The Nursery Milk Scheme costs millions of pounds each year but has never been formally evaluated. This study will assess how the scheme actually works, whether it improves children’s diets, and whether it is good value for money. Many young children in the UK do not get enough calcium, iodine, and other nutrients found in milk. Children from socially disadvantaged and minority ethnic households are at particular risk. The Nursery Milk Scheme provides free milk to children in early years settings, but no one has checked whether it reaches the children who need it most, or whether it makes a meaningful difference to their overall diet. If this research succeeds, it could lead to changes in how the scheme is delivered—for example, targeting milk to specific groups, or changing the type of milk provided. The findings will go directly to the Department of Health and Social Care, which funds the scheme. Any changes could affect thousands of early years settings, milk suppliers, and families across England and Wales. The study will also model alternative delivery models, so policymakers can see what else might work better for the same cost.
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Background UK children aged 1-5 years are advised to consume ≥350ml milk or two servings of dairy products a day. This helps to achieve recommended intakes of protein, calcium, iodine, zinc and vitamin A. Some demographic groups are at greater risk of poor nutrient intake, including children from socially disadvantaged and minority ethnic households. The nursery milk scheme (NMS) is a statutory scheme funded by Department of Health and Social Care (DHSC). Eligible and registered early years settings (EYS) are funded to provide 1/3 pint (189 ml) cows milk each day (or powdered first infant formula for babies under 12 months) for children (< 5 years) who attend for at least two hours. The NMS costs around £70 million per year in England and Wales. No formal evaluation has been conducted previously. Aims and objectives This study aims to evaluate how the NMS operates and contributes to the dietary intakes of children, and the value, cost-effectiveness