1. Faculty of Environment
  2. School of Food Science and Nutrition
  3. Promoting regulatory standards in the baby food market: The WHO NPPM

Promoting regulatory standards in the baby food market: The WHO NPPM

Tins of food on shelves

The World Health Organization Nutrient and Promotion Profile Model (NPPM) is a world-first and has become an essential tool in assessing the quality of commercial baby foods. It was developed by the University of Leeds-World Health Organization Collaborating Centre in Nutritional Epidemiology.

Nutrient Profile Models are designed to classify and rank foods and for the first time, the NPPM encompasses both nutritional and marketing standards – providing holistic product evaluation.1 This ready-made tool aims to provide evidence on product quality (or poor quality) to support meaningful policy change and product regulation. This will address growing international concerns over the suitability of some commercial food products for infants and young children (sold as suitable up to 3 years of age).

We urgently need to clean up the baby food aisle. The commercial baby food market is largely unregulated, allowing space for products that are marketed in misleading ways, obscuring poor nutritional content and making it hard for families to make good choices

Dr Diane Threapleton

Current market trends reveal a dominance of sweet purées and snack foods that derive significant calories (energy) from free sugars, such as fruit juice and pureed fruit. Intense puréeing releases intrinsic sugars and pureed products are often also too watery (low in calories), further complicating nutritional assessment. Additionally, many baby food products are marketed as suitable from 4 months, contradicting NHS and WHO recommendations to introduce solid foods around 6 months.

Regulations in the UK and elsewhere are seriously outdated, in most cases, not providing any standards on sugar content for instance. Shockingly, commercial baby and toddler food products are among the least regulated foods in the supermarket, falling outside of recent HFSS (High Fat, Salt, Sugar) regulations in the UK.

The UK Nutrient Profile Model which classifies HFSS foods would also not be appropriate for baby foods as the model does not encompass the range of nutritional and marketing specifications in the NPPM. This policy black-hole has resulted in the marketing and sale of many inappropriate products.

Families are being let down, in the supermarket parents are faced with an overwhelming number of fruit pouches and snacks, some marketed as suitable from 4 months. It’s hard to understand how products marketed as ‘healthy’, ‘nutritionist approved’, ‘1 of 5 a day’ could be unsuitable for their young children

Dr Diane Threapleton.

In response to poor regulation across the region, WHO Europe commissioned the University of Leeds to prepare the NPPM, to support Member States, industry, policymakers, and other stakeholders ensure appropriate products, with clear promotional messages, are sold for infants and young children aged 6 months to 3 years. The NPPM establishes nutrient and promotional requirements across various product categories. It can be adopted in full or adapted at the national level to suit local requirements. When products are evaluated against NPPM criteria, findings indicate product suitability, guide product reformulation, and inform policy reform to support public health goals for optimal infant nutrition and development.

The universal belief that the health and development of infants and young children is critically important underpins the commercial baby and toddler food Nutrient & Promotion Profile Model (NPPM).

Timeline of development  
2016 The World Health Assembly approved WHO guidance on ending the inappropriate promotion of foods for infants and young children through resolution WHA69.9.The aims of the guidance are to protect breastfeeding, prevent obesity and chronic diseases, promote a healthy diet and ensure caregivers receive clear and accurate information on infant and young child feeding. Resolution WHA69.9 requested that WHO provide technical support to Member States in implementing the guidance recommendations, including the development of nutrient profiling tools.
2018 WHO Europe commissioned researchers at the University of Leeds (later to become the WHO Collaborating Centre in Nutritional Epidemiology) to develop a Nutrient Profile Model to address concerns with the baby food market across Europe
2019 Publication of the draft Nutrient Profile Model (NPM). The model was developed by the team at Leeds and carefully followed WHO guidance on NPM development processes. The NPM was validated against product data from Denmark, Spain and the United Kingdom and was pilot-tested in a further seven WHO European Region Member States.3 [add url]
2022 Publication of the NPPM. The draft NPM was updated, refined, and streamlined following consultation with users of the draft model and other stakeholders across the WHO European Region and using up-to-date published evidence.  [add url]
2022

Launch of the NPPM online tool. The tool allows for large-scale product evaluation against NPPM specifications, providing evidence to support policy and regulatory reform around the globe. https://babyfoodnppm.org/
2025

Commercial Baby Foods In Crisis: Addressing Health, Marketing and Inequalities Publication of a policy report and study Technical Report. Research led by Dr Threapleton at Leeds evaluated UK baby food using the NPPM and also involved a 1000-person UK-wide parent survey and parent focus groups to contextualise findings. Evidence based and impactful recommendations have been made for policy makers, retailers and manufacturers .Report launch 8pm April 28th.

Image of a globe

NPPM IN ACTION: GLOBAL CASE STUDIES 

The widespread use of the NPPM by public health professionals and academics across the globe demonstrates the appetite and need for regulatory reform in this market to promote healthier food environments for infants and young children. By providing a clear framework for assessing baby food products, the NPPM empowers policymakers, health professionals, and consumers to make informed decisions that support optimal child health and development. 

