The guidelines are applicable to all foods and drinks marketed for children under 36 months, except commercial milk formulas.
On nutrition, they focus on sugar and salt. They set out recommendations on added sugars (allowed or not allowed), total sugar (expressed as max % fruit content or max g fruit/100g product or as a max % of energy per 100g), added salt (not allowed) and total sodium (mg/kcal) by product category (baby meals; baby finger foods marketed for use under 12 months; baby finger foods and snacks marketed for use from 12 months of age; drinks).
They also advise food producers to consider other aspects of composition:
producing more vegetable and savoury foods than fruit-based and sweet foods
using more bitter and less sweet vegetables as ingredients
refraining from masking the flavour of vegetables
producing more single-flavour fruit and vegetable foods
producing fewer highly blended foods to help enable texture progression
reducing the total sugar and free sugar contents of foods wherever possible
appropriate portion sizes, particularly for finger foods and products aimed at children aged up to 12 months
avoiding producing sweet desserts
On marketing and labelling, the guidelines ‘strongly encourage’ food producers to:
label products in line with scientific and government advice to introduce solid foods at around 6 months of age
provide honest labelling so that product names are not misleading and are aligned with the quantity of the primary ingredients
restrict inappropriate on-pack marketing and promotional statements that make ‘implied health claims’ about health or nutritional benefits that are not based on scientific evidence
have clear feeding instructions (for example ‘use a spoon’ or ‘do not suck’) on the front of products packaged in pouches with a nozzle
stop labelling and marketing snacks or food products that can be eaten between meals as suitable for children aged 12 months and under
A lot of the above is positive and welcome, but some concerning details from our perspective include the following:
Added sugars are allowed in finger foods and snacks marketed for use from 12 months.
Maltodextrins are not counted as added sugars so are allowed (see below).
No total sugar limits are given for fruit and vegetable foods but at the same time there is also no recommendation to alert parents to their high sugar content, e.g. high sugar warning labels.
Less stringent salt limits than WHO recommendations (see below).
Growing up milks and drinks marketed for use from 12-36 months are not counted as drinks and are exempt from these guidelines despite containing lots of sugar and widespread misleading marketing and labelling.
Regulated health and nutrition claims such as ‘no added sugar’ are permitted.
Action to improve the nutritional quality and appropriateness of the commercial baby and toddler food offer is long overdue, and these products are widely and frequently used by families with children under 3 years of age in all socio-economic groups. So, IF adhered to, these guidelines will be positive, however voluntary measures have been shown to have limited effect. Stronger mandatory regulations are therefore still needed to replace the current regulations which date from 2003. There is agreement across the sector that these should be informed by the NPPM and UK public health recommendations. We are also advocating that they should take in to account emerging research, including on ingredient markers of ultra-processed foods such as maltodextrins and on texture.
This report comes after new data from colleagues at Leeds University confirming that more than a third of commercial baby and toddler foods can be classified as ultra-processed, with the proportion in certain product categories like baby snacks and cereals much higher. Read more in this news report in the Independent: “Ultra-processed baby foods ‘set children up for lifetime of obesity,’ experts warn”.
A reminder given all of the above, the NHS now makes clear that families should not rely on shop bought baby foods and home-prepared foods are often healthier and cheaper. Read about this change in public facing advice in our July newsletter.
For practical, pictorial guidance on feeding babies under 12 months and young children between the ages of 1 and 5 years, without using commercial baby and toddler foods, see our FREE eating well guides here.
Image credit: First Steps Nutrition Trust, UPF report
Some points we found striking:
21% of 16-18 month olds were given commercial baby/toddler finger foods/snacks daily, and 84% at least once a week.
23% of 16-18 month olds were being given breastmilk at least once a day, 16% of caregivers said breastmilk was their child’s main milk drink.
18% said plant-based alternatives were their child’s main ‘milk’ drinks, but this included 2% who drank plant-based toddler or growing-up drinks.
Only 53% of 16-18 month olds gave their child vitamin drops.
18% of 16-18 month olds were being given a formula milk at least once a day, and 7% had these as their main milk drink.
52% of 16-18 month olds drank squash, 21% drinking this at least once a day.
