Welcome to the May edition of our newsletter – contents below.
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Commercial baby foods in the news: Panorama’s ‘The Truth About Baby Food Pouches’, new research from the University of Leeds and First Steps Nutrition Trust recommendations
On Monday 28 April, the BBC aired a new documentary on baby food pouches, which we and many peers have been feeding into for nearly a year. The programme can be watched in the UK using BBC i-Player, at this link.
The programme featured new data from the BBC’s lab-testing of selected pouches from the six leading brands (Aldi's Mamia, Heinz, Little Freddie's, Ella's Kitchen, Piccolo and Lupilu by Lidl), and from new research undertaken by researchers Dr Diane Threapleton, Ali Morpeth and Prof Janet Cade at the University of Leeds. Key findings include:
Very high levels of sugars, and low levels of vitamin C and iron
Misleading marketing suggesting products are nutritionally appropriate, can/should be used at an age when babies should only be drinking milk (i.e. 4 months+ instead of 6 months+), and that they can be used every day in place of home-prepared meals
Assumption of parents that the products are healthy and suitable as advertised, and shock that this is not the case
Concern that the common frequent use of these pouches is driving dental decay and obesity
The legislation governing commercial baby foods is very old, outdated and too narrow in scope and needs to be strengthened and made mandatory
Three of the companies in the programme have said they are going to change their age labels from 4months+ to 6 months+, but there were no clear commitments on other aspects of marketing or for reformulation.
The DHSC’s formal response included the statement that “Existing laws already set nutrition needs for baby foods”.
The Leeds University “Commercial baby foods in crisis” research is summarised here, along with links to their policy report, full technical report, brand score cards and information for parents. While Panorama focused on baby food pouches and used Leeds’ data, it should be noted that the Leeds’ research involved evaluation of 632 commercial baby foods, snacks and drinks across the product category as well as a survey of 1000 parents. Some of their key findings include:
25% of all products have sugar content that warrants a front-of pack warning label
7 in 10 parents agree with a front of pack warning label on high sugar baby foods
41% of main meals had high sugar levels
100% of products included nutritional or marketing claims
55% of snack products contain added sugars
21% of cereals, meals, and fruit products were too watery, with low energy density
Over one third of products (38%) were pouches with spouts
51% of products with a spout did not include any recommendation not to drink via the spout
30% of pouches had misleading names, often masking the use of cheap fruit fillers (apple, pear and banana)
40% of parents with babies under 6 months fruit-based products daily
64% of parents use savoury baby food snacks (including crackers, crisps and puffs) daily or several times per week
Financial pressures are having a noticeable impact on how parents purchase food for their children. Nearly one in five surveyed parents reported making significant adjustments to their household purchases because of financial strain, and 34% of parents reported making more home-made foods.
70% of parents of 1-3 year olds reported using growing up/toddler milks, 30% daily.
For anyone who has read our baby foods reports, many of the results above are not surprising. What is surprising, and infuriating, is that these persistent problems are being ignored by Government.
We wrotethis policy briefing to accompany the documentary, outlining our three core policy asks as follows:
Revise, strengthen and independently monitor and enforce the UK baby food regulations to set new legally binding standards for composition, labelling and marketing in line with WHO Europe’s Nutrient and Promotion Profile Model and UK public health recommendations.
Upgrade and independently monitor and enforce the UK formula milk regulations in line with minimum international standards (the Code).
Better support parents/carers to feed their babies healthy home-prepared foods (which SACN states are preferable) by:
Enabling parents/carers in low-income households to better access healthy whole foods through strengthening the national nutrition safety net, the Healthy Start scheme.
Ensuring easy access to independent information and practical guidance through proper investment in the health visiting service and Family Hubs/Sure Start centres.
Supporting early years settings to apply Government guidelines on food provision.
If YOU would like to see the government strengthen the current weak and outdated baby foods regulations, please send a letter to your MP using this template. It takes less than two minutes.
To support practice, we have created this new infographic pictured below, and have been publicising our practical and pictorial Eating Well guides, especially ‘Eating Well: the first year’. These guides can help families to feel more confident in preparing foods for their babies and toddlers, without paying over the odds for less healthy pouches.
