A new report was published by Public Health England (PHE) on 17 July 2018. The Scientific Advisory Committee on Nutrition (SACN) stated the need for a child to have the best start in life to avoid the over-eating which is leading to an epidemic of obesity in our society. This report, which covers infant feeding from birth up to 12 months of age, looks at evidence on the impact of infant feeding on short and longer-term health outcomes for infants and mothers. After considering factors that influence eating behaviour and varieties in diet it makes several recommendations on feeding in the first year of life.
New guidance confirms the importance of breastfeeding
This is the first new guidance the UK Government has issued on feeding babies in over twenty years and it largely confirms existing advice on infant feeding. It states that:
- Breastfeeding makes an important contribution to infant and maternal health.
- Existing advice for women to exclusively breastfeed for around the first six months, not to introduce solid foods until around six months of age, and to continue breastfeeding for at least the first year of life, should be retained.
- A wide variety of solid foods should be introduced in an age appropriate form from around six months with flavours and textures becoming increasingly diverse. New foods may need to be presented to infants on many occasions before they are accepted, particularly as infants get older.
- Cow’s milk should not be given until 12 months, high sugar or high salt foods should be avoided and foods containing peanut, and hen’s eggs could be introduced at six months as delaying this might increase the risk of food allergy (although seeking medical advice would be appropriate if there is a strong family history of food allergies).
The report echoes La Leche League’s information
This guidance echoes information La Leche League has provided since its early days. Back in 1963 La Leche League’s The Womanly Art of Breastfeeding raised concerns about the overfeeding of infants. It says: “Today medical scientists are talking about excessive intake as well as deficient intake… Overfeeding can result from the premature introduction of solid foods. Breastmilk, on the other hand, gives the best assurance of proper nourishment because it is Nature’s complete food for your baby… There is usually no reason for adding any foods to the breastfed baby’s diet in the early months.” and “There are at least two very good additional reasons for waiting. First, you want to maintain milk supply and the more solids the baby takes the less milk there will be. In other words, you are substituting an inferior food for a superior one.”
Back in 1963 babies sometimes had solids at one month of age causing a reduction in milk production. This often then led to early cessation of breastfeeding as mothers believed they didn’t have enough milk. The book continues: “The second reason is that the younger the baby, the more likely it is that any foods other than breastmilk will cause food allergies. No one food will necessarily do this, but you can’t tell until you try. It seems both the kindly and the wise course to give the baby the benefit of a few extra months of the food that Nature has devoted millions of years to perfecting for him, until his immature digestive system grows up to the point where it can utilize other foods without upset.”
Obesity is on the increase
This new report says that three-quarters of UK babies and toddlers weigh more than the ideal weight for their age and may be eating more calories than they should. It’s important that this trend towards overfeeding and overweight infants is addressed. It’s known that people who are overweight as children are more likely to be overweight as adults and nearly a quarter of children in England are already obese or overweight at four to five years old when they start primary school.
Public Health England suggests that improved breastfeeding rates could reduce overweight and obesity by 13%.  Given that the first 1000 days of life provide a unique opportunity for preventing obesity, consistently good support for breastfeeding is vital. This should be alongside appropriate education on responsive bottle-feeding for babies who are not exclusively breastfed, and information about introduction of solids at an appropriate age. At the moment many mothers don’t have the support they need to continue breastfeeding as recommended by PHE, and many services are being cut or curtailed. 
The significance for short- and long-term health
Breastfeeding helps prevent both women and children from diseases caused by obesity, including type 2 diabetes and heart disease. Increased breastfeeding rates would not only contribute to improving health issues, it would also address social inequalities as families where babies are least likely to be breastfed are more likely to have obese children.
What will make a difference
In the next phase of its plan to tackle childhood obesity, the government will examine whether baby food is healthy enough and whether it contains too much sugar. To achieve the aim of halving childhood obesity by 2030, evidence-based interventions which aim to prevent obesity in the early years need to be put in place across the country. These plans need to include appropriate and experienced breastfeeding support and accurate introduction of solid foods.
If the Government wants to support parents, it needs to make it easier to make healthy choices. It’s important to monitor infant feeding to help tackle overfeeding and the tendency to become overweight. However, the data used in this new report came from the Infant Feeding Survey  and the Diet and Nutrition Survey of Infants and Young Children  carried out in 2010 and 2011. The Infant Feeding Survey (IFS) 2015 was cancelled and PHE says that more up-to-date statistics are needed; the hope is that the Department of Health and Social Care will consider this. At present, there are no plans to reinstate the IFS but the Department say they will consider the SACN report’s findings.
Written by Anna Burbidge for La Leche League GB, July 2018
 Scientific Advisory Committee on Nutrition. Feeding in the First Year of Life. 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/725530/SACN_report_on_Feeding_in_the_First_Year_of_Life.pdf (accessed 30 July 2018).
 La Leche League. The Womanly Art of Breastfeeding, 1963, 1st edition, pages 120-121.
House of Commons Health Committee. Childhood obesity: Time for action. May 2018. https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/882/88202.htm (accessed 30 July 2018).
 UNICEF UK. Cuts that Cost – The State of Infant Feeding Support Services. https://www.unicef.org.uk/babyfriendly/cuts-that-cost/ (accessed 30 July 2018).
 HM Government. Childhood obesity: a plan for action – Chapter 2. June 2018. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/718903/childhood-obesity-a-plan-for-action-chapter-2.pdf (accessed 30 July 2018).
 NHS. Infant Feeding Survey – UK, 2010. https://digital.nhs.uk/data-and-information/publications/statistical/infant-feeding-survey/infant-feeding-survey-uk-2010 (accessed 30 July 2018).
 Department of Health and Food Standards Agency. Diet and Nutrition Survey of Infants and Young Children, 2011. https://www.gov.uk/government/publications/diet-and-nutrition-survey-of-infants-and-young-children-2011 (accessed 30 July 2018).