Only 28% of 16-18 month olds usually used an open cup or free-flowing cup, with 27% using a cup or beaker with a valve and 24% still using a bottle.
20% of primary caregivers reported being currently eligible for the Healthy Start scheme but only 74% of those had registered for the scheme.
25-33% of caregivers reported experiencing food insecurity, e.g. worrying about food running out and not being able to afford balanced meals.
Of all primary caregivers surveyed, 10% had used growing-up milk and 9% had used prescribed specialist formula.
33% of 16-18 month olds were given solid food before 6 months.
65% of caregivers said they were yet to take their child to the dentist.
Nb. Across the topics covered by the survey, there were some differences between subgroups. Caregivers who were more affluent (as shown by having higher household incomes or living in less deprived areas) were more likely to align with UK guidance, compared with caregivers with lower household incomes or those living in more deprived areas.
The conclusion states that the report highlights some areas of concern in the eating habits of children aged 16 to 18 months, including:
Sugary foods as a regular part of children’s diets
Salt added to food for young children
Frequent use of purchased snacks and ‘treats’ (such as sweets, crisps, chocolates and ice cream)
Use of drinks other than breast milk, water or milk
Use of formula milks (including infant formula and follow-on formula) after 12 months of age, and growing-up or toddler milks
It acknowledges that further support and guidance are needed for families with young children, particularly about healthy snacks and drinks, and advice on feeding from birth including breastfeeding.
It fails to acknowledge that these findings also highlight the need to improve the food environment to better enable parents to follow public health recommendations, e.g. strengthening and enforcing regulations on the marketing of commercial milk formulas, especially follow-on formula and growing up milks and drinks. UNICEF’s latest report ‘Feeding Profits’ makes a comprehensive set of recommendations for improving the food environment, including for babies and toddlers. See below.
To summarise the latest recommendations on plant-based milk alternatives for young children from the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity (CoT), we have produced the following infographic. Read more about the recommendations in our August newsletter.
New infographic: Can food insecure women breastfeed?
To summarise our frequently asked questions (FAQ) on this topic which we shared with you in our May newsletter, we have produced the following infographic. Its purpose is to address widespread misconceptions about the links between maternal diet, stress and breastfeeding. The full FAQ is available on our infantmilkinfo.org website here.
The key message being reiterated by this report, is that, for the first time ever, among school-aged children and adolescents globally, overweight has exceeded underweight as the dominant form of malnutrition. This same pattern is seen in the UK:
in children under five, stunting in the UK is reported at 4% in 2024, compared to overweight at 8%. This compares to global averages of 23% for stunting and 5% for overweight in children under 5.
among school-aged children (5-19 years), as of 2022, modelled estimates for underweight in the UK are reported to be 2% while overweight is 30%. This compares to global averages of 10% for underweight and 20% for overweight.
The report provides a number of helpful definitions, latest data on the status, trends and inequities in overweight and obesity among children and adolescents worldwide and through regional profiles (in the Data tables and Annex 1) and an analysis of the drivers of unhealthy food environments.
Four key drivers of unhealthy food environments are described:
Inexpensive ultra-processed foods and beverages are flooding retail markets and infiltrating schools
Children are highly exposed to the marketing of ultra-processed foods and beverages at home, school and play, particularly digital marketing
The unethical practices of the ultra-processed food and beverage industry undermine government action and exploit children, even in times of crisis
Inadequate legal measures and policies enable the ultra-processed food and beverage industry to manipulate children’s food environments
Based on the analysis provided and using recent examples of countries that have made progress, the report presents eight recommendations to transform children’s food environments:
Implement the International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions to protect and promote breastfeeding and appropriate complementary feeding.
Implement comprehensive, mandatory measures to transform food environments (school food environments, food marketing restrictions, food labelling, taxes on unhealthy foods and beverages and food reformulation).
Implement comprehensive policies to improve the availability and affordability of locally produced nutritious foods for children and adolescents.
Establish robust safeguards to protect public policy processes from interference by the ultra-processed food industry.
Implement social and behaviour change initiatives that empower families and communities to claim their right to a healthy food environment.