The Leeds University team also collated key information for parents, including advice for those shopping in the baby food aisle, which can be accessed here.
There has been a huge amount of media coverage around the Panorama documentary. We will share the TV and radio news and print press we feature in our website here.
New SACN statement: The WHO guideline on non-sugar sweeteners (NNS)
The Scientific Advisory Committee on Nutrition (SACN) published this statementon 2 April, reviewing the 2023 WHO guidelines to consider whether non-sugar sweeteners (NSS) are effective for reducing overweight and obesity, preventing weight-related non-communicable diseases (NCDs) and promoting dental health within a UK context.
We give an overview of what non-sugar sweeteners are, what they’re used for and health concerns, in our 2019 report, with a focus on pregnant women, infants and young children.
While they are not allowed in commercial baby foods and drinks marketed for the under 3s, NSS are found in thousands of ultra-processed food and drink products, many labelled as ‘diet’, or low/reduced sugar, which are consumed by young children, e.g. fruit squash and fizzy drinks; jellies, ice creams and custard; baked beans, canned spaghetti and ketchup. Although there is limited data, the prevailing opinion is that drinks are the main dietary source. The most up to date national data indicates that 65% of 18-36 month olds consume NSS-containing soft drinks, with average intakes equivalent to a can a day.
As a backdrop to these high intakes, in 2023 the WHO published new guidelines with this ‘conditional’ recommendation to be considered by policy makers in specific contexts: “WHO suggests that non-sugar sweeteners (NSS) not be used as a means of achieving weight control or reducing the risk of noncommunicable diseases.”
SACN’s approach to the evidence base for the WHO guidelines is somewhat different to the WHO’s view, because, as one would expect, they give more weight to the experimental evidence (from randomized controlled trials) than observational evidence (from prospective cohort studies). This is important as the results of these different study types when looking at adiposity, are different: RCT evidence consistently suggests NSS compared with free sugars reduce energy intake and therefore body weight (with low certainty). The opposite association was found between NSS and measures of body fatness in prospective cohort studies, noting concerns about potential for confounding and reverse causality. However, they acknowledge that the observational evidence may well give an insight in to consumption patterns of NSS sweetened foods and drinks in ‘real-life’ settings.
SACN states that the evidence on the impact of consuming NSS on dental health is poor and more good research is needed. But importantly, they highlight that soft drinks which contain acids (for example phosphoric, citric, carbonic) whether sweetened with free sugars or NSS, may increase the risk of dental erosion.
It is important to note a critical limitation in the evidence base is that there is lack of research comparing NNS with water.
Additionally, the WHO and SACN acknowledge that more research is needed among children and pregnant women, the latter group for which there may be unfavourable effects of NSS consumption on birthweight and adiposity (body fat) in offspring later in life while at the same time consumption may be increasing.
In relation to the use of NSS as a means to reduce free sugars intake, SACN concludes that “the evidence indicates that there may be some value in using NSS to help reduce weight gain in the short to medium term, but it is not essential and is not the only option”. It further concedes: “UK public health policies on overweight and obesity have reduced free sugars in soft drinks and some other products. The resulting reduction in intakes of free sugars may have increased NSS consumption. It remains unclear whether NSS play a useful role in supporting a long-term move to a diet lower in free sugars. Further research is needed to understand whether there are public health advantages to a gradual reduction in the overall sweetness of the diet. A process of gradual reduction of salt content in processed foods has been successful in reducing population salt intakes”.
Ultimately, SACN’s recommendations discourage NNS use, which matches the WHO view. “SACN and WHO agree that a reduction in consumption of free sugars, alongside other positive changes to diet, is likely to be beneficial to health overall”. SACN defer to policy makers on how to achieve this, but at the same time make these specific recommendations, in the context of existing UK government dietary recommendations, which they say should be read alongside SACN’s 2025 evidence update on processed foods and health (see below). They also highlight that they are precautionary because evidence on NSS and health outcomes is inconsistent (i.e. there is evidence of benefit and of harm). NEW recommendations are shown in green.
