Welcome to the February edition of our newsletter – contents below.
Before you get stuck in, 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.
NEW guide: “Eating Well for pregnant and breastfeeding women, babies and young children living in Temporary Accommodation”
This new addition to our suite of practical, photographic eating well guides has been written for those whose work involves catering for or supporting women and young families living in temporary accommodation to eat well.
It tackles challenges including limited access to practical resources such as kitchens, utensils and storage, money to purchase food and resources, and to social and community support, and offers practical advice to help families maintain good nutrition in resource-poor settings. It also includes lots of no-cook recipes suitable for different ages.
NEW guideline: NICE guidelines on Maternal and Child Nutrition
These new evidence-based guidelines were released on 15 January after a three year development process. The guidelines cover nutrition and weight management in pregnancy and nutrition in children up to five years. Pre-pregnancy weight management and post-partum weight loss, and infant feeding for the first 8 weeks are covered in other NICE guidelines which are signposted within.
The guideline refers to Government recommendations on healthy diets, which are not repeated within.
The purpose of the guideline is to support those working with new and expectant mums, babies and children in their practice (as health or early years professionals), in relation to offering advice and supporting eating well and feeding. It is also aimed at commissioners and service provides as well as individuals families themselves.
There are recommendations on the following areas, which have been carefully written to take into account context (such as cost of living pressures and widespread misleading marketing) and highlight the need for advice to be based on non-commercial, evidence-based, information sources (such as First Steps Nutrition Trust!):
vitamin supplementation
healthy eating, physical activity and weight management during pregnancy
breastfeeding and formula feeding
weighing babies and young children
healthy eating behaviours in babies and children from 6 months and up to 5 years.
NEW report: The Broken Plate 2025: The state of the nation’s food system
The Food Foundation launched their latest annual Broken Plate report in parliament on Wednesday 29 January. It paints a concerning picture with persisting challenges across all three food environment metrics: price and affordability, appeal and availability of healthy food; and outcome metrics: diet quality and environmental and health outcomes.
Executive Director Anna Taylor highlighted “the barrage of marketing is delivering a health crisis starting in childhood” and called for “primary legislation to give the direction of travel for the food system”.
The report reveals that children are consuming less than half their recommended amount of fruit and vegetables yet double the amount of sugar. This may not be surprising considering healthier foods were found to be twice as expensive per kcal as unhealthy options in UK supermarkets.
Contributing to the report, Action on Sugar carried out a survey of front-of-pack labels for baby and toddler snacks and found that 74% of products with front-of-pack promotional claims had high or medium sugars (compared to recommendations for adults). In addition, just 24% of products surveyed were classified as low in sugar. In 2023, the WHO created new guidelines specifically for assessing foods marketed for children under 3 years of age, based on the “Nutrient and Promotion Profile Model”. When comparing the front-of-pack claims with these guidelines, 94% would not be permitted. We strongly agree with The Food Foundation’s call to reduce the inappropriate marketing of unhealthy foods, particularly to “Regulate marketing and composition of toddler and baby foods and restrict nutrition and health claims on the front of packaging”.
Due to the growing evidence linking poor health outcomes with the consumption of ultra processed foods (UPF), in their report the Food Foundation also highlights an opportunity to strengthen how we define “unhealthy” foods in food policy. Presently, foods are classified as unhealthy if they are high in salt, fat, sugar and salt (HFSS) and this report endorses a need to go beyond this definition to include other measures of healthfulness such as degree of processing and inclusion of harmful ingredients. We strongly agree that food policies should address UPFs as well as HFSS foods and drinks, to rebalance our children’s diets in favour of minimally processed nutritious foods.
We support The Food Foundation’s recommendations presented in the 2025 Broken Plate report, and the need to ensure healthy diets are affordable, appealing, and available to all, especially in the early years.