Strengthen social protection programs to address income poverty and increase children’s access to nutritious and healthy diets.
Engage young people in public policymaking on food justice by fostering youth-led advocacy.
Strengthen global and national data and surveillance systems to monitor food environments, diets, and overweight among children and adolescents.
Priority regulatory actions to create healthy food environments for children (page 17, full report) are also provided, based on content from the UNICEF Nutrition Strategy 2030 and the WHO Acceleration Plan to Stop Obesity. These include breastfeeding, first foods and foods in pre-schools and schools, as well as food marketing, labelling, subsidies, taxes and reformulation.
Our advocacy and policy influencing work in the UK aligns with several of the above recommendations.
There are also specific recommendations for various stakeholders to ensure commitment and accountability for action (Pg 6-7 of Full report), including to Governments who are acknowledged as bearing the primary responsibility for protecting children’s right to food and nutrition, but need to be supported through unified and comprehensive action from multiple stakeholders, including:
New paper:Ultra-processed or minimally processed diets following healthy dietary guidelines on weight and cardiometabolic health: a randomized, crossover trial
This paper by Sam Dicken and colleagues from a wide range of global institutions, reports on the results of a 2 by 2 randomised, controlled, cross-over trial among 55 overweight adults (BMI ≥25 and <40kg/m2) in England, whose habitual UPF intake was ≥50% kcal day. It assessed outcomes of two, 8 week-long ad libitum diets (separated by a six-week period), one minimally processed (MP) and one ultra-processed (UPF); i.e. each person ate 8 weeks of the MP diet then 8 weeks of the UPF diet, or vice versa (as shown). Both diets met with the recommendations of the UK Eat Well guide in terms of the nutrition and balance of different food groups they provided. All foods/drinks were delivered to participants at their homes. The primary outcome was within-participant difference in percent weight change (%WC) between diets, from baseline to week 8. Secondary outcomes were change in anthropometry, body composition, cardiometabolic markers and appetite.
The main finding was that both the MP and the UPF diets led to weight loss: MPF (%WC, −2.06 (95% CI −2.99, −1.13) and UPF (%WC, −1.05 (95% CI −1.98, −0.13)). The weight loss on the UPF diet was unexpected given the results of previous trials, but the weight loss on the MP diet was significantly more than on the UPF diet: %WC on MPF (change in %WC, −1.01 (95% CI, −1.87, −0.14), P = 0.024; Cohen’s d, −0.48 (95% CI, −0.91, −0.06)).
Weight and BMI were significantly lower at 8 weeks from baseline on both diets. There were some positive changes in body composition on the MPF but not the UPF diet, including lower fat mass. Changes in blood pressure and heart rate did not differ significantly between diets. The clinical markers showed a mixed picture, with some better on the MP diet and some better on the UPF diet. Some but not all measures of subjective appetite measures were better on the MP than the UPF diet.
The potential mechanisms behind the results were the greater energy density, flavour and taste ratings and potentially appeal of the UPF than the MP diet, noting it was delivered in its original packaging including health and nutrition claims. These differences mean that energy intake could have been greater on the UPF diet.
The authors conclude that dietary guidance needs to include the extent of food processing in addition to existing food and nutrient based recommendations.
How is this relevant to the early years? In this pre-recorded PowerPoint presentation from April 2025, our Director Vicky outlines the latest evidence on UPF consumption and childhood adiposity. UPFs dominate UK diets from infancy and through the early years. One study by Rana Conway and colleagues at UCL found that UPFs accounted for 47% total energy intakes in a cohort of UK twins at 21 months (in 2009/2010) and 59% by the time they were 7-year-olds (in 2014/2015). Daniela Neri and colleagues analysed UK National Diet and Nutrition Survey data and found that UPFs contributed 61% of total mean energy intake in 2–5-year-olds (in 2008-2014). At the same time obesity levels in children aged 4-5 years are more or less stable and high. Latest National Childhood Measurement Programme data report a prevalence of overweight and obesity at 22% at 4/5 years of age in England in 2023/2024. As summarised in the presentation, a growing number of studies show associations between UPF consumption and adiposity in young children.