SACN recommends that intake of NSS be minimised
For younger children, SACN recommends:
not giving them drinks sweetened with sugar or NSS
giving them unsweetened food (not sweetened with either sugar or NSS
For older children and adults, SACN recommends:
swapping sugars for NSS may help reduce sugar intake from foods and drinks (and so reduce energy intake), at least in the short term - the long-term goal is to limitboth sugar and NSS intake
SACN recommends that government:
monitors the NSS content of food and drinks in the UK diet and their consumption, including trends, particularly among high consuming and vulnerable groups
evaluates the impact of policies to reduce energy and sugar intakes on intakes of NSS, particularly among high consuming and vulnerable groups
compels industry to make publicly available data on the amounts of individual NSS within foods to enable monitoring and further research on associations with health outcomes
We’re pleased to see this statement and recommendations from SACN and will be updating our 2019 report in the coming months, including making new recommendations to Government in light of this new position. These recommendations will include calling for the SDIL levy to be extended to drinks containing NSS and for warning labels on products which contain them to ensure consumers can make informed decisions when shopping.
SACN also published this rapid evidence update on 2 April, focusing on higher quality evidence from umbrella reviews (5), systematic reviews of prospective cohort studies (8), and prospective cohort studies with subgroup analysis of different types of foods and drinks in the UPF category (11).
SACN acknowledge that limitations identified in their 2023 position statement remain, including: that studies appear to inconsistently account for important covariates including SES, BMI, energy and nutritional intake; issues related to data collection and difficulties in reliably classifying ultra-processed foods (UPF); issues with short follow up; selection bias and limited generalisability of findings to the general population as well as a risk of residual confounding.
Nonetheless, they report that the new studies reviewed consistently indicated that increased consumption of UPF was associated with increased risks of adverse health outcomes, which included, but were not limited to, overweight and obesity, type 2 diabetes, cardiovascular, cancer and mental health conditions. SACN reports finding these observations very concerning. However, evidence from subgroup analyses also indicates that not all UPFs may affect health in the same way. The categories of UPF consistently associated with adverse health outcomes were those including meat and animal products and sweetened beverages, for which recommendations already exist. Vegetarian meat-alternative products were found to have no association with adverse health outcomes. Other categories including UPF breads and/or cereals, and savoury snacks; dairy products or dairy based dessert or sweets were all found to have mixed results.
With the exception of sweeteners (see above), SACN highlight that the evidence base they considered contains little information on the health impacts of processing or the ingredient markers of UPFs. They say it is therefore not possible to assess any effects these have on health separately from the established effects of the poor nutritional characteristics of UPF. We are unclear why they have not acknowledged the evidence on food texture, which is an impact of processing and especially relevant for the early years. Or the evidence which shows an association between the extent of processing of a diet and the health harms observed, independent of nutrient profile.
The rapid evidence update highlights existing recommendations of relevance to UPFs, including these from their 2023 report “Feeding young children aged 1 to 5 years”:
Foods (including snacks) that are energy dense and high in saturated fat, salt or free sugars should be limited
Dairy products including yogurts should ideally be unsweetened
Sugar-sweetened beverages should not be given
Follow on formula and commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet nutritional requirements for this age group.
Notably, they excluded the recommendation “commercially manufactured foods and drinks marketed specifically for infants and young children are not needed to meet nutritional requirements”, even though a variable proportion of these products are UPF.
SACN stress that diets high in UPF are often energy dense, high in saturated fat, salt or free sugars, high in processed meat and/or low in fruit and vegetables and fibre. They highlight their existing lines that consumption of excess energy, saturated fat, salt, free sugars and processed meat is linked to poor health outcomes, and higher consumption of fruit and vegetables, wholegrain foods and fibre reduces health risks. Furthermore, they acknowledge that higher UPF intakes will be indicative of less healthy dietary patterns. This content of their report is important, because it indicates the importance of rebalancing diets away from highly processed foods - both HFSS (high fat, salt and sugar) and reformulated - in favour of healthy whole foods, and ensuring the public understand and are enabled to make food choices that align with this dietary advice.
In their conclusions, SACN report that there may be potential to develop subcategories within the existing NOVA classification, based on nutritional composition in addition to processing. They also note a substantial but incomplete overlap between HFSS and UPF foods.