NEW paper: “Evaluating alignment of UK commercial baby food products with the WHO nutrient and promotion profile model”
New research published this January by Cigdem Bozkir and colleagues explored whether 469 UK commercial baby food products aligned with the WHO Nutrient and Promotion Profile model (NPPM) guidelines. The WHO’s NPPM is a standardised tool which can be used to evaluate commercial baby foods which was designed in response to concerns about these products with regards to high sugar levels, especially in fruit purees, labelling that promotes the early introduction of solids, and nutrient deficiencies meaning products are unlikely to meet the nutritional needs of infants and young children. The researchers found only 45% of products met the WHO’s NPPM nutritional standards, and that 59% of products analysed did not meet the criteria for sugar content. In terms of promotion, no products met the standards for marketing, nutrient and health claims and just 5% had adequate messaging to support breastfeeding.
This study highlights that commercial baby foods in the UK are not meeting nutrition composition standards and that marketing practices are routinely inappropriate. You can find a broader discussion into UK commercial baby foods in our previous reports, which can be found here.
Currently, there are limited regulations for the nutritional composition of commercial baby foods in the UK, and none that restrict sugar levels. Additionally, NHS guidance makes no explicit mention of commercial baby foods leaving a gap in advice for parents/carers. We recommend that the UK Government strengthens and enforces regulations in line with WHO Europe’s NPPM (and ensures consistency with public health recommendations), and clarifies NHS complementary feeding advice to include explicit guidance on commercial baby foods in line with SACN recommendations which state:
Commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet nutritional requirements.
Home-prepared foods are generally recommended to help introduce infants and young children to a range of appropriate flavours and textures.
These steps are necessary to enable parents/carers to make informed decisions about what foods to choose when feeding their infants and young children, in line with public health recommendations.
We produce practical ‘eating well’ guides to show parents/carers how to feed their babies and young children diets based on nutritious, minimally processed foods, avoiding the need for commercial baby foods. You can find our eating well guides for infants and new mums here, including for those following vegan diets.
Government response to the House of Lords Food, Diet and Obesity inquiry report
The House of Lords inquiry report “Recipe for Health: A plan to fix our Broken Food System” was published on 24 October to overwhelming positive reaction from public health and food system advocates. This podcastreleased in December gives an insight into the inquiry and an overview of the evidence given. On 29 January, there was a long and well attended debate in the House of Commons on the report (find the transcript here). But, despite some enthusiasm in that debate for recommendations within the report, we were surprised and dismayed by the formal response of Government published on Thursday 30 January.
In short, the report acknowledges high levels of overweight and obesity and the need for action, but makes no new commitments, doubling down on work already in train and deferring any future action to the future National Food Strategy announced by DEFRA minister Steve Barclay on 10 December.
Focusing on chapter 6 (infants, children and young people), the Government:
Deflects any commitment to acting on the inquiry recommendation for a comprehensive and integrated maternal and infant nutrition strategy, stating that the new NICE guidelines (above) and work being undertaken by SACN will “inform future actions and goals”. It chooses to highlight ongoing work under the NHS England’s Three-year delivery plan for maternity and neonatal services (which started in 2023); the Better Health - Start for Life website; and the 24/7 National Breastfeeding Helpline.
Deflects any commitment to acting on the inquiry recommendation to strengthen regulations on the composition and marketing of follow-on, toddler and growing up milks, suggesting 1. That existing Government advice against using growing up milks is sufficient to tackle their very high levels of consumption and contribution to excessive sugar intakes, 2. They’re waiting for the CMA response and may do something about cross promotion of follow-on formula (though note there are a lot more far-reaching recommendations in the CMA report than addressing this one issue).
Ignores the recommendation of the inquiry to strengthen regulations on the composition and marketing of commercial baby foods, stating that they are already ‘comprehensive’, and they will keep them under review.
Takes on board the recommendation of the inquiry to review food standards for early years settings (noting the recommendation also includes making them mandatory, supporting early years settings to meet them and establishing a performance framework).