So, whilst this study by Sam Dicken and colleagues was among overweight adults, it seems reasonable to assume generalisability to children. This would support a recommendation that dietary guidelines for children need to include food processing as well as nutrient and food based recommendations. This was the top recommendation of our 2023 UPF report, which you can read here.
New paper: How Does Household Food Insecurity Impact Complementary Feeding, in High Income Countries, in a Cost-of-Living Crisis? A Systematic Scoping Review
This paper by Grace Hollinrake and colleagues at Swansea University sought to review available evidence on the effect of household food insecurity on complementary feeding practices in high income countries. Their search yielded only five articles (two qualitative and three quantitative) from studies in Australia, New Zealand and the USA, showing that this is a new area of research, but also quite neglected. They report that the studies revealed that coping strategies to prevent hunger and food waste negatively affected some aspects of complementary feeding; children were encouraged to finish their food, foods that might not be accepted were not offered and the variety of foods given was reduced. These are at odds with advice to feed responsively, to give a wide variety of foods and to offer repeatedly and accept frequent rejection. This is concerning because what and how young children are fed impacts on their health and development and shapes their food preferences and eating styles in the short and long term.
Other interesting findings from the studies were: that food banks were used by some families but that this reduced the variety of foods; that high satiety foods were preferred to make more filling meals and also products with high sugar content; that food insecure families were more likely to give their babies baby food pouches (which typically are high in sugar) and less likely to practice baby-led weaning; but also that that some parents emphasised providing home-cooked meals.
Image credit: First Steps Nutrition Trust, UPF report
The authors conclude that diet and feeding practices could be negatively affected by household food insecurity. Diet quality and variety may reduce, baby food pouches may be more likely to be used, and persuasive feeding practices could be used to avoid food waste and child hunger. However, more research is needed to inform UK policy and practice to support families with young children experiencing the current cost of living crisis.
The paper indicates the importance that health workers supporting families with complementary feeding are aware of the challenges food insecurity poses to them applying public health recommendations for infant and young child feeding, and to tailor their advice and give additional support accordingly. This approach is recommended in the NICE guidelines on Maternal and Child Nutrition (NG 247), which also recommends discussing: the cost of healthy food and where to get support, including government and local schemes that offer advice and help to buy healthy food and milk (including Healthy Start, depending on eligibility) and income support schemes.
New paper: How labelling of commercial infant food impacts parents’ beliefs about sugar content and related purchasing and feeding decisions: a scoping review
This paper by Rana Conway and colleagues at University College London was commissioned by the DHSC and is meant to inform policy. It reviewed available literature on parental feeding beliefs and decisions for children under 3, from high income countries and regions similar to the UK. They found 15 unique studies, seven quantitative, seven qualitative and one mixed methods. Specific review questions were 1. What is known about how primary caregivers understand terms used on commercial infant foods to describe sugar? and 2. What is known about how primary caregivers might use sugar warning labels on commercial infant foods?
They found little research to answer their specific questions, but key findings included the following:
Simply labelling products as suitable for babies elicited a trust that they were healthy, including not having a high sugar content.
Strategies to raise awareness of sugar content (sugar warning labels, counter marketing videos and provision of information sheets) were only tested in three studies. They show some indications of success in shaping intentions to serve, product choices and attitudes towards high sugar products.
One study looked at parents’ ideas of strategies to promote avoidance of sugar sweetened drinks, and these included illustrations of sugar content and messages on the negative effects of sugar on children’s health might change feeding behaviours.
Marketing claims are commonplace, effective and misleading: in 11 of the 15 studies, parents described the claims ‘no added sugar’, ‘less sugar’ and ‘only natural sugar’ on product labels as appealing, and many understood these all to mean low sugar. [This is highly problematic because in the UK these are regulated claims and are widely used despite being misleading].
Parents are unaware of the high sugar content in many baby foods, find the on-pack messaging confusing and deceptive and want clearer information on sugar content. Parents support regulation on the content and marketing of commercial infant foods.
The authors rightly highlight that while UK legislation limits the amount of certain nutrients in commercial infant foods, for most products there is no limit on the total sugar content. They highlight the WHO Nutrient Profile and Promotion Model as a tool that could be used to set limits. They also share that a survey by Action on Sugar has shown that UK parents would support government action to ensure all foods and drinks on the baby aisle are nutritionally appropriate and in line with NHS recommendations.