The recommendations state:
On balance, most people are likely to benefit from reducing their consumption of processed foods high in energy, saturated fat, salt and free sugars and low in fibre.
SACN reiterates its existing advice in relation to processed foods, particularly in relation to minimising intake of sugar-sweetened beverages and the avoidance of high intakes of red and processed meat.
SACN reiterates its recommendations on sugar and existing and new recommendations on sweeteners (see above).
That government should:
consider strategies and actions to implement SACN’s existing recommendations on processed foods, including those from SACN’s Feeding young children aged 1-5 listed above
Consider whether the inclusion of messaging on processing improves dietary intakes, particularly in relation to reducing consumption of processed foods that are HFSS, without unintended adverse consequences
Compel industry to make processing data (including the amounts of individual additives such as emulsifiers and NSS within food products and the specific processes used) publicly available to enable monitoring and further research on associations with health outcomes - publicly available data are required
Monitor the consumption of individual additives such as emulsifiers and NSS in the UK diet, particularly among high consuming and vulnerable groups
Continue to review opportunities to monitor consumption of processed foods within the national diet and nutrition survey (NDNS)
Our Director Dr Vicky Sibson recently gave a keynote lecture on Ultra-Processed Foods in the diets of the UK’s infant and young children at the University of Central Lancashire’s MAINN (Maternal and Infant Nutrition and Nurture) conference on April 29th. This presentation summarises the content of our 2023 report and provides an up-to-date overview of the relevant evidence as regards intakes, health harms and plausible mechanisms as well as addressing why there is controversy about the UPF concept, and expanding on our recommendations as to what should be done about excessive intakes. You can watch a pre-record of the presentation here.
New obesity data: Changes in BMI category of children between the first and final years of primary school
The Office for Health Improvement and Disparities (OHID) has published data on changes in BMI for primary school children moving from reception (age 4 to 5 years) in 2017/2018 to year 6 (age 10 to 11 years) in 2023/2024 in England. Most children in reception were a healthy weight (84.8%), and most stayed a healthy weight (77.6%), although this percentage was slightly lower for boys, and those living in the most deprived areas.
Source: OHID report, Changes in BMI category of children between the first and final years of primary school, 2023 to 2024
It is encouraging that children who are a healthy weight are likely to remain a healthy weight. However, it is concerning that those living with obesity were very likely to remain living with obesity (35.6%) or move to living with severe obesity (35.4%). The data also shows that for many minority ethnic groups, including Bangladeshi, Indian, Pakistani, Black African and Caribbean or mixed-race children were more likely to move from a healthy weight to a higher BMI category than all children overall.
These findings highlight the importance of actions to enable healthy diets in the early years, including strengthening the Healthy Start scheme, so that those in the most deprived areas are enabled to eat a nutritious diet based on unprocessed and minimally processed nutritious foods. See our new joint briefing on Healthy Start and asks of Government below.
For our practical guides to support eating well in the early years, you can download our resources for free here.
New briefing: Strengthening the Healthy Start Scheme to protect children’s health by the Food Foundation and First Steps Nutrition Trust
On 2 May this new joint policy briefing written by ourselves and colleagues at the Food Foundation was published and shared widely with relevant DHSC civil servants, civil society organisations and local authorities. The briefing seeks to make the case for strengthening the Healthy Start scheme so that it can function as the nutrition safety net it is intended to be. It covers why the scheme is needed, its health benefits, and necessary improvements. We hope it will be a useful reference in our ongoing advocacy.
New report: Corporate Lobbying: The Dark Side of the Plate by the Food Foundation
On 3 April, the Food Foundation published this briefing to share initial findings from research on food industry lobbying in the UK. The briefing provides a good explanation of lobbying, commercial influence and conflicts of interest. It explains that while lobbying of elected officials is key to transparent and democratic policymaking, there are clear power imbalances in the UK food system that limit the government's ability to implement policies supporting public health. For example, during January 2020 – June 2024, at Defra (the government department responsible for food and farming), ministers met with food businesses and their trade associations 40 times more than with food NGOs and ministers (!). The briefing concludes with general recommendations for how transparency in lobbying can be improved in the UK, and a list of specific engagement questions for investors. A 10-minute Pod-Bite summarising the findings is available here.
