Babies, children, mothers and families barely got a mention in the Spring Statement on 26 March, and on the contrary the announced forthcoming changes are expected to worsen poverty and food insecurity. This is hugely worrying given already high rates of both, and the fact that young families are most at risk and it does not align with Labour manifesto promises.This 10-minute podcast from the Food Foundation provides an excellent summary of the issues.
New inquiry: The First 1,000 Days: a renewed focus
The Health and Social Care Committee have launched this new inquiry on 21 March, with a deadline for submission of evidence now Tuesday 22 April, see here.
The background info explains that the first 1,000 days of life, from conception to age two, are widely recognised as a critical period for child development, shaping long-term health, well-being, and life outcomes. The previous Committee examined this period in its 2019 First 1,000 days of life inquiry considering national strategy, current spending and barriers to investment and local provision. Since then, there have been a number of significant policy developments in this area. The most notable being the shift to integrated care services (ICSs) under the previous Government in 2022.The current Government has allocated £126 million for early years support and the expansion of Family Hubs under its mission to “break down the barriers to opportunities”. The Committee’s inquiry will examine progress made since 2019, the effectiveness of family hubs and integrated care systems in improving early childhood outcomes and how inequalities in access can be most improved.
We at First Steps Nutrition Trust will be making an evidence submission focused on diet, nutrition and feeding in pregnancy and the first 2 years. Please help us raise the importance of maternal diet, and what and how babies and young children are fed – you can contact Vicky if you would like to see our draft, vicky@firststepsnutrition.org
New podcast:Childhood Allergies - influence of Infant feeding practices
Food allergies are perceived to be on the rise, and a problem that may disrupt breastfeeding if maternal dietary restriction is recommended (as it commonly is). However, this is an area that is fraught with misinformation, driven by industry. Our friends at La Leche League GB have recently updated their ‘common concerns’ webpage on breastfeeding and allergy and now include a new podcast with paediatric allergy specialist Dr Robert Boyle. You can access it here.
New podcast:Childhood Dental Decay – influence of infant feeding practices
A second new podcast which is well worth a listen to is this episode of ‘Makes Milk with Emma Pickett’ with dentist Gillian Smith. This podcast explores the evidence around breastfeeding and dental health and debunks the wide-held view that breastfeeding can cause dental decay. An evidence review on breastfeeding beyond the first year of life and development of dental caries can be found on pages 361-363 of the Scientific Advisory Committee’s Feeding young children aged 1-5 years. Evidence that breastfeeding beyond 1 year protects against malocclusions can be found in the same report, on pages 370-371. The NHS endorses the WHO recommendation that all babies are breastfed for up to 2 years or longer, and advises mothers to keep breastfeeding in to the second year and for as long as it suits, e.g. see here and here.
New report: World Breastfeeding Trends initiative UK
On Tuesday 25 March 2025, through a hybrid event, the World Breastfeeding Trends Initiative (WBTi) UK 2024 Report was officially launched. The report documents include Part 1 – Full Report(132 pages), Part 2 – Supplementary Information (60 pages), a UK Report Summary 2024 (16 pages including an Executive Summary and Report Cards) and separate report cards for the UK, England, Northern Ireland, Scotland and Wales. This second WBTi UK report following the first WBTi UK 2016, unfortunately reveals little progress since the first assessment. The devolved nations continue to show national leadership, with stronger policies and programmes on infant feeding and consistently higher scores than England.
The WBTi assessment project was developed and is led by theInternational Baby Food Action Network (IBFAN) and has been conducted in 100 countries around the world. The WBTi assesses 10 key areas of infant feeding policies and programmes: National policies; UNICEF UK Baby Friendly Initiative; Regulation of marketing of infant milks, bottles and teats; Maternity protection in the workplace; Health systems and training; Breastfeeding support; Accurate information; Infant feeding and HIV; Infant feeding in emergencies and Data collection, monitoring and evaluation. The WBTi UK project is a collaboration of health professional bodies, organisations and experts, with an advisory group of government officials from all four nations and a Core Group responsible for providing inputs.
We at First Steps Nutrition Trust are a member of the WBTi UK Core Group and supported the hosting of Core Group meetings. As secretariat of the Baby Feeding Law Group UK, we provided technical support, responses and examples for Indicator 3 on the regulation of marketing of infant milks, bottles and teats, including Implementation of the International Code of Marketing of Breastmilk Substitutes.
