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February 2015

Welcome to the First Steps Nutrition Trust February newsletter

Looking forward in 2016

I am sure for many of you working in public health these are difficult times, and I hope that the work we do can support you as cuts bite over the next few months. We will all need to work more smartly together – and this will be the theme of our conference on April 20th this year. We really hope to see many of you there, and updated details are included in this newsletter.

Work opportunity!

First Steps Nutrition Trust is a small organisation that has no full-time staff or offices, and we use freelance staff to help us with specific projects and pieces of work. We are currently looking for someone who can work for about 50 days freelance over the next 3-4 months – we need someone with experience in UK public health (nutrition knowledge a bonus), must be able to work flexibly, have good writing skills, show considerable initiative – and obviously understand the importance of working within the WHO Code. Work will be mostly home based, but ability to meet in London weekly required. If you are interested send a CV and details of your freelance day rate to


Also in this newsletter

We have details of our updated ‘Infant Milks in the UK’ report and some other new resources on our updated infant milks web pages, which we hope will signpost people more efficiently to information they may need. We are working on our new campaign to highlight how advertising to health professionals is not always ‘scientific and factual’ and hope to have that ready for the next newsletter.

We also report on the WHO Commission on ending childhood obesity, highlight the work of LIFIB, report on the new Access to Nutrition Index report and the Lancet Breastfeeding series.

Infant Milk News


This website now links you to 7 different areas related to infant milks that we hope will help you find information more easily.

To see an overview of all these pages, click on "Infant Milks Overview" beneath "Topics" in the left sidebar.

Or follow the links below to reach the individual areas you are interested in ...

2. Infant milks in the UK

Infant Milks in the Uk


This page is where you will find our latest Infant Milks in the UK report. This report is designed for health professionals, researchers and policy makers and contains all the background information anyone would need about infant milks. The February 2016 version is now available. It is nearly 200 pages long, so is very much a reference text. We have made some changes to the detail of information we give about products in this latest version, as well as making sure all new products are included.

Both Aptamil and SMA have launched new ranges of infant milks, so there are a number of new products included this month. We will be expanding our summary sheets on particular products over the next month so that you can see the claims being made and the evidence companies to give to support their claims in context. Whilst many claims are made about ingredients used in ‘new’ products, scientific opinion that these are unnecessary remains the same. It is good to remember that if an ingredient was found to have efficacy and benefit infant health, it would be mandatory in all milks, and no claims could be made for it.

Infant Milk Compositio

As some people may want to have easy access to just the compositional information of products, we have now done a summary document of this section.

We've also costed all the infant milks currently on the UK market, using the best data we can find on scoop weights and current prices to make it as accurate as possible.  Costs vary enormously and are worth some discussion with families who may need to be reassured that paying a lot more for a product does not mean that it is superior. 

Find this information here ...


The high cost of starter packs of first formula is particularly startling – a family using 8 x 70ml bottles of Aptamil Profutura 1 First Milk a day in the first week after birth would spend a whopping £102, and if they used SMA Pro First Infant Milk this would be £65 a week. Ready-to feed milks are significantly more expensive than powdered equivalents, and are also a greater environmental burden as they require more packaging and cost more to transport. Whilst there may be circumstances where these milks are the safest option, ensuring families know how to make up powdered infant milks safely remains a priority.

Find this information here ...

2. Simple guides to infant formula, follow on formula and other infant milks

We have updated the Simple Guides – and have now tailored the additional information sections for England, Scotland, Wales and Northern Ireland – you can select the one for use in your area by the flag on the cover. We are always keen to hear from anyone about new FAQs we can add to this report, so please do send ideas to us.

Infant Milks: A simple guide for England Infant milks: A simple guide for Scotland
Infant Milks: A simple guide for Wales Infant milks: A simple guide for Northern Ireland

3. Specialised milks marketed for infants 0-6 months

access this page here ...


4. Fortified milks for children over the age of 1 year

5. Making up infant milks safely

access this page here ...

This new section pulls together information on the importance of making milks up safely, we have updated statements on using vacuum flasks to store water when out and about and automatic milk preparation machines, and link to other useful work in this area. We are compiling a new report on bacterial contamination which will be available next month, and which will highlight the worrying trend globally of adding probiotics to infant formula (which have no benefit) and the risk of bacterial infection when milks are made up at low temperatures.

Nutramigen Formula

Anyone who heard my talk at the UNICEF Baby Friendly conference will know our concerns about a product launched in the UK last year called Nutramigen with LGG (marketed for infants with cows’ milk protein allergy). An endorsement of safety and efficacy was given to the company that makes this milk (Mead Johnson) by The Food Standards Agency and Department of Health after a ‘restricted’ piece of work that was not put in the public domain.

After many requests the FSA have now said they will publish the minutes of the meeting where this was discussed (9 months ago) on February 2nd. We await this with interest and will challenge further if the information presented is inadequate. Watch out for a blog on this story as soon as I can find time!

6. Working within the WHO Code

We also have a new section where we will be providing information about working within the Code – we will be adding to this over the coming months.

7. Milk and food in the first year of life

We also have a new section where we will be looking at amounts of milk, and managing milk and food in the first year. We have a summary of amounts of infant milk that might be needed in the first year and we will be providing more information on complementary feeding over the coming months.