We are in the process of challenging the Government’s response to the recommendation to strengthen regulations on the composition and marketing of commercial baby foods on the basis that the regulations are far from ‘comprehensive’ (see pages 16, and 87 and 88 of our 2017 baby foods report, and Bozkir et al’s paper and Action on Sugar’s analysis of infant foods for the Food Foundation’s Broken Plate 2025 summarised above). We have also been in touch with DEFRA to feed into the promised National Food Strategy. While we are not feeling very optimistic, watch this space…
NEW paper: “The NOVA system can be used to address harmful foods and harmful food systems”
An editorial published in PLOS Medicine by Jean Adams from the University of Cambridge explores how the NOVA system can be used to address the health of both people and the planet concurrently. Unhealthy diets cause 15% of deaths globally and the food system contributes to 15% of global greenhouse gas emissions. Both unhealthy foods and food production systems disproportionately impact those who are less affluent.
The NOVA system is proposed by Dr Adams as a potential indicator for the harmfulness of foods, both to people and the planet. There is extensive epidemiological research that suggests UPF-rich diets are harmful to health. In addition, UPF are often designed to encourage consumption in excess combined with wide profit margins and thus excessive profits for large multinational corporations whilst also contributing to knock-on costs to healthcare systems. There are concerns that the organisations profiting from UPF might be responsible for diluting the evidence surrounding UPF and even directly funding scientists and creating conflicts of interest in the research base.
This article highlights the urgent need for action to reduce UPF consumption to rebalance diets towards the nutrient-dense, less processed/whole foods necessary to meet dietary requirements, but also to reduce the burden that this system has on the environment.
We feel strongly that reducing UPF consumption in the early years will help lay the foundation for healthy dietary preferences and habits. Our policy recommendations for UPF in the UK are in our 2023 report here.
The Centre for Food Policy has created a video in collaboration with Redbridge Borough Council in London to promote the Healthy Start Scheme. The Healthy Start scheme provides help for pregnant teenagers, low-income pregnant and breastfeeding women and families with children under the age of 4 years to buy infant formula (if needed) and healthy foods such as, fruit, vegetables, cows’ milk, and pulses. If parents/carers join the Healthy Start scheme, they are also entitled to vitamins for pregnant women and new mothers, as well as vitamins for their children up to the age of 4.
One parent, Jo, shares “We all want to be really good parents, and we all want them [our children] to grow and be healthy and be strong. Healthy Start helped me to be able to do that, and to be able to give and provide the best that I can for my son, which maybe I wouldn’t have been able to do if I didn’t have Healthy Start”.
This video outlines how and when to sign up, who might be eligible for the scheme and answers some common concerns about the scheme.
The alternative to Healthy Start in Scotland is Best Start Foods, you can find out more information about this here.
ICYMI our practical guide to Healthy Start and Best Start Foods is designed to help families make the most of the Healthy Start scheme in England, Wales, and Northern Ireland, and the Best Start Foods scheme in Scotland. It includes a range of healthy family recipes using ingredients that can be bought through the Healthy Start or Best Start Foods schemes and shows how these can feed the whole family.
The UK Food Security Report (UKFSR) sets out an analysis of statistical data relating to food security in the UK. It examines past, current, and future trends relevant to food security.
The report states: “The combination of higher food prices and general inflation caused a rise in household food insecurity in the UK as household budgets were squeezed. Consumers have responded by buying cheaper goods and prioritising price over other factors (such as environment, health, and wider ethical values). Market and supply volatility has therefore weakened access to food and also agency by weakening choice. The impacts of these issues are felt most acutely by particular demographic groups, including those with lower incomes, households with children and those with disabilities. While for the majority a food security issue might mean limitation or reduced choice such as buying less meat, it could mean a significant reduction in food security for vulnerable groups. The continuing trend of most people not meeting UK dietary recommendations demonstrates ongoing issues with utilisation whether that’s through food environment, price, lifestyle, time or educational factors”.
