Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years

Commissioners, service providers and healthcare professionals should ensure that information about the importance of folic acid supplementation before and during pregnancy is readily available online and in healthcare settings such as:

• community pharmacies

• GP surgeries

• sexual health clinics

• contraception clinics

• fertility clinics

• antenatal and postnatal care clinics

• specialist clinics for pre-existing medical conditions (for example, diabetes or epilepsy)

• clinics in community centres

• multi-agency health and social care hubs

• young people's services. [2025]

Discuss the importance of folic acid with anyone who may become pregnant, is planning a pregnancy or is already pregnant (whether it be their first or a subsequent pregnancy), during face-to-face, telephone or virtual appointments, or group sessions about:

• contraception

• sexual health

• pregnancy planning and preconception health

• reproductive health

• fertility

• antenatal health and wellbeing

• future pregnancies, postnatal health and wellbeing, and child health. [2025]

When discussing folic acid, provide information about the following that is in the person's preferred format and relevant to their individual circumstances and level of understanding:

• What folic acid is and how it helps prevent neural tube defects and other congenital malformations.

• The need to take folic acid before trying for a baby (ideally for 3 months before) or as early as possible after a first positive pregnancy test, and for at least the first 12 weeks of pregnancy.

• The importance of taking folic acid supplements even if food (including flour) is fortified with folic acid.

• That folic acid supplements are easy to take and are well tolerated (also see NHS advice on taking folic acid with other medicines and herbal supplements).

• How to remember to take the folic acid supplements each day (for example, setting up reminders or pairing with routine activities such as brushing teeth).

• How to obtain Healthy Start vitamins for free or at low cost, who is eligible for the free vitamins, and how to apply.

• That Healthy Start vitamins contain a daily 400 microgram dose of folic acid, and vitamins C and D.

• Where else to obtain low-cost folic acid supplements.
  
  For more guidance on communication (including different formats and languages), providing information and shared decision making, see the NICE guidelines on patient experience in adult NHS services and shared decision making. [2025]

Advise anyone who may become, or is planning to become, pregnant or is in the first 12 weeks of pregnancy to take 400 micrograms of folic acid a day, in line with UK government advice. [2025]

Offer a high-dose folic acid supplement (5 mg a day) to anyone who is planning to become pregnant or is in the first 12 weeks of pregnancy if they have an increased risk of having a baby with a neural tube defect or other congenital malformation, for example, if they:

• (or their partner) have, or if there is a family history of, a neural tube defect or other congenital malformation

• have had a previous pregnancy affected by a neural tube defect or other congenital malformation

• have type 1 or type 2 diabetes

• have a haematological condition that requires folic acid supplementation, such as sickle cell anaemia or thalassaemia

• are taking medicines that can affect how folic acid is absorbed or metabolised (for example, people taking anti-epileptic medicines or medicines for HIV). [2025]

Reassure anyone with a body mass index (BMI) of 25 kg/m² or more who is planning to become pregnant or is in the first 12 weeks of pregnancy that they do not need to take more than 400 micrograms of folic acid a day, unless they have any of the factors listed in recommendation 1.1.5. [2025]

Reassure anyone with an increased risk of pre-eclampsia who is planning to become pregnant or is in the first 12 weeks of pregnancy that they do not need to take more than 400 micrograms of folic acid a day unless they have any of the factors listed in recommendation 1.1.5. [2025]

If a person has had bariatric surgery and is planning a pregnancy or is pregnant, advise them to contact their bariatric surgery unit for individualised, specialist advice about folic acid and other micronutrients. [2025]

For anyone who is not taking the recommended folic acid supplement, explore any reasons or barriers, and offer support through individualised information and follow-up reminders (including digital health technologies such as apps or digital support groups, if available). Also see NICE's guideline on medicines adherence. [2025]

Discuss the importance of vitamin supplements during and after pregnancy, and for children under 5 years, at opportunities such as:

• antenatal health and wellbeing appointments

• health visitor appointments

• baby development checks

• postnatal health and wellbeing appointments, including the 6‑ to 8‑week maternal postnatal GP consultation

• vaccination appointments (both during pregnancy and after the birth)

• appointments in specialist clinics for pre-existing medical conditions (for example, diabetes or epilepsy)

• community pharmacy visits

• visits to multi-agency health and social care hubs

• visits to young people's services

• breastfeeding support group sessions. [2025]

Advise anyone who is pregnant or breastfeeding about taking vitamin D and other vitamin supplements. Discuss the following and provide information that is in the person's preferred format and relevant to their individual circumstances and level of understanding:

• Why vitamin supplements are needed in addition to a healthy diet.