2020 UK Public Health DRAFT PROPOSALS: Commercial baby food and drink guidelines 

Published in 2020 this draft guideline for voluntary action by industry cited the 2019 draft NPM as informing some recommendations. The scope of this draft guideline was narrow, only including salt and sugar but the draft guideline did adopt several NPPM recommendations for sugar reduction and recommendations aimed at food producers (Annex 3).4  

2022 Consortium for Improving Complementary Foods in Southeast Asia (COMMIT) 5 

COMMIT was established to better understand the use, quality and regulation of commercially produced complementary foods in seven Southeast Asian countries: Cambodia, Indonesia, the Lao People’s Democratic Republic (PDR), Malaysia, the Philippines, Thailand and Viet Nam. The joint initiative included UNICEF, non-governmental organisations in the region and the University of Leeds.6 One major workstream involved product evaluation using a slightly modified version of the draft NPM (published in 2019) as COMMIT work was underway before the NPPM publication in 2022. Analysis revealed systemic issues across the baby foods market in all 7 countries, contributing to public health issues in the region. Partners have called for policy and regulatory reform.7,8,9 

 

2023 Food Safety Authority of Ireland: Reformulation targets for commercially available complementary food 

Dr Diane Threapleton supported FSAI in evaluating a sample of products from the Irish market using the NPPM specifications and contributed to the consultation process for the draft targets in 2023. Both the WHO NPPM and UK Public Health Draft guidelines (noted above) informed development of the Irish guidelines.10 The scope again only centred on salt and sugar but ‘These targets are based on the World Health Organization (WHO) and the University of Leeds Nutrient and Promotion Profile Model (NPPM)(World Health Organization, 2022).’11  

2024 An Evaluation of the Nutritional and Promotional Profile of Commercial Foods for Infants and Toddlers in the United States Researchers evaluated 651 products on sale from the top 10 US grocery chains against NPPM criteria. Findings indicate major concerns with the suitability of products on sale and authors call on US policymakers to regulate this sector.12 

2023/2024 Ongoing work in Australia aims to improve composition and marketing of commercial infant foods. Health professionals have used the NPPM to assess baby foods, highlighting the need for stronger regulations.13,14,15 Public Health Australia provided input to the Australian Government’s Consultation on Improving Commercial Foods for Infants and Young Children in 2024, calling for regulation based on standards within the NPPM: “PHAA recommends that the Government pursue a comprehensive range of reforms to ensure that all commercial foods for infants and toddlers align with international best practice (NPPM)”.16  

2025  Evaluating alignment of UK commercial baby food products with the WHO nutrient and promotion profile model Researchers identified 469 baby foods on sale in the UK and evaluated suitability using NPPM criteria. Products are revealed as widely unsuitable being high in sugar and marketed in misleading ways. Authors call for baby food regulation in the UK context.17 

2025 Assessment of Commercial Baby Food Quality and Promotion in Malaysia for Policy Development In Malaysia, 285 baby food products were sampled and evaluated using NPPM criteria. Authors highlight poor product quality in terms of nutrition and marketing and call for urgent action to improve the quality of baby foods via policy development.18 

2025 Commercial Baby Foods In Crisis: Addressing Health, Marketing and Inequalities in the UK The team at Leeds undertake an in-depth assessment of the commercial baby foods sector, focusing on product quality and price. REPORT LAUNCH DUE IN Q2 2025. 

Contact us: If you would like to discuss this area of research in more detail, please contact Dr Diane Threapleton d.e.threapleton@leeds.ac.uk  

REFERENCES 

  1. Nutrient and promotion profile model: supporting appropriate promotion of food products for infants and young children 6–36 months in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2022. Licence: CC BY-NC-SA 3.0 IGO. 

  1. European Food and Nutrition Action Plan 2015–2020. In: Regional Committee for Europe 64th Session, Copenhagen, Denmark, 15–18 September 2014. Copenhagen: WHO Regional Office for Europe; 2015 (https://apps.who.int/iris/handle/10665/329405, accessed 8 October 2022). 

  1. Ending inappropriate promotion of commercially available complementary foods for infants and young children between 6 and 36 months in Europe: a discussion paper outlining the first steps in developing a nutrient profile model to drive changes to product composition and labelling and promotion practices in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2019 (https://apps.who.int/iris/handle/10665/346583, accessed 8 October 2022). 