New report: Infant and young child feeding in emergencies (IYCF-E) on the island of Ireland: a guidance document for creating an all-island preparedness plan
Aileen Kennedy, Dr Liz O’Sullivan (both TU Dublin) and Dr Clare Patton (Queens University Belfast/ Leeds University) led this project, researching and highlighting why infant and young child feeding is so important in emergencies, including those that occur on the island of Ireland, and what needs to be done to ensure the needs of this vulnerable group are met. The report draws both on pre-existing published evidence and involved new primary research. It provides guidance for developing an IYCF-E plan, including how to prepare for, respond to, and recover from a variety of emergencies that may occur on the island of Ireland.
Preparatory activities include developing and implementing an IYCF-E plan under the leadership of a coordinator, investing in milk bank services, implementing the Code, prioritizing breastfeeding protection, promotion and support to build resilience, and providing detailed guidance for families on what they should do in anticipation of an emergency, or what they should bring if they need to evacuate their homes.
This report and its recommendations are relevant to the UK, where currently there is no national plan or public guidance on infant and young child feeding in emergencies.
House of Lords Debate: Report from the Food, Diet and Obesity Committee: 'Recipe for health: a plan to fix our broken food system'
This debate on 28 March was an opportunity for the inquiry committee to react to the very disappointing Government response to their inquiry report, which we wrote about in our February newsletter. You can watch the debate in two halves here: part 1 (105 mins) and part 2 (42 mins) or read the transcript here.
The debate was opened with introductory remarks from the Chair, Baroness Walmsley, followed by 6-minute statements from each of the 12 (former) committee members and closed with a response from the Parliamentary Under-Secretary of State, Department of Health and Social Care, DHSC, Baroness Merron.
The statements that explicitly mentioned the early years were as follows:
Baroness Walmsley highlighted the gap in commitments to improving Healthy Start and restricting the marketing on foods for infants and young children.
The Earl of Caithness described how pregnant women, infants and children, in particular, are being neglected by government.
Baroness Brown of Silvertown welcomed recent NICE guidelines on maternal and child nutrition (nutrition and weight management in pregnancy, and nutrition in children up to 5 years) but reiterated the limitations of guidance which needs to be accompanied by structural actions to address inequalities.
Baroness Suttie raised questions around the availability, composition and marketing of commercial produced baby foods and drinks, including food pouches, follow-on formula and growing up milks, criticising the government’s lack of response to suggestions for how obesity prevention needs to start in the early years.
Baroness Merron’s response on behalf of the DHSC, highlighted the importance of affordable and high-quality infant formula products for those who use it, and welcomed the Competition and Markets Authority (CMA) report, stating that the DHSC “will consider carefully the recommendations and will respond to it.” We are anticipating the DHSC response to the CMA report by mid-May.
Baroness Merron ended by thanking the Committee and stating “We know we have to go further, where previous Governments have not done so. I look forward to being able to set out further actions that we will take in due course.” We eagerly await government action, especially given the Labour government’s commitment to give all babies the best start in life and to have the healthiest generation of children ever.
New paper: Cross‐Sectional Associations Between Exposure to Commercial Milk Formula Marketing, Beliefs About Its Use, and Socioeconomic Position Among Pregnant Women and Mothers in the UK
Martha Athanasiadou and colleagues published this research which explores associations between exposure to commercial milk formula marketing and beliefs about its use among pregnant women and mothers in the UK. Over 1000 women were interviewed from lower, middle and higher socioeconomic positions. Most participants were exposed to commercial milk formula marketing on TV (67.6%), and nearly half on social media (45.3%). In-store marketing and magazines/newspapers were also a common marketing source (33.5% and 20.6% of participants), as well as active participation in baby clubs run by commercial milk formula companies. Women in each socioeconomic background were equally exposed to commercial milk formula marketing, with around six forms of marketing each. Alarmingly, this study found that over a quarter agreed with the statement ‘breastfeeding and formula feeding provide a baby with the same health benefits’, with a higher percentage of women from the lower (35.7%) compared to the higher socioeconomic position group (20.8%).