At the launch event on 25 March 2025, the focus was on Indicator 5: Health Care Systems in support of breastfeeding and infant and young child feeding, where the UK scored 6/10 and revealing that UK health professionals lack sufficient training on infant feeding. The policy recommendations from the WBTi UK 2024 Report will be presented at a parliamentary event in June 2025, and we will share details for this when they are available.
What’s especially worrying is that parents believe that they are feeding their children healthy foods. This is the result of sophisticated and exploitative marketing tactics combined with regulations that are outdated and not fit-for-purpose. Bee writes, “Manufacturers have done a spectacular job of convincing many parents that feeding a baby with highly processed pouches, powders and crisp-like snacks is not just the convenient option but the healthier and better one. Does your baby refuse greens? A pouch will provide all the veg they require. Worried about your child choking? Give them a “melty” snack”. One low-income parent said she used the puree to “get the nutrients in” and the packaged finger foods to “explore the textures”. Similarly, parents often don’t realise that the ‘growing up’ and ‘toddler’ milk offerings are largely unregulated (unlike first infant formula) and are often concerningly high in sweet ingredients which can reinforce sweet food preferences.
This problem is not unique to the UK, as seen in this US article, and the latest concerns raised in Australia by the Food for Health Alliance and its‘Kids are Sweet Enough’campaign.
An example of the misleading marketing practices of baby food pouch manufacturers in Australia, from the Food for Health Alliance.
High levels of intakes of commercial infant and toddler foods likely drives weight gain and longer-term ill health (obesity, diabetes, cardiovascular disease). We strongly agree with Bee that “If anyone should be protected from the ultra-processed world we are now living in, you might think it would be babies”. Our advocacy ask of Government is to:
Revise and strengthen the 2003 “Processed Cereal-based foods and baby foods for infants and young children regulations”, setting new legally binding standards for composition, labelling and marketing of commercial baby and toddler foods and drinks in line with WHO Europe’s Nutrient and Promotion Profile Model (NPPM) and UK public health recommendations.
We would welcome the publication of the voluntary commercial baby food and drink guidelines in the short term, which could improve the composition, labelling, and marketing of baby and toddler foods while the process to update the regulations is ongoing.
For practical guidance for eating well in pregnancy, infancy and early childhood, on diets based on unprocessed and minimally processed nutritious foods, see our range of ‘eating well guides’ here.
New report: ‘Nourishing Our Future’: Exploring food provision in Essex early years settings
On 15 March, academics at Anglia Ruskin University hosted a conference to launch the report of their research exploring food provision in early years settings in Essex, a project called “Nourishing Our Future”. Fundamentally the concern is that children attending settings may consume up to 90% of their daily nutrient intake at the setting, and what they eat and learn about food shapes lifelong habits, added to which more than 1 in 5 children start school in Essex already with an unhealthy weight classified as overweight or obese. The aim of the research was to explore food provision, environment, experiences and perceptions towards health eating for children aged 1-5 years in private, voluntary and independent settings in Essex. Methods included an online survey (201 responses), workshops (88 practitioner attendees), photo capture (749 photos), menu analysis (25) and parent interviews (5).
Some of the key findings are as shown:
In addition, the research found that 41% of food was parent-provided (i.e. packed lunches), rising to 70% in pre-schools, with significant variations in nutritional quality, including very high use of commercial baby/toddler foods and other packaged snacks and convenience foods.
Based on their research findings, their recommendations include:
Extended funding to ensure all children have access to high-quality, nutritious meals in early years settings
Provision of food and nutrition support for practitioners and parents
Creation of accessible, clear guidance tailored to the diversity of settings
Advocacy for a healthier, affordable, transparent food system
Targeted support for children’s food preferences, allergies, and special educational needs.
For practical guidance on eating well in infancy and between 1 and under 5 years of age suitable for use in early years settings, see our range of ‘Eating Well guides’ here. Our ‘Packed lunches for 1 to under-5 year olds’ resource may be particularly useful if the findings from Essex are indicative of elsewhere in the country.
New survey: The Cost of Living on Maternity Leave 2025, by Maternity Action: interim findings
Maternity Actionpublished interim findings from its Maternity Action Cost of Living on Maternity Leave Survey 2025 in March, here. Over 1,000 women responded to the survey between mid-December 2024 and February 2025. The report highlights that Statutory Maternity Pay and Maternity Allowance are worth half the national living wage. Most survey participants reported money-related stress, and many shared concerns that the drop in income impacted food and fuel purchase. New mothers are struggling to feed themselves; 38% reported smaller or skipped meals due to money, and a quarter said that they go without food so that they can prioritise their children. On mother said “I will often go without in the middle of the day so that my child can eat. Sometimes his meals consist of part of mine so that I don't have to buy extra.” This also impacts the kinds of food new mothers buy, with 50% purchasing less healthy foods due to high costs. Nearly 60% told Maternity Action that money worries were impacting their mental health and physical wellbeing.