  1. DRAFT PROPOSALS: Commercial baby food and drink guidelines. Public Health England. November 2020. https://www.babymilkaction.org/wp-content/uploads/2020/11/DRAFT-PHE-proposals-for-2023-commercial-baby-food-and-drink-guidelines.pdf 

  1. UNICEF East Asia and the Pacific Regional Office, Alive & Thrive, Access to Nutrition Initiative, Helen Keller International, JB Consultancy, University of Leeds School of Food Science and Nutrition, and World Food Programme Asia Pacific Regional Office. Consortium for Improving Complementary Foods in Southeast Asia (COMMIT) – COMMIT to better first foods for young children: A call to strengthen national regulations on commercially produced complementary foods in Southeast Asia. Summary report. Bangkok: UNICEF 2023. https://www.unicef.org/eap/media/15151/file  

  1. Reformulation Targets for Commercially Available Complementary Foods Published by: Food Safety Authority of Ireland, Dublin. 2024. ISBN: 978-1-910348-77-2 https://www.fsai.ie/publications/food-reformulation-task-force-reformulation-target 

  1. Reformulation targets for commercially available complementary food: consultation outcome. Food Safety Authority of Ireland. 2024. https://www.fsai.ie/getmedia/d73bfd3f-a83b-4711-ae49-67a196f4744d/commercially-available-complementary-foods-consultation-feedback-report.pdf?ext=.pdf 

  1. COMMIT to better first foods for young children. Protecting the diets of young children in Southeast Asia. UNICEF website: https://www.unicef.org/eap/commit-to-better-packaged-foods-young-children 

  1. Bassetti E, Blankenship J, White JM, Sweet L, Threapleton D, Pries AM. Benchmarking the nutrient composition and labelling practices of dry or instant cereals for older infants and young children across seven Southeast Asian countries. Matern Child Nutr. 2023 Dec;19 Suppl 2(Suppl 2):e13603. doi: 10.1111/mcn.13603. PMID: 38092376; PMCID: PMC10719057. 

  1. Bassetti E, Blankenship J, White JM, Mulder A, Threapleton D, Pries AM. Benchmarking the nutrient composition and labelling practices of commercially produced ready-to-eat purées and meals for older infants and young children across seven Southeast Asian countries. Matern Child Nutr. 2023 Dec;19 Suppl 2(Suppl 2):e13585. doi: 10.1111/mcn.13585. PMID: 38092377; PMCID: PMC10719058. 

  1. Pries AM, Bassetti E, White JM, Mulder A, Threapleton D, Blankenship J. Benchmarking the nutrient composition and labelling practices of finger foods and snacks for older infants and young children across seven Southeast Asian countries. Matern Child Nutr. 2023 Dec;19 Suppl 2(Suppl 2):e13598. doi: 10.1111/mcn.13598. PMID: 38092380; PMCID: PMC10719055. 

  1. Coyle DH, Shahid M, Parkins K, Hu M, Padovan M, Dunford EK. An Evaluation of the Nutritional and Promotional Profile of Commercial Foods for Infants and Toddlers in the United States. Nutrients. 2024 Aug 21;16(16):2782. doi: 10.3390/nu16162782. PMID: 39203918; PMCID: PMC11357546.  

  1. Chung A, Torkel S, Myers J, Skouteris H. Assessment of foods for infants and toddlers in Australia against the World Health Organization's Nutrient and Promotion Profile Model for food products for infants and young children. Public Health Nutr. 2024 Oct 4;27(1):e201. doi: 10.1017/S136898002400171X. PMID: 39364645; PMCID: PMC11504510. 

  1. Dunford EK, Scully M, Coyle D. Commercially-produced infant and toddler foods-How healthy are they? An evaluation of products sold in Australian supermarkets. Matern Child Nutr. 2024 Oct;20(4):e13709. doi: 10.1111/mcn.13709. Epub 2024 Aug 12. PMID: 39133124; PMCID: PMC11574637. 

  1. Scully M, Jinnette R, Le L, Martin J, Schmidtke A. Compliance of Australian commercial foods for young children (<36 months) with an international nutrient and promotion profile model. Aust N Z J Public Health. 2024 Jun;48(3):100158. doi: 10.1016/j.anzjph.2024.100158. Epub 2024 Jun 17. PMID: 38886145. 

  1. Public Health Association of Australia submission on Improving Commercial Foods for Infants and Young Children https://www.phaa.net.au/common/Uploaded%20files/Submissions%202024/PHAA%20Submission%20-%20240913%20-%20Toddler%20and%20Infant%20Foods.pdf  

  1. Bozkir C, Esin K, Threapleton D, Cade JE. Evaluating alignment of UK commercial baby food products with the WHO nutrient and promotion profile model. Eur J Pediatr. 2025 Jan 11;184(2):128. doi: 10.1007/s00431-025-05971-7. PMID: 39797916; PMCID: PMC11724783. 

  1. Shyam S, Tan SY, ALsheibani BAA, How KE, Morpeth A, Rippin H, Threapleton D, Cade JE. Assessment of Commercial Baby Food Quality and Promotion in Malaysia for Policy Development. Asia Pac J Public Health. 2025 Jan 28:10105395241313419. doi: 10.1177/10105395241313419. Epub ahead of print. PMID: 39876534.