The authors also acknowledge that the NPPM recommends a high sugar warning where certain limits are exceeded, and that the logic of the high sugar warning is to push industry to reformulate (so they can market their products without a warning) or diversify product offerings to include more less sweet options, as well as to aid parent’s decision making. However, the review only found one study on sugar warning labels to include and while it found positive results that the warning averted choices in favour of products without the warning, the authors state concern about what alternative foods parents might select if sugar warning labels were added to commercial infant foods and suggested further research is needed on benefits and harms of their use.
The authors conclude that parents’ understanding of the terms such as added sugar was unclear as was the impact of introducing sugar warning labels. Nonetheless, parents’ find the current labelling of commercial infant food misleading and desire clearer labelling to support informed purchasing and feeding decisions. They highlight that current lack of regulation makes parents vulnerable to making underinformed choices for their children and that the results support calls for legislation to make commercial infant food labelling clearer to reduce free sugar intakes. However, they recommend more research on sugar warning labels.
It should be noted that the conclusion of this scoping review compares to a more favourable position on sugar warning labels from a mixed methods study conducted by the same study team published in May this year, and summarised in our June newsletter. This study concluded that: “Results suggest that the mandatory use of minimum age guidance and sugar warning labels on commercial infant foods could provide parents with agency and shift feeding behaviours toward closer alignment with recommendations. Importantly, the impact of these label changes appears socioeconomically equitable, and they are supported by parents”.
New paper: Baby food pouches and Baby-led Weaning: Associations with energy intake, eating behaviour and infant weight status
This new paper written by Alice Cox and colleagues in New Zealand explored the associations between baby food pouch intake, baby-led weaning and energy intake, eating behaviour and BMI for infants aged 7-10 months. Data from over 600 infants were included in the study, where the researchers assessed baby pouch use frequency, baby-led weaning status, diets and feeding behaviour, and BMI z-scores.
Image credit: First Steps Nutrition Trust, UPF report
Around 30% of the participants reported ‘frequent pouch use’, once a day or more. Less frequent pouch users offered their infants pouches up to 2-4 times a week. At 6 months, most infants in the study were spoon feeding (76%), 10% with partial baby-led weaning and 13% full baby-led weaning. Whereas by 7-10 months, around half were still spoon feeding, a quarter partial baby-led weaning, and a quarter were full baby-led weaning. There were no differences in energy intakes or BMI z-scores between those with frequent or infrequent pouch use or related to baby-led weaning status. The study found an association between food responsiveness and frequent pouch use. The food responsiveness scale measured desire to eat regardless of hunger ques (such as, “Even if my child is full up s/he finds room to eat his/her favourite food”). Therefore, children who consumed pouches frequently were more likely to eat even when they weren’t hungry. Full or partial baby-led weaning was associated with reduced restrictive/selective eating at both 6 months and 7-10 months. For example, children who showed signs of restrictive/selective eating were likely to avoid foods of certain textures or temperatures.
The authors highlight that families may offer pouches more regularly early on if their infant shows signs of fussy eating behaviour. On the other hand, if infants are not exposed to appropriate textures early on in the complementary feeding period, they may reject certain textures later on, which could contribute to fussy eating behaviour.
This study is important for a number of reasons. Research into the texture of baby foods is limited, yet dietary texture progression is important for young children. The study highlights that eating directly from pouches means that infants are unable to learn about the food’s sensory properties, such as texture and feel. And that relying too much on pouches could lead to a delay in age-appropriate texture progression to lumpy, chewable foods. The NHSrecommends that parents should move babies on from puréed or blended foods to mashed, lumpy or finger foods as soon as they can manage them. This is because it helps them learn how to chew, move solid food around their mouth, and swallow. It is important to remember that some babies take longer to get used to new textures, whereas others like to start with mashed, lumpy or finger foods. Additionally, appropriately timed texture introduction is thought to be important for food acceptance as children get older.