The report is said to present “a full and impartial analysis of UK food security”...except it does not include babies.
We have received confirmation from SMA that its SMA Soya First Infant Milk has been discontinued. SMA reported that this was due to ongoing supply issues with a key ingredient since early 2024, and subsequent shortages and that they made the decision to discontinue the product due to the decrease in use as parents and caregivers explored different options as a result of shortages. This means that there is currently no soya-based infant formula available on the market. The UK government advises that soya protein-based infant formula should only ever be used if it has been recommended or prescribed by a health visitor or GP (typically for cows’ milk allergy), and then only from 6 months. There are other formula milks for non-breastfed infants with diagnosed cows’ milk allergy, so this discontinuation should not be cause for concern. Read our report “Specialised milks marketed for infants with allergies in the UK” for more information.
NEW paper: “Formula labelling in the UK and (non-)compliance with the Code, UK legislation and guidance”
On 31 January 2025, the Maternal and Child Nutrition journal published our original research paper, from a study conducted by Maiko Kamata, as part of a Master’s degree through the London School of Hygiene and Tropical Medicine with support of First Steps Nutrition Trust. This is the first study of UK infant and follow‐on formula labels which evaluates compliance with both UK legislation and Guidance Notes designed to interpret the law, as well as the International Code of Marketing of Breastmilk Substitutes and subsequent World Health Assembly resolutions (‘the Code’). This research provides compelling evidence of how commercial milk formula manufacturers in the UK violate national legislation and guidance, and the Code. A robust process was followed to assess all infant formula (IF) and follow-on formula (FoF) labels of products available for sale in the UK in 2022, using labelling checklists to systematically assess compliance and then compare compliance scores between the regulatory frameworks, formula types and brands.
There was low overall compliance among the 57 labels assessed (32 IF and 25 FoF): 50% complied with UK law, 32% with Guidance Notes and 40% with the Code. None of the labels complied with provisions prohibiting the provision of text and photographs that idealise formula milk and/or discourage breastfeeding. All labels contained nutrition and health claims. All labels (and therefore all manufacturers and all brands) used cross‐promotion between formula types, with similar text, images and/or colours on labels of infant and follow‐on formula milk (as shown in the photos). This provides clear evidence of inappropriate marketing across all IF and FoF products in the UK. Our main recommendations are that existing legislation has to be better enforced, and that current legislation needs to be strengthened to be in line with the Code. These measures would protect breastfeeding AND support safer, appropriate formula feeding AND lessen commercial influence on infant feeding practices.
Tackling conflicts of interest: News in the British Medical Journal (BMJ)
During January 2025, three news pieces were published in the BMJ following our alert to conflicts of interest:
“Danone’s use of midwives to give branded infant feeding advice in supermarket sparks anger”
During November 2024, we were contacted by a midwife to alert us to a conflict of interest, where Tesco stores were piloting a service for midwives to be available in-store to provide infant feeding services while customers shopped. The problem was that Danone was funding this project, through its Aptaclub programme, run by Nutricia. The project included branded Aptaclub leaflets, uniforms and an online booking system done through Aptaclub. The Aptaclub branding is very similar to that of Aptamil formula, Danone’s flagship product. This raises a clear conflict of interest, where a company that stands to profit from increased sales of its product (infant formula) was paying health professionals to provide infant feeding support. The risk was that the service was not impartial or free from commercial and marketing influence. This news piece was published on 8 January 2025, drawing substantial media coverage, including a radio interview on LBC news between Shelagh Fogerty, with our Senior Nutritionist, Dr Katie Pereira-Kotze and the midwife who alerted us to this, Marina Jordan. Before publication, Tesco maintained they would continue the pilot and roll out the project to other stores.