• Which vitamins are important during pregnancy, after pregnancy and for babies and children, in particular, folic acid (see the section on folic acid) and vitamin D (see NICE's guideline on vitamin D: supplement use in specific population groups and the NHS advice on vitamin D).

• How to take vitamin supplements, different formulations and the importance of taking the recommended dosage.

• Ways to remember to take the vitamin supplements each day.

• Where to obtain vitamin supplements, including how to obtain Healthy Start vitamins for free or at low cost, who is eligible for the free vitamins, and how to apply.

• That Healthy Start vitamins for anyone who is pregnant or breastfeeding contain a daily 400 microgram dose of folic acid as well as vitamins C and D.

• That Healthy Start vitamin drops for children contain vitamins A, C and D.
  
  For more guidance on communication (including different formats and languages), providing information, and shared decision making, see the NICE guidelines on patient experience in adult NHS services and shared decision making. [2025]

In line with UK government guidance, advise anyone who is pregnant or breastfeeding about the following:

• They should take a vitamin D supplement (10 micrograms or 400 international units [IU] a day) between October and March (because the body produces vitamin D from direct sunlight on the skin, and between October and early March, the sun is not strong enough for the body to make enough vitamin D).

• They should take vitamin D (10 micrograms or 400 IU a day) throughout the year if they are at increased risk of vitamin D deficiency because they, for example:

  • have darker skin, such as people of African, African-Caribbean or south Asian ethnicity, because they may need more sunlight exposure to produce the same amount of vitamin D as people with lighter skin pigmentation or

  • have little or no exposure to sunshine because they are not often outdoors or usually wear clothes that cover up most of their skin when outdoors.

• If they are eligible for free Healthy Start vitamins (which contain vitamins D, C and folic acid), that they should take 1 vitamin tablet a day.

• That during pregnancy, they should not take cod liver oil or any supplements containing vitamin A (retinol); this may include regular (non-pregnancy) multivitamins.

• If they are following a restricted diet (for example, a vegan or gluten‑free diet), that they may need to add foods and drinks containing vitamin B12 to their diet or take a vitamin B12 supplement (see the NHS advice on being vegetarian or vegan and pregnant and the NHS advice on B vitamins. Also see the NICE guideline on vitamin B12 deficiency in over 16s for advice about taking vitamin B12 supplements and what to do if vitamin B12 deficiency is suspected or confirmed). [2025]

Advise parents and carers of babies and children under 5 years to give vitamin supplements in line with UK government recommendations about vitamins for babies and vitamins for children; see table 1 on vitamin supplements for babies and children under 5 years. Also advise parents that those eligible for Healthy Start vitamins can receive the free vitamin drops up to their fourth birthday (these contain vitamins A, C and D and are suitable from birth). [2025]

Commissioners and service providers should offer free vitamin D supplements for anyone who is pregnant or breastfeeding, and for children under 5 years (except babies under 1 year who take more than 500 ml of formula milk a day), if they have:

• darker skin, for example, people of African, African-Caribbean or south Asian ethnicity, because they may need more sunlight exposure to produce the same amount of vitamin D as people with lighter skin pigmentation or

• little or no exposure to sunshine because they are not often outdoors or usually wear clothes that cover up most of their skin when outdoors. [2025]

Discuss the importance of healthy eating with anyone who is pregnant. Ask people about their usual dietary habits and preferences, and discuss the following:

• The benefits of healthy foods and drinks, as well as healthy dietary habits, for the pregnant person, baby and the wider family.

• Foods and drinks that should be encouraged and avoided during pregnancy (see NHS advice on foods to avoid in pregnancy and the UK Chief Medical Officers' low risk drinking guideline chapter on pregnancy and drinking).

• Healthy food and drink options that are acceptable and available for the person.

• Myths about what and how much to eat during pregnancy. For example, reassure people that they do not need to 'eat for two' and, other than avoiding specific foods and drinks, they do not need a special diet during pregnancy, but it is important to eat a variety of different foods every day to get the right balance of nutrients for them and their baby. [2025]

When discussing healthy eating in pregnancy:

• Take into account the person's needs and circumstances (including, for example, any difficulties with eating or communication).