We first raised concerns about the use of baby food pouches in our report published in 2017 on Baby Food in the UK. Since then, pouches have gained in popularity and various issues with their use have been exposed. Earlier this year, BBC Panorama published its programme ‘The Truth About Baby Food Pouches’, which exposed issues with high sugar levels and a lack of certain micronutrients, such as iron. Alongside this, researchers from the University of Leeds published research that found pouches make up nearly 40% of the baby food market and that fruit-based pouches had enough sugars to warrant a high sugar warning level according to the WHO Nutrient Profiling and Promotion model. These findings are reflected in a narrative review of over 30 research papers that we published with the University of Glasgow in July this year. We found that over 50% of products on the baby food market were classified as puréed, of which many are pouches, and that the median sugar content of purées was over 10g of sugar per 100g.
Recently, the Department of Health and Social Care published voluntary industry guidelines for commercial baby foods; read more about this above.
Parents must be given more support to feed their children diets based on nutritious, minimally processed foods, as this will give them the best start in life. As above, the timely introduction of varied tastes and textures during complementary feeding can help to influence children’s long-term preferences.
See our eating well resources for practical, pictorial guides for feeding young children here.
New paper: “You Want to Eat Healthy, Especially When You're Pregnant. But Sometimes, It's Just Not Possible”: Perceptions of Facilitators and Barriers to Healthy Food and Diet Practices During Pre-Conception and Pregnancy
This paper by Jane McClinchy et al (published on 7 September 2025) is a write up of research commissioned by the Food Foundation for their 2023 report “Preconception, Pregnancy and Healthy Weight in Childhood”. This qualitative study used focus group discussions with UK women trying to conceive, pregnant or with a baby under 6 months of age, to explore faciliators and barriers to eating well in pregnancy and how these could be addressed or used to improve dietary practices.
Challenges to eating well in pregnancy included: ‘mothers’ load’, i.e. tiredness and busyness when women have jobs and other children to care for; pregnancy side effects including nausea, cravings and heartburn; accessibility, availability and cost of healthy foods and marketing of unhealthy foods; and lack of individualised advice with too great an emphasis on what to avoid and what supplements to take and too little information and advice on healthy meals and snacks.
Facilitators to eating well in pregnancy included: meal planning and cooking skills; and partner and family support with meal preparation.
Changes recommended to support eating well in pregnancy included: access to professional advice and support like cooking classes; co-creation of healthy eating resources with pre-pregnant and pregnant women available for all.
This insightful paper shares important knowledge relevant to all those with a role in supporting women to eat well for and during pregnancy. To support practice, our Eating Well pregnancy guides provide lots of ideas of simple, cost effective snacks and meals to meet the nutritional needs of pregnant women and pregnant teenagers, as well as tips and hints for managing on a budget. They can be accessed for free here.
New editorial: Food Allergy Prevention: Is Earlier Complementary Food Introduction Really the Optimal Approach?
This editorial by Catherine Breen and colleagues outlines the tensions that exist between allergy research seeking to explore the preventive effects of introduction of common allergenic foods (especially egg and peanut) before 6 months of age, with public health recommendations to exclusively breastfeed to around 6 months to protect infants and mothers from a wide range of negative health outcomes. The authors recommend that trial designs seek to test simpler interventions, focused on one of timing of: introduction of allergens (alone or alongside other complementary foods), form/dose of allergen or frequency of allergen, rather than mixing up these exposures. They highlight that there are no published or registered clinical trials which focus on testing timing of allergenic food introduction alone, without changing intensity of allergenic food consumption and/or timing of complementary feeding. The authors suggest allergy prevention research could focus on working within, rather than against, government infant feeding guidelines. More specifically, they recommend research to establish whether the optimal approach to food allergy prevention might actually involve allergenic food introduction that is consistent with current public health guidance; i.e. introduction of common allergenic foods at around 6 months with regular exposure through the complementary feeding period. This is because available data indicate poor compliance with these current recommendations.
Lastly, they urge caution in light of the vested interest of the formula industry in research that focuses on shortening the duration of exclusive breastfeeding, and the possible harms to infant health that may arise as a result of commercial exploitation.
We have had a number of queries about cold water sterilising because of inconsistency in the advice on different NHS webpages and also with that given by Milton on their product labels and website.