We are concerned by the findings of this research which highlights that so many women in the UK are exposed to commercial milk formula marketing contravening the International Code for the Marketing of Breastmilk Substitutes. Similarly, we also concerned that UK public health messaging is being drowned out by marketing messages. The NHS is clear that breastfeeding protects infant and maternal health in ways which cannot be replicated by formula milks, including reducing babies’ risk of SIDS (sudden infant death syndrome), child diabetes, and leukaemia, as well as protecting them from infections.
As secretariat of the Baby Feeding Law Group UK, we continue to challenge widespread commercial milk formula marketing, and high cost of infant formulas positioned as equivalent or even better than breastmilk. Last month, we compiled a formal and comprehensive BFLG-UK response to the CMA infant and follow-on formula market study calling for the Government to accept and implement all 11 recommendations.
We have written this new FAQ to help myth bust widespread misconceptions about how maternal diet affects breastfeeding. It can be found under ‘General questions about infant feeding’ on our Infant milk info website.
In short, yes, food insecure women can breastfeed. Hunger, malnutrition, poor diets and stress can all have negative effects on breastfeeding, but women experiencing these situations can and should be supported to breastfeed if they want to. Some of the key points from our FAQ are:
Household food insecurity prevalence in the UK is high; the Food Foundation found that 23.6% of households with children under 4 were food insecure.
Women living in food insecure households breastfeed for a shorter duration. This has been called ‘the breastfeeding paradox’, as mothers who are least likely to breastfeed are also least likely to be able to afford infant formula.
The reasons for lower breastfeeding rates in food insecure households include women's perceptions that their poor diets and stress negatively affect their breastmilk supply and/or quality (see more below), compounded by a lack of breastfeeding support. Several studies also found that those experiencing food insecurity were exposed to misinformation about breastfeeding and likely to have a negative perception of it. However, breastfeeding is physiologically robust and mothers who want to breastfeed should be supported to do so, including with adequate hydration, foods and psychosocial support.
The public health recommendations about infant feeding are the same in emergencies and situations of food insecurity and in stable situations, the world over. It is widely accepted that breastfeeding is the safest method of infant feeding during emergencies in almost all cases, and that exclusive breastfeeding should be continued up to around 6 months and beyond.
The risk of malnutrition is increased if breastfeeding is interrupted and the protective benefits of breastfeeding can be more important during emergencies to limit the spread of infections and diseases. Breastfeeding is protective against hospitalisation for diarrhoea and respiratory infections.
To read the full FAQ, including links to further resources on this topic, please see here.
New briefing: Marketing restrictions for follow-on formula and growing-up milks: Global examples and guidance
We wrote this briefing to provide further evidence to support our ask of the Government to accept the Competition and Markets Authority recommendation to extend marketing restrictions on infant formula to follow on formula, and to further make the case that the extension needs to cover growing up milks marketed for use from 12 months plus as well. It outlines which countries regulate FoF and/or GUM marketing, the reasons why some countries do not regulate these products, the relationship between Code implementation status and infant feeing practices indicating why it is important to regulate FoF and GUM marketing, and a reminder of global guidance and recent, relevant evidence.
For more information on growing up milks and plant-based alternatives on the market read our briefing here. Additionally we published this editorial on the high levels of sugar in plant-based growing up drinks. The Daily Mail published this article on these products based on our analysis.
World Health Assembly 78 (19-27 May 2025) and resolution on the digital marketing of breastmilk substitutes
From 19 – 27 May 2025, the 78th session of the World Health Assembly will meet in Geneva. All official documents and livestreaming will be available here. Other information, including the list of side events will be available here. On the provisional agenda, item 13.9 Global Strategy for Women’s, Children’s and Adolescents’ Health is of interest, as this is when the decision regarding a proposed resolution for Regulating the digital marketing of breast-milk substitutes will be discussed, as put forward from the Executive Board meeting in February 2025, through item EB156(30). Several Non-State Actors (NSAs) will be attending and advocating in support of this, including the International Baby Food Action Network (IBFAN), International Lactation Consultants Association (ILCA), Save the Children and the World Cancer Research Fund (WCRF), among others.
Webinar: Evaluation of the Healthy Start Scheme, 24 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.