• Take into account the person's current dietary habits and preferences, and recognise that for some people, healthy eating may be the goal over a longer period of time.

• Provide tailored, non-judgemental and culturally sensitive information that is in the person's preferred format.

• Provide evidence-based, non-commercial sources of further information, such as printed and online materials.

• Consider additional support for young pregnant people and those from low income or disadvantaged backgrounds (see the NICE guideline on pregnancy and complex social factors). This may include, for example, longer or more frequent contacts, bespoke or enhanced services, modified communication, referrals to or information about services in local family hubs or charities, and information about Healthy Start (depending on eligibility).

• Take into account affordability and people's resources when giving advice about a healthy diet and cooking; if needed, provide information about government and local schemes that can offer advice and help to access healthy food and drinks (including Healthy Start, depending on eligibility) and income support schemes.
  
  For more guidance on communication (including different formats and languages), providing information and shared decision making, see the NICE guidelines on patient experience in adult NHS services and shared decision making. [2025]

Help people gain the skills and the confidence they need to incorporate healthy foods into their diet. For example, refer people to local cookery classes or groups promoting healthy eating where people share their skills by cooking and eating together. [2025]

Discuss the importance of physical activity with anyone who is pregnant (see the UK Chief Medical Officers' guidance on physical activity in pregnancy and the NHS Start for Life advice on exercising in pregnancy). Ask people about their usual physical activity and exercise habits and preferences, and provide information on the following that is in the person's preferred format and relevant to their individual circumstances:

• How to safely continue with physical activity.

• How to gradually increase physical activity during pregnancy if they are not already physically active.

• The importance of minimising sedentary time, such as sitting for long periods. [2025]

When discussing weight during pregnancy, follow the recommendations on sensitive communication and avoiding stigma during discussions about weight in the NICE guideline on overweight and obesity management. For more guidance on communication, providing information (including providing information in different formats and languages) and shared decision making, see the NICE guidelines on patient experience in adult NHS services and shared decision making. [2025]

In line with NICE's guideline on antenatal care, offer to measure the person's height and weight and calculate BMI at the first face-to-face antenatal appointment, and explain why this is important for planning care. Use a BMI centile chart (see the Royal College of Paediatrics and Child Health's BMI chart) for anyone under 18, because the BMI measure alone does not take growth into account and is inappropriate for this age group. [2025]

Reassure the person that their weight and BMI can be shared sensitively with them (for example, by being written down rather than spoken aloud) or not shared with them, depending on what they prefer. [2025]

For anyone with a BMI of over 30 kg/m² at the booking appointment, offer testing for gestational diabetes in line with the recommendations on testing in the NICE guideline on diabetes in pregnancy. [2025]

For anyone with a BMI of over 40 kg/m² at the booking appointment, discuss the option for referral to a specialist obesity service or a specialist practitioner for tailored advice and support during the pregnancy. [2025]

Because there are uncertainties around optimal weight change in pregnancy, focus advice on starting or maintaining a healthy diet and physical activity during the pregnancy. This is because of the following:

• There are different factors that can affect weight change during pregnancy, for example, weight of the baby, weight of the placenta, maternal increase in blood volume, amniotic fluid, breast tissue expansion and body fat, and how these (especially the weight of the baby) vary between individuals and affect weight differently.

• There is a lack of evidence about what the optimal total weight change in pregnancy or weight change in each trimester should be.

• There is not enough evidence to suggest that any particular nutritionally balanced diet is better than another in helping to achieve optimal weight change in pregnancy. [2025]

Give people advice on how they can monitor their diet and physical activity levels (see the sections on healthy eating in pregnancy and physical activity in pregnancy) as well as local and online sources of information and support, including self-management tools and materials (particularly those that are free or low cost). [2025]

Do not routinely offer to weigh people throughout their pregnancy unless there is a clinical reason to do so (for example, gestational diabetes, hyperemesis gravidarum or thromboprophylaxis). [2025]

If people are interested in monitoring their weight change during pregnancy, refer them to the estimated healthy total weight change in a singleton pregnancy according to pre-pregnancy BMI; see table 1 in the National Academy of Medicine's report on the current understanding of gestational weight gain among women with obesity and the need for future research, taking into consideration recommendation 1.2.11. Topics for discussion could include the following:

• The risks associated with gaining excessive weight during the pregnancy for people with a pre-pregnancy BMI in the healthy, overweight and obesity weight categories (see NHS information on BMI ranges). Risks include having a baby who is large for gestational age, developing hypertension or gestational diabetes, or needing a caesarean section (see the section on excessive weight gain in pregnancy).

