The Nurture Early for Optimal Nutrition (NEON) Programme

It is well evidenced that the first 1,000 days of a child’s life are an important period for both growth and brain development, and that feeding practices developed during this period can impact children’s nutrition, growth, dental health and cognitive development, leading to longer-term health problems later in life.

Children of South Asian origin in east London have a much higher risk of poor nutrition and obesity than the average UK child. The Nurture Early for Optimal Nutrition (NEON) programme aims to optimise infant feeding, care, and dental hygiene practices among children under 2 years old, within communities of South Asian origin in East London. It shifts the power to these communities to better support mothers and carers.

The NEON programme uses the WHO-recommended Participatory Learning and Action (PLA) approach, which involves the formation of community groups facilitated by multi-lingual community facilitators. 

The first phase of the project (NEON 1) ran from 2015-2018 and involved formative research and developing the PLA intervention for British Bangladeshi communities in Tower Hamlets in East London. It has had significant impact on the local community and Local Authority early year programmes. It was funded by the NIHR CLAHRC North Thames (our ARC predecessor) in partnership with the London Borough of Tower Hamlets. Find out more about NEON 1 here and in the short film below. 

The second phase of the of the NEON project started in December 2019 and is a feasibility randomised controlled trial, to develop the intervention for further South Asian communities across more boroughs in East London. This is funded by the NIHR Academy in partnership with the Tower Hamlets GP Care Group CIC and the London Boroughs of Tower Hamlets, Newham, and Waltham Forest, and supported by ARC North Thames. This phase of the project will run until May 2023. 

The first phase of the study identified infant feeding and care practices, and features of this community and environment, that could be targeted to improve children’s health. This included:

• specific cultural beliefs (e.g. ‘chubby equals healthy’), and modifiable practices (e.g. a tendency to over feed and preference for fast food). Members of the community offered insights; one mother described kheer, a sweet dish made from milk, rice and sugar. She said of her son: “He absolutely loves it. Any time of the day you feed him that, he’ll eat it.
• environmental factors such as fast-food outlets and advertising. First-time parents were especially keen to have more support and information from health professionals
• cultural behaviours such as that hand feeding by parents is seen as a symbol of love for the child and may continue for years, potentially causing over-feeding.

Overall, the first phase of the study saw improved nutrition and feeding practices, maternal and neonatal survival rates within the Tower Hamlets British-Bangladeshi community. 

The researchers found that consulting the community led to more appropriate and better-quality interventions than ‘top-down’ approaches devised at a distance

The research has influenced Tower Hamlets and Newham Local Authority early year programmes.

The NEON film (above) has been included in The Birthing a Better Future Art & Science Exhibition, aimed at raising awareness of the crucial first two years of life, currently touring the UK.

Together with UCL and the charity India Alliance, the UCL NEON team launched an online global art and science exhibition to raise awareness of the importance of the first 1000 days for a child’s health.

The findings and participant feedback from the first phase of the study have led to the phase 2 NEON intervention toolkit, which was co-developed with wider South Asian Communities in East London. The toolkit includes:

• A cultural recipe book which promotes healthy baby feeding practices
• Participatory community asset maps (e.g. identifying low-cost fruit and vegetable shops and play areas)
• A list of services supporting infant feeding, care and dental hygiene practices
• Picture Cards detailing recommended and non-recommended practices, as well as facilitators and barriers to uptake, and solutions to address these issues

The NEON team are working to develop the NEON intervention to support further South Asian communities across more boroughs in East London.

Waltham Forest Council 

Newham Council

North East London NHS Foundation Trust NHS Foundation Trust (NELFT) 

East London NHS Foundation Trust (ELFT)

University College London

London Borough of Tower Hamlets

The Parent and Family Support Services in Tower Hamlets

First Steps Nutrition Trust

UCLPartners

British Heart Foundation

Newcastle University

Tower Hamlets GP Care Group