“Unethical infant feeding service is axed in Tesco climbdown”
However, Tesco then subsequently announced that they would conclude the pilot at the end of January and re-evaluate how they support customers in future, as reported in a follow-up news piece in the BMJ on 15 January 2025. We feel this is an example of successful advocacy that created awareness of an inappropriate partnership and resulted in the service being stopped. While the principle of a retailer providing an infant feeding service is not objectionable, it would need to be implemented without funding or support from the formula industry using information that is aligned with NHS advice, evidence based, and free from any commercial influence.
“Midwifery conference criticised for repeatedly accepting formula milk sponsorship”
NEW: briefing on distribution of infant formula from food banks and baby banks
In response to confusion regarding the legality and appropriateness of distribution of infant formula via food or baby banks (for example, here: Government confirms food banks can supply baby formula to families), we felt it was timely to collate a Frequently Asked Questions (FAQ) document on the subject. This briefing draws from the existing guidance including the 2022 Guide for local authorities and health boards supporting families with infants under 12 months experiencing food insecurity. We collaborated with endorsing organisations (BFLG members, the Independent Food Aid Network (IFAN), and the Trussell Trust) and consulted the Baby Bank Alliance to ensure that the information presented reflects the current realities for families, food and baby banks and statutory services. The FAQ provides interpretation and practical advice to common questions we are asked and concerns raised. This is an important topic and infant formula should always be accessible to families who need it, for as long as they need it. However, targeting is key and any additional support needs families may have to use it safely should also be met, to minimise risks to their baby’s health.
The All-Party Parliamentary Group for Infant Feeding had its first meeting on 27 November 2024 and was formally registeredon 2 January 2025. Jess Brown-Fuller, Liberal Democrat MP for Chichester, is the Chair. The APPG aims to “raise awareness of infant feeding and allow MPs, peers and policy stakeholders an opportunity to meet regularly to ensure that this topic remains a priority for HM Government with a view to reducing inequalities and improving health”. Current officers are listed as Andrew Griffith, Josh Fenton-Glynn and Alison Bennett. We anticipate that more information will be shared in due course, with a first meeting in early March. Follow us on social media for confirmation of date/time.
Sustain’s Children’s Food Summit Tuesday 25 February, London
Sustain’s Children's Food Campaign is hosting its second Children's Food Summit on Tuesday 25 February 2025 in London. It promises to be an exciting and interactive afternoon of discussion with policy makers, public health and education organisations, researchers, parent ambassadors, young people and other key figures making a difference in the children’s food space. We will be there, presenting the first ever award for “Early Years Nutrition Champion”. The three finalists are Early Start Nutrition, Tiny Tums Best Practice Award and the Breastfeeding Network.
You may be interested to see that early years food and nutrition pervades all awards categories (good and bad!), showing the high level of interest in and appreciation of the importance of eating well from preconception to age 5.
MAINN Conference, Monday 28 - Wednesday 30 April, Cumbria
This interdisciplinary conference organised by the Maternal, Parental and Infant Nutrition and Nurture Unit (MAINN) of University of Central Lancashire aims to:
Illuminate the socio-cultural, political and economic influences upon infant and child feeding practices.
Explore the nature of relationships within families in connection with various types of nutritive and nurturing behaviour in infancy and childhood.
Increase the understanding of breastfeeding as a bio-psychosocial activity.
Enhance understanding of the complex interactions between socio-cultural, psychological and biological factors in infant and child feeding, eating and nutrition.
Focus on key initiatives that may impact upon practices related to infant and child feeding, eating and nutrition.
We at First Steps Nutrition Trust are presenting several posters, workshops and a keynote lecture, and would love to see you there. You can find out more and book your place here.
We’re excited to share news of our fourth First Steps Nutrition Trust baby - our (newly promoted) Senior Nutritionist Rachel’s beautiful baby boy Zacharias James Robert who arrived on his due date on 10 January, weighing 10lb 2oz. Mum and baby doing well.