• The risks associated with gaining too little weight during the pregnancy regardless of pre-pregnancy BMI, for example, having a baby who is small for gestational age (see the section on low weight gain in pregnancy).

• Where to access weighing equipment, if needed. [2025]

Advise people that intentional weight loss during pregnancy is not recommended because of potential adverse effects on the baby. [2025]

If concerns about low weight gain during the pregnancy are raised by anyone who is pregnant, or by a healthcare professional as part of weight monitoring for a clinical reason (also see recommendation 1.2.13):

• ask for further details, for example, ask about the person's physical and psychological wellbeing, and any clinical interventions that have been offered

• discuss healthy eating and physical activity in pregnancy (see the sections on healthy eating in pregnancy and physical activity in pregnancy)

• ensure routine monitoring of the baby to check whether they are potentially small for their gestational age (see the section on monitoring fetal growth and wellbeing in NICE's guideline on antenatal care). [2025]

If concerns about excessive weight gain during the pregnancy raised by anyone who is pregnant, or by a healthcare professional as part of weight monitoring for a clinical reason (also see recommendation 1.2.13):

• ask for further details, for example, ask about the person's physical and psychological wellbeing

• discuss healthy eating and physical activity in pregnancy (see the sections on healthy eating in pregnancy and physical activity in pregnancy)

• ensure routine monitoring of the baby to check whether they are potentially large for their gestational age (see the section on monitoring fetal growth and wellbeing in NICE's guideline on antenatal care)

• consider a test for gestational diabetes. [2025]

When a person is diagnosed with gestational diabetes, ask about their usual diet and physical activity in order to provide individualised advice. [2025]

Advise people with gestational diabetes that there is currently no convincing evidence that a particular diet (for example, a low-glycaemic-index diet, low-carbohydrate diet, low-fat diet, or high-fibre diet) is better than the other. Discuss a healthy diet for gestational diabetes that is the most preferable and appropriate for the person. See NHS advice on a healthy diet for gestational diabetes. [2025]

To improve the likelihood of continued breastfeeding in line with national recommendations, provide support throughout the pregnancy and the postnatal period about planning, starting and establishing breastfeeding in line with the recommendations on planning and supporting babies' feeding in the NICE guideline on postnatal care. [2025]

At each health contact, discuss the baby's feeding in a sensitive, non-judgemental way. Ask how it is going, whether there are any new or continuing issues or questions, and seek to address them. See the sections on:

• supporting continued breastfeeding and

• supporting safe and appropriate formula feeding. [2025]

At each health contact, provide information, reassurance and support about continuing breastfeeding, as follows:

• If the parent is exclusively breastfeeding, provide encouragement and reassurance to continue exclusive breastfeeding until around 6 months.

• If the parent is combination feeding, discuss whether they would like to re-establish exclusive breastfeeding, provide encouragement to sustain breastfeeding and advice about how they can maintain their breast milk supply. [2025]

When discussing breastfeeding, include the following topics:

• The value of breastfeeding and breast milk for the baby's health and development, and for maternal health (see NHS Start for Life advice on the benefits of breastfeeding).

• The importance of continuing breastfeeding alongside solid foods for the first year, and the value of continuing until around 2 years or beyond.

• The impact that combination feeding can have on breast milk supply and how to maintain breast milk supply (see the section on safe and appropriate formula feeding).

• The person's experience of breastfeeding and its emotional impact, including feeding decisions and challenges.

• How people can feel more confident and comfortable to breastfeed in different situations, including the right to breastfeed in any public space (under the Equality Act 2010).

• The level of support available from partners, family and friends to continue breastfeeding.

• Attending local breastfeeding support groups, for example, breastfeeding 'cafes' and drop-in groups.

• Practical suggestions and tips for convenience, such as how to safely express and store breast milk. See NHS Start for Life advice on expressing breast milk and storing breast milk.