HuffPost reported on the survey here, highlighting that this survey comes ahead of a 1.7% rise (£3.15 a week) in Statutory Maternity Pay, lower than the current 3% inflation. A Government spokesperson responded to the findings, saying “These [Statutory Maternity Pay/Maternity Allowance] are increased each year and are just one part of the support available for pregnant women and new mothers, who may also be eligible for Universal Credit or Child Benefit”. But Maternity Action disputed this statement.
We are concerned by these findings and support Maternity Action’s call to improve maternity pay, agreeing that this could improve child health outcomes and help tackle child poverty. It is our goal that all children in the UK eat well from the start of life from preconception to age five. Ensuring that new mothers can afford safe, nutritious, and minimally processed foods is essential to achieving this goal.
Maternity Action’s findings also highlight the importance of strengthening the ‘Healthy Start’ scheme, by increasing the allowance value and expanding the coverage so that more vulnerable families can be supported to eat well through improved access to fruit, vegetables, pulses and milk, and access to free vitamin supplements. 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.
Call for participants: Swansea research project on formula in food banks *by 10 April*
We are collaborating with academics at Swansea university to conduct some research to understand how the cost-of-living crisis and financial difficulties are affecting parents’ ability to access formula milk for their baby. This is a Swansea University research project led by Professor Amy Brown from the Faculty of Medicine, Health and Life Sciences.
There has been lots of discussion in the media about this issue and what support parents need if they need formula and find themselves unable to buy it for their baby. The research aims to understand the impact on parents of not being able to afford formula milk for their baby under 12 months old, how they currently try to access it for their baby, and how they think things could be improved.
As part of this, participants are being recruited to take part in a short survey. There are TWO separate surveys, one for parents and another for people who are working or volunteering roles around parenting, infant feeding and food insecurity. Please share this survey link with parents based in the UK, aged 16+, with a baby 12 months or younger, who are fully or partly formula feeding before the 10 April 2025.
If you are working or volunteering in a role related to parenting, infant feeding or food insecurity, are based in the UK and aged 18+, please do consider participating yourself. You can fill out the survey here before the 10 April 2025.
We hope that the findings from our research will raise further awareness of the impact of formula milk prices and be used by policy makers and those working with families so that parents who use formula to feed their babies can access infant formula more easily in the future.
For more information about this research project, click here.
New report: Nourishing the Future: making healthy food accessible for every child by Barnardo’s
Barnardo's published this new policy reporton 12 March, highlighting the barriers facing many families in eating well. They make wide ranging recommendations to Government to improve food at home, in schools, in communities and in society, including to: improve Healthy Start; facilitate health worker referral of families to community kitchens and food pantries, cooking classes and support provided by local food partnerships; fund family centres in all communities to be a ‘one stop shop’ for family-friendly food advice including breastfeeding support, cooking skills and culturally informed food education; fund the above and other recommendations through a sugar/salt tax (see the Recipe for Change campaign we at First Steps are a part of), and lastly to develop a Children and Young People’s Food Strategy to address the challenges facing young people’s diet including structural issues with the food system that make it hard for children to eat well. It is great to see common asks of Government being made from diverse organisations, and we are in touch with Barnardo’s to see how we can work together in the future.
The Office for Health Improvement and Disparities released an updated nutrient analysis of cows’ milkin early March. The survey was carried out in 2022/2023 and its aim was to provide up-to-date composition data for selected micronutrients in commonly consumed types of cows’ milk. The reason was because the last comprehensive nutrient analysis was undertaken in 1996 since when changes in breeding, feeding practices, production and processing methods may mean changing levels of certain nutrients, the focus being riboflavin, vitamin B12 and iodine. The new data will be used in the National Diet and Nutrition Survey (NDNS) analyses, will update McCance and Widdowson’s ‘The Composition of Foods’ and will be incorporated into the next update of thecomposition of foods integrated dataset(CoFID).