There are a lot of rumours flying about that there may be changes to current guidance on introduction of solids at about 6 months, and we will be addressing this in a statement in the next few weeks. Exclusive breastfeeding for about 6 months has been UK health policy for 13 years: this is a global recommendation that would not be changed without very extensive discussion. Unfortunately dietitians attending baby feeding company sponsored study days seem to be being convinced by data from an as yet incomplete and unpublished study.

It is important that health professionals wait for a clear steer from expert committees before declaring individual opinions on ‘policy change’. The latest recommendations for health professionals in England comes from the NICE Quality Standards in July 2015 where introduction of solids at about 6 months remains the stated recommendation.

Childhood obesity strategy
Ending Childhood Obesity

We all await the Public Health England childhood obesity strategy (which is promised for week February 8th ….), but the WHO Commission on Ending Childhood Obesity was published in January and you can read their recommendations here ...

The recommendations in sections



relate to areas we work in, and can support. We hope that many of these are also in the PHE childhood obesity strategy. There is clear acknowledgment that what happens at the start of life is of fundamental importance in reducing the global burden of obesity.

The recommendations include, yet again:

'Enforce regulatory measures such as The International Code of Marketing of Breast-milk substitutes and subsequent World Health Assembly resolutions’

It is therefore with some sadness we have to report that we lost our battle in the EU to bring in better regulation on the advertising of infant formula, follow on formula and milks for special medical purposes. MEPs were convinced by lobbyists that ‘there is little advertising of these products in the EU’ - and so the current regulations will remain in place. We plan a new campaign to highlight inaccurate claims made by companies about infant milks, and are currently building a new dedicated website for our infant milk work which we hope to launch next month.

LIFIB logo

LIFIB launch

The Local Infant Feeding Information Board – who have done great work in Lancanshire on infant milks and infant health over many years – spearheaded by Shel Banks – has now got an open access website

Health professionals can join for free and there is a lot of very useful information available. Subjects covered include guide to Lactose Intolerance, Colic and Reflux, and Cows’ Milk Proteins Allergy. You can also find out about study events.

LIFIB reports

Access to Nutrition

Access to Nutrition

It was with some trepidation that we attended the launch of the Access to Nutrition Index report in January and their launch of a global ranking for the 6 biggest global breastmilk substitute (BMS) producers.

The aim of the Index is to hold companies to account for their actions and in-actions relevant to promoting global nutrition, but as with all indices, someone has to come top! These indices can be used for PR by companies to spin any findings, and so even though all BMS producers were found to be poorly adhering to the Code, Nestle were proud to announce their top ranking and to challenge claims they're not ‘code compliant’.

You can read the Access to Nutrition Index findings here ...

You can read a joint Statement from Unicef UK Baby Friendly Initiative and Save the Children on the Access to Nutrition Index report here ...

We will continue to hold BMS companies to account, and look forward to the World Health Assembly in May 2016 and new recommendations to Member States about the inappropriate promotion of foods to infants and children.

Lancet Breastfeeding series
Lancet Breastfeeding series

The Lancet launched their breastfeeding series at the end of January 2016 and you can read all the papers here ...

We all know that breastfeeding is a fundamental part of global public health – but this series will hopefully take it to a new audience and – optimistically -  challenge Governments globally to make change.

Infant Milk News

Our 5th Birthday Conference

Best Foot Forward Balloons

Wednesday 20th April 2016
Kensington Town Hall, Hornton Street, London W8 7NX

Our ‘Best Foot Forward’ conference will explore how organisations across health, social care, NGO’s and the charity sector can work more effectively to promote good nutrition from pre-conception to five years.  Speakers will be asked to focus on how we can put evidence into practice, work to protect the health of women, and offer every child the best start in life. Everyone who comes to the conference will be asked to reflect on how we ‘turn the tanker round’ – and work more effectively across sectors to improve maternal, infant and child nutrition.

We have great speakers, good food, a lovely venue and a really exciting bunch of people who will there to exhibit and to network with. There will be lots of resources available and we hope the event will inspire everyone to work better together in these challenging times.
The full programme and details of how to book a place can be found at Follow the links to events.


First Steps Nutrition Trust offers information and resources to support good nutrition from pre-conception to 5 years.
Our aim is to produce clear and independent resources to support people who want to know more about eating well before and during pregnancy, eating well for infants and young children, and food composition and food quality.

First Steps Nutrition Trust takes no industry funding. We are funded through charitable trusts and donations. We aim to provide a one-stop shop for useful and accurate evidence-based information on good nutrition from pre-conception to five years.
First Steps mother and baby
First Steps Nutrition Trust takes no industry funding. We are funded through charitable trusts and donations. We aim to provide a one-stop shop for useful and accurate evidence-based information on good nutrition from pre-conception to five years.

To find out more about the Trust on our About Us page.

Contact us at:

Follow us on twitter @1stepsnutrition
First Step Nutrition Trust's newsletter is published regularly to promote information and awareness of the importance of good nutrition from pre-conception to 5 years and to highlight the work of the Trust.
Registered Charity No: 114640