• Reassurance that a special diet is not required to meet the nutritional needs for the baby, but that anyone who is breastfeeding should have a healthy diet (see also recommendations 1.1.10 and 1.1.11 on vitamin supplementations when breastfeeding). [2025]

Be aware that parents from a low income or disadvantaged background may need more support to continue breastfeeding. Signpost to government and local schemes that can offer advice and help to access healthy food and drinks (including Healthy Start, depending on eligibility) and income support schemes. [2025]

Use appropriate resources for safe medicine use and prescribing during breastfeeding, such as the UK Drugs in Lactation Advisory Service, to enable continued breastfeeding. [2025]

Provide information and encouragement for partners and other family members to support continued breastfeeding, as appropriate. [2025]

When discussing continuing breastfeeding, allow adequate time so that conversations do not feel rushed. Information provided should support informed decision making and be:

• clear, evidence-based and consistent

• tailored to the person's needs, preferences, beliefs, culture and circumstances

• supportive, non-judgemental and respectful.
  
  For more guidance on communication, providing information (including providing information in different formats and languages) and shared decision making, see the NICE guidelines on patient experience in adult NHS services and shared decision making. [2025]

Provide additional support (for example, virtual support groups, phone calls, emails or text messages, depending on the person's preference) by appropriately trained healthcare professionals or peer supporters to supplement (but not replace) face-to-face discussions about continuing breastfeeding. This may include information about out-of-hours support (such as the national breastfeeding helpline) and peer support. [2025]

Offer face-to-face breastfeeding support group sessions (such as breastfeeding 'cafes' or drop-in groups) where appropriately trained healthcare professionals or peer supporters provide people with individualised, practical, emotional and social support to maintain breastfeeding. [2025]

Reassure people who are breastfeeding that they do not need to stop when they return to work or education. See NHS Start for Life advice on breastfeeding and returning to work. [2025]

Encourage people to inform their employer or education provider about continuing breastfeeding in good time before they return to work or study. Advise that they may find it helpful to involve human resources or student services in the discussions, as appropriate. [2025]

Discuss how people can balance breastfeeding with returning to work or education, and encourage them to think about what support they may need from their employer or education provider for as long as they continue breastfeeding. Topics to discuss include the following:

• The person's views, preferences and perceived challenges and potential solutions about continuing breastfeeding when they return to work or education.

• The timing of any shared parental leave, because it may be more helpful for the other parent to take parental leave after breastfeeding has been well established.

• The timing of the person's return to work or education, whether they can take extended leave or extend their studies, and whether there are flexible working or learning possibilities such as different working hours or days, hybrid or remote work or study options.

• The need to express breast milk, and facilities for expressing milk (depending on the age of the child and duration of separation).

• The support that employers and education providers can offer, for example, providing a private, safe and hygienic area to express milk, fridge and storage space, and additional breaks.

• That the Equality Act 2010 states that it is legal to breastfeed in public places anywhere in the UK, and that it is unlawful for businesses to discriminate against anyone who is breastfeeding a child of any age.

• That employers have legal requirements and guidance that they need to follow, for example:

  • Health and Safety Executive (HSE) guidance for employers about protecting pregnant workers and new mothers and

  • ACAS advice on returning to work.

• How to express breast milk (by hand or with a breast pump) and how to safely store expressed breast milk. See NHS Start for Life advice on expressing breast milk.

• Childcare options, including the facilities that childcare settings have for safe storage and provision of breast milk (as needed), and the practical benefits of childcare being near to the place of work or education.

• Sources of further advice and support about returning to work or education, for example, helplines such as the national breastfeeding helpline, peer support and local and national support groups. [2025]

Employers, human resource teams, senior leadership staff and managers, and staff in education settings should take into account the following to improve the work and education environment and meet legislation around accommodating breastfeeding employees or students:

• Legal requirements and guidance for employers, for example:

  • Health and Safety Executive (HSE) guidance for employers about protecting pregnant workers and new mothers and

  • ACAS advice on returning to work.

• Options for flexible, hybrid or home working.

• How settings can support people to breastfeed or express milk (for example, providing a private space, fridge and storage space, and additional breaks).

• Developing a breastfeeding policy for employees and students.

• Appointing a designated breastfeeding lead.

• Training for all employees about policies and legislation.