In general, lower values for riboflavin, vitamin B12 and iodine in cows’ milk were observed in this latest survey compared to the 1996 data, especially in pasteurised milk. The differences between seasons were more consistent in the 2022 to 2023 survey, where winter samples had higher contents of all 3 nutrients compared to summer samples. These findings are important given than cows’ milk provides a significant proportion of riboflavin and iodine in children’s diets; read more in our briefing paper: “Animal milks in the diets of children aged 1 to under-5 years”.
New supplement: VEG-1 baby and toddler liquid multivitamin
The Vegan Society now sells a new supplement - VEG 1 Baby and Toddler which provides a 5-month supply (150ml) of a liquid multivitamin for children aged six months to four years, suitable for infants and young children being raised on vegan diets. Each dose provides Vitamin B12 (5μg – 200%), Vitamin A (400μg – 50%), Vitamin C (30mg – 37%), Vitamin D (10μg – 200%), Iodine (50μg – 33%), Selenium (10μg – 18%), therefore meeting the EU Nutrient Reference values of the vitamins included.
We will include this information in our Eating well: vegan infants and under-5s guide when we next update it, in Autumn this year. The timing of this update will depend on the final report from the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) on‘Assessing the health benefits and risks of consuming plant-based drinks’. This detailed scientific analysis will inform updated public health recommendations on plant-based milk alternatives to cows’ milk for the whole population from the age of 1 year and up. These recommendations are very important because of the rising popularity of these products among families where an alternative to cows’ milk is required for medical, ethical or dietary reasons, and because if used in place of milk there are big implications for diet quality. We submitted a response to the draft report in September 2024here.
It reports on this investigation by the US organisation ‘Consumer Reports’ in which 41 infant formulas were tested for lead, cadmium, mercury, aluminium, potassium, bisphenol A, bisphenol F and bisphenol S, acrylamide and PFAS (“forever chemicals”).
They report that more than 12 infant formula products among 41 tested had “potentially harmful” levels of heavy metals – specifically lead.
The report states that “almost all samples contained lead, and eighteen formulas contained 50 to 100 percent of the “Maximum Allowable Dose Level” for a three-month-old (as set by the California Office of Environmental Health Hazard Assessment)”. However, EU/UK regulations permit 0.02mg/kg lead in powdered infant formula (equivalent to 20 micrograms/kg). None of the samples tested exceed this level and all were a long way off; the highest level recorded was 4.1micrograms/kg.
They reported ‘high levels’ of inorganic arsenic in two formulas. The EU/UK regulations permit 20 micrograms/kg and the maximum reported was 19.7micrograms/kg in Abbott’s Elecare Hypoallergenic.
They found one product (Enfamil Nutramigen, an FSMP for infants with cows’ milk allergy) to contain Bisphenol-A and acrylamide. We have written about bisphenols and acrylamide in our report “Ultra-processed foods in the diets of infants and young children in the UK”, see page 48. BP-A is a chemical used to make plastics sturdier, and research has demonstrated its tendency to contaminate food and propensity to interfere with normal hormone functioning. Acrylamide is a process contaminant which may arise following high temperature processing and is a likely carcinogen. There are no regulations for these chemicals. Abbott disputes Consumer Report’s findings.
The Consumer Report authors go on to state “Environmental pollutants are pervasive in our food supply, and all the contaminants in our tests—arsenic, lead, BPA, acrylamide, and PFAS—have also been previously detected in breast milk, food, and water”. Nb. There is in fact evidence that breastfeeding protects infants from arsenic intakes, see here.
At First Steps Nutrition Trust we have done some investigations in to selected contaminants of concern in formula milks which you can read here. While we can be encouraged by products meeting the regulatory requirements that exist for some contaminants, we ought to be concerned that not all are covered by regulations, with key ones missing including aluminium, the bisphenols and acrylamide.
Practical steps to reducing potentially harmful contaminants in the diets of infants and young children include protecting, promoting and supporting breastfeeding and basing diets on nutrient-dense unprocessed and minimally processed foods, as shown in our ‘eating well’ guides.
Lastly, families who have been prescribed Nutramigen for their babies may wish to discuss the findings above with their GP, noting that alternative extensively hydrolysed peptide-based infant formulas are available, see our report “Specialised milks marketed for infants with allergies in the UK”.
We have updated our FAQs: ‘What are the nutrition composition and ingredient differences between infant formula and follow-on formula on the market?’, and ‘What are the differences between marketing and promotional practices for infant formula and follow-on formula?’, to include updated information on whey:casein ratios.
Key points:
Whey and casein are the two major proteins of breastmilk. There are no specifications in the regulations regarding whey to casein ratio. However, brands commonly adapt the whey:casein ratios of infant formula to be whey dominant and apply claims regarding ‘closeness to breast milk’, and digestibility. Furthermore, for follow-on milk (and toddler milks), the whey content is often reduced alongside the claim that it reflects the changes in breast milk over time.
Most but not all infant and follow-on formulas have a whey:casein ratio which emulates breastmilk. However, there is no evidence that altering the whey:casein ratio of formula improves the functionality of the product. While infant formulas are modelled on breastmilk composition and ingredients, breastmilk has a dynamic nature and cannot be replicated.
Since we wrote about this product in our March newsletter, we have been informed by Abbott that it has been approved by ACBS as of September 2024 and updated on the NHS Drug Tariff. The British National Formulary for Children is yet to be updated, and we plan to update our Specialised milks marketed for infants with allergies in the UK once it is.
BFLG-UK response to the Competition and Markets Authority (CMA) infant and follow-on formula market study
On 14 February 2025, the Competition and Markets Authority (CMA) published the final report in its infant formula and follow-on formula market study, setting out its findings and recommendations to the UK, Northern Irish, Scottish and Welsh governments for action to deliver “better outcomes” for parents who depend on infant formula to feed their babies.
The BFLG-UK’s full endorsement of implementing the 11 recommendations and recommended next steps
Comprehensive responses to each of the 11 CMA recommendations.
This response has been shared with Minister Ashley Dalton, Parliamentary Under-Secretary of State for Public Health and Prevention and the Department of Health and Social Care (DHSC) project team, who will be compiling the government response to the CMA report (which we are expecting to be published around mid-May). First Steps Nutrition Trust is also coordinating a joint letter to Minister Dalton to call on government to accept and implement ALL 11 measures recommended by the CMA.
NEW paper: A Descriptive Investigation of Infant Feeding Bottles Marketed in the UK Designed to Replicate Breastfeeding and the Evidence That Underpins Them
This research paper by Clare Maxwell and colleagues was published in March. It is a descriptive study that included two stages. Stage 1 involved identification of the 10 most popular bottles marketed in the UK as “best for breastfeeding”. Marketing materials and information from these brands were captured from manufacturer websites and codes were identified to describe the main marketed bottle features claiming to be aligned with breastfeeding. Stage 2 included capturing of and then a quality appraisal of the evidence provided on brand websites that support the claims made that features of the bottles align with breastfeeding.
Main findings include that the eight marketed bottles claimed to: prevent or reduce nipple confusion; prevent or reduce bottle refusal; aid combi-feeding; mimic breast/nipple; mimic physiology of breastfeeding; aid latch; have high teat acceptance and positive impact on breastfeeding. These show how the bottles and teats are being marketed as ‘equivalent’ to breastfeeding, with claims that they can replicate and in turn replace breastfeeding. However, the scientific evidence used to support these claims was found to be extremely limited, almost universally of low quality, generally outdated, exhibited small sample sizes and at times misleading. The authors recommend that “greater awareness of the lack of evidence to support advertised features of bottles that are claimed to be aligned to breastfeeding is required”, so that parents can make better informed choices. Furthermore, author recommendations include that research is needed on the impact of the marketing of bottles on infant feeding choices and breastfeeding practices, and that more effective regulation of bottle company advertising is urgently required.
This research paper is important because there is hardly any published research on the marketing of bottles and teats in the UK, and they are currently unregulated. Bottles and teats fall under the International Code of Marketing of Breastmilk Substitutes, and our view is that their marketing should be regulated alongside stronger enforced marketing of commercial milk formulas.
This interdisciplinary conference organised by the Maternal, Parental and Infant Nutrition and Nurture Unit (MAINN) of University of Central Lancashire will take place from Monday 28 – Wednesday 30 April 2025. Our team (Dr Vicky Sibson, Dr Katie Pereira-Kotze, Jasmine Brand-Williamson and Rachel Childs) will be there learning, presenting and networking. Please find us to say hello!
Webinar: Evaluation of the Healthy Start Scheme, 25 June
The Glasgow university led Maternal and Child Health Network (MatCHNet) are hosting a webinar by Christina Vogel of City St George’s University of London on their Evaluation of the Healthy Start Scheme. This will be online on Tuesday 24 June at 12.20pm. Sign up here: https://matchnet.sphsu.gla.ac.uk/events/
