Below are two new infographics to summarise the latest data, as of October and November 2024. The first offers information for health care professionals to share with families on the most affordable products, and the second outlines our recommendations for policy makers on how to ensure that infant formula is consistently affordable for all who need it.
Update: Two-pager on responsive bottle feeding and which formula to choose
In case you missed it, we worked with Unicef Baby Friendly Initiative to update this two-pager on responsive feeding and which infant formula to choose.
Competition and Markets Authority: Interim report on the infant formula market study
On 8 November the CMA published their interim market study report with a three-week consultation period for response to a list of proposed policy solutions to high infant formula prices and concerns on how the market functions.
ICYMI this market study was undertaken after an initial investigation published last November, which used our infant milk cost data to confirm profiteering by the big brands. We have been concerned about the high cost of infant formula for some time, first publicising our concerns in this report prepared on behalf of the All Party Parliamentary Group on Infant Feeding and Inequalities in 2018, and raising them again in 2022 and 2023 as we observed rising prices during the cost of living crisis.
Read a summary of the CMA’s findings and potential solutions here, and the response we prepared on behalf of the BFLG with extensive member inputs, here.
The CMA will publish their final report in February, and the DHSC will have 90 days to respond. We will continue to support the CMA in their work and liaise with the nutrition legislation team and representatives of the devolved nations as we advocate for policies to protect and support breastfeeding, and enable safe and appropriate formula feeding when needed, in line with the Code.
New Eating Well Guide for pregnant and breastfeeding women, babies and young children living in temporary accommodation
Image by Cleveland Health Clinic (clevelandcliniclondon.uk)
We are planning to publish a new Eating Well guide later this month aimed at healthcare practitioners, community groups, social services, volunteers, and hotel staff who support pregnant and breastfeeding women, babies, and young children living in temporary accommodation in the UK.
The guide will address challenges often encountered in these contexts, including limited access to practical resources such as kitchens, cooking utensils, storage equipment and the money to purchase food and resources, and to social and community support, which restrict families' food choices and eating habits.
It will provide practical advice on how to support pregnant and breastfeeding women, babies and young children to eat well in a range of resource-poor contexts, highlighting the importance of good nutrition during pregnancy and the early years.
The guide will be published alongside our other Eating Well resourceshere.