• Support from breastfeeding ambassadors, champions or advocates, and from peers. [2025]

Commissioners and service providers should ensure that healthcare professionals provide independent and non-commercial, evidence-based, consistent advice on safe and appropriate formula feeding. [2025]

Commissioners and service providers should ensure that healthcare professionals do not inadvertently promote or advertise infant or follow-on formula by displaying, distributing or using any materials or equipment produced or donated by infant formula, bottle and teat manufacturers, including, but not limited to, product samples, leaflets, posters or charts. [2025]

When discussing babies' feeding, if parents are thinking about introducing formula, support them to make an informed decision and offer information about how to maintain breast milk supply if they are planning to combination feed. Also see the section on supporting continued breastfeeding. [2025]

If parents give formula milk, offer non-commercial, evidence-based, consistent advice about safe and appropriate formula feeding practices, and direct them to additional non-commercial, evidence-based, consistent sources and advice, such as:

• NHS Start for Life advice on bottle feeding

• NHS Start for Life advice on mixed feeding

• NHS bottle feeding advice

• Better Health Start for Life and UNICEF UK Baby Friendly Initiative Guide to bottle feeding

• NHS advice on when to introduce beakers and cups

• schemes that offer advice and help to buy healthy food and milk (including Healthy Start, depending on eligibility).
  
  Also see the recommendations on formula feeding in NICE's guideline on postnatal care. [2025]

Commissioners and providers of services should ensure that healthcare professionals have independent and non-commercial, evidence-based, and consistent information about the timely and appropriate introduction of solid foods to babies in line with UK government advice and this guideline. [2025]

Commissioners and providers of services should support healthcare professionals who have knowledge and expertise in introducing solid foods to babies (for example, health visitors) to act as 'champions' to pass on information to other staff. [2025]

In the final trimester of pregnancy, advise parents-to-be:

• that they should introduce solid foods to their baby from around 6 months onwards, alongside usual milk feeds

• about 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. [2025]

When the baby is 2, 3 and 4 months old, remind parents that they should not introduce solid foods until their baby is around 6 months old. This could include reminders at appointments, or sending text messages or letters. [2025]

When the baby is between 4 and 5 months old, health visiting teams or other community health services should arrange an opportunity for parents to find out more about introducing their baby to solid food from the age of 6 months. This could be a face-to-face or online appointment, phone consultation or group session. [2025]

When discussing and giving advice on introducing solid foods, discuss the topics in Box 1 and:

• provide independent, non-commercial, evidence-based information in line with current UK government advice, and use printed or online resources (for example, Start for Life materials) to complement and reinforce the discussions

• take into account the family's circumstances and living conditions

• be culturally sensitive. [2025]

For babies between 6 months and 1 year old, at every contact and at the Healthy Child Programme developmental review at 8 to 12 months, ask about the baby's feeding and remind families of the topics discussed in recommendation 1.5.6. [2025]

Commissioners and providers of services should ensure that healthcare professionals and people working in early years services have independent and non-commercial, evidence-based and consistent information about healthy eating and drinking for children from 1 up to 5 years, in line with UK government advice and this guideline. [2025]

Take into account the family's circumstances, and sensitively tailor the discussion and advice around healthy eating and drinking to the child's and family's needs, circumstances, preferences and understanding. Give particular consideration to children from low income or disadvantaged backgrounds, for example, by providing additional support for their families, such as longer or more frequent contacts, bespoke or enhanced services, modified communication, referrals to or information about services in local family hubs or charities and information about Healthy Start (depending on eligibility). [2025]

Provide independent, non-commercial, evidence-based and consistent information on healthy eating practices and promote interventions, such as:

• schemes that improve access to healthy foods, for example, Healthy Start, free school meals or local initiatives

• interventions that improve families' skills and confidence to include healthy foods in their diet such as 'cook and eat' classes. [2025]

When discussing healthy eating and drinking with families, discuss the topics in Box 2 and:

• provide independent, non-commercial, evidence-based information in line with current UK government advice, and use printed or online resources (for example, Start for Life Feeding at 12 months and over) to complement and reinforce the discussions

• take into account the family's circumstances and living conditions

• recognise that for some families, healthy eating may be the goal over a longer period of time

• be culturally sensitive. [2025]

Early years settings should ensure that healthy eating and drinking are prioritised, and that actions are part of a whole setting approach that involve the following:

• Providing healthy foods and drinks in line with the early years foundation stage (EYFS) statutory framework (if possible, prepared on-site; also see example menus for early years settings in England), including produce from settings-based gardens where possible.

• Repeated offering of unfamiliar foods (vegetables and fruit) and role modelling.

• Talking to children about healthy foods and healthy eating, and food education such as cooking, play and themed weeks.

• Involving families and carers to promote consistency between the setting and home.
  
  See also recommendations on preventing overweight, obesity and central adiposity for early years settings, nurseries, other childcare facilities and schools in NICE's guideline on overweight and obesity management. [2025]