After consulting and connecting relevant organisations, we hope that the advice will become more consistent. The important point to note is that following cold water sterilisation, baby feeding equipment should be rinsed with cooled boiled water.
Image credit: www.nhs.uk
This NHS page ‘How to make up baby formula’states (Step 5): If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse them with cooled boiled water from the kettle (not tap water).
The NHS and Start for Life webpages simply advise families to follow the manufacturer’s instructions.
Research from Swansea University that we here at First Steps Nutrition Trust collaborated on, suggests that 50% of families are using formula preparation machines. These machines are marketed as being convenient methods of preparing formula feeds from powdered formula, for consumption within minutes. However, formula preparation machines regularly dispense water below the recommended minimum of 70ºC (either by design, as is the case for the Baby Brezza or not, as our study showed for the Tommee Tippee Perfect Prep). This is problematic because the water needs to be at least 70ºC to kill any bacteria that may be present in the powdered infant formula, which is not sterile. Using hotter water is possible; the nutrients in the formula will not be affected although the taste may change. If there is probiotic bacteria in the powdered infant formula these will be killed. However, probiotics have no proven benefits for infants when added to infant formula and the priority when reconstituting powdered infant formula should always be optimising microbiological safety rather than maintaining any live bacteria.
You can find more detail about making up infant milks safely, and some helpful infographics on safe formula preparation to share with families who use formula to feed their babies here: Making infant milk safely — First Steps Nutrition Trust
For our FAQs on infant milk safety, head to our Infant Milk Info site here.
New paper: Maternal Recognition of Formula Food Brand Logos and Its Association with Breastfeeding
Research by Selen Pervane and Betul Ulukol at Ankara University in Turkey, found that over 60% of over 400 mums recognised infant formula logos. The study recruited women who were pregnant for the first time, and mums with infants under 6 months of age. Participants were shown formula brand logos with the names removed, and were asked whether they recognised the logo, whether it was associated with infant formula, and where they recognised it from. Over half of mothers who had never used formula to feed their babies also recognised the logos. Around 30% of the women reported seeing the logos on TV or from the internet, suggesting that digital advertisements are a key exposure. The rate of formula usage was 51% among mothers who recognised the logos, compared with 27% among those who did not recognise the logos.
These findings are concerning because they show how pervasive formula marketing strategies clearly influence the feeding decisions of parents and carers, as also outlined by the WHO in this report from 2022. They also show how digital marketing is key. These findings support the need to implement the Code to better protect breastfeeding, noting that this is also the top recommendation of UNICEF’s latest report ‘Feeding Profits’ which we write about above.
New paper: Breastmilk substitute marketing practices in four countries: an analysis using a community-based approach
On 31 July 2025, a four-country paper (including the UK, US, Australia and Canada) on monitoring of Code violations was published in the journal, Archives of Public Health. The purpose of this quantitative study was to collect data on the breadth and scope of violations of the Code in four industrialized countries (U.S., Canada, Australia and the UK) that either do not abide by the Code or only partially abide by it, or that do not adequately enforce Code-related policies or laws. The researchers used a community-based approach by inviting volunteers in the four countries to participate by downloading a “scavenger hunt” mobile application (called GooseChase Adventures). Participants were required to fulfil 30 “missions” listed within the application, which incorporated tasks to find products that were marketed in a way that violated the Code. Missions were completed through uploading photographic evidence of examples of Code violations to the appropriate category of examples. Enrolment and data collection took place between July 2023 to July 2024.
The target sample size was 1,000 people per country, but over the course of the year only 1,261 individuals expressed interest in participating and only 138 completed the demographic survey, finished enrolment, created a profile on the module app, submitted verified Code violations and were therefore included in the sample. The sample was all female and predominantly made of individuals from the US (n=99; 71.7%) with only 20 participants from the UK (14.5%), 14 from Australia (10.1%) and just 5 from Canada (3.6%). Most participants (n=122; 88.4%) were lactation support professionals. A total of 700 violations were submitted, and the most frequently reported Code violations were Facebook adverts for BMS. The researchers concluded that Code violations are prevalent across the four countries (noting that 71.7% of the findings come from the US), and the public remain exposed to misleading marketing of breastmilk substitutes. The author’s recommended that countries should legislate the Code into law and commit to its implementation, noting that this is also the top recommendation of UNICEF’s latest report ‘Feeding Profits’ which we write about above.
New paper: Profits Before Health? New Zealand Government Rejection of Stricter Infant Formula Marketing Standards and the Lobbying Behind It
On 6 August 2025, a Perspective Article was published in the Maternal and Child Nutrition journal, written by Naomi Hull and colleagues in Australia. This paper provides a timely country case study of how transnational dairy and baby food corporations lobbied the New Zealand (NZ) government, exerting strong political influence and using economic arguments, to reject updated infant formula standards, despite strong evidence for policy designed to protect infant health and despite support across Australia for reform. The researchers sourced data through NZ Official Information Act requests, which included communications between commercial milk formula (CMF) industry lobbyists and the government representatives including the Prime Minister and cabinet ministers of the NZ Government. The Food Standards Australia New Zealand (FSANZ) is the government body responsible for setting joint food standards for Australia and NZ and these standards (specifically 2.9.1) regulate the composition, labelling and sale of infant formula products. In 2012, the FSANZ started a process to review regulatory requirements for infant formula, which included seven rounds of public consultation. Two CMF companies provided strong opposition to recommendations to restrict sales of specialised formulas and claims on infant formula packaging, indicating that this would have economic implications through reduced exports to China. In 2024, the NZ government announced its decision to opt out of the proposed new standard, despite evidence that the revised standard's benefits to infant health outweighed industry impact.
Neither Australia nor NZ have effective regulations to legislate the Code. This case study illustrates weaknesses in NZ's political transparency laws, where no mandatory lobbying registers and reporting requirements exist. It also demonstrates how the CMF industry has a notable level of access to and influence over politicians.
The researchers provide strong statements in the conclusions, that
“Ensuring that infant feeding decisions are not influenced by commercial marketing is crucial to population health.
Governments must withstand corporate pressures to expand trade and instead prioritise the health and safe nutrition of this most vulnerable group.”
The researchers further conclude that “it is crucial for governments to make policy decisions without the influence of the baby food industry and provide a strong argument for better regulation of corporate lobbying”.
This article provides a timely and critical lesson for the UK government. Industry responses to the work of the Competition and Markets Authority on infant formula and follow-on formula (here and here) include inadequate attempts to challenge the evidence supporting some public health recommendations on infant and young child feeding in the UK. We shared this paper with contacts in the DHSC and hope that they have taken on board the lessons of what has happened in NZ as they finalise their response to the CMA’s recommendations.
A reminder: What YOU can do to challenge conflicts of interest
We have compiled a comprehensive list of suggestions for what healthcare professionals can do if they identify conflicts of interest, especially relating to challenging the inappropriate marketing of breastmilk substitutes or commercial milk formula targeting health professionals. See the suggestions provided on the First Steps Nutrition Trust website here.
All Party Parliamentary Group on Infant Feeding and Inequalities, 28 October, hybrid
The next meeting of the All-Party Parliamentary Group on Infant Feeding and Inequalities will take place on Tuesday 28 October, in a hybrid format (in-person at Portcullis House, and online via Microsoft Teams) at 13:00. There will be an external speaker, in addition to an update on the work of the APPG. The invitation will be shared by Jess Brown-Fuller’s team in the coming weeks. If you would like to be added to the APPG IFI mailing list, please send an email request to Jess: jess.brownfuller.mp@parliament.uk and Jess’s parliamentary assistant, Edmund Leagrave: edmund.legrave@parliament.uk
This year’s annual UNICEF UK BFI conference is in person at the Telford International Conference Centre. From confronting corporate power, the latest research on the microbiome, and updates on the Infant Feeding Survey, the programme features a diverse range of talks by renowned professionals and researchers. Information on the programme and speakers can be found here and you can book your tickets here. See you there!
We're delighted to have Tami Mann join our team as Nutrition Intern for Social Media and Communications. Tami is currently pursuing an MSc in Nutrition for Global Public Health at the London School of Hygiene and Tropical Medicine. Welcome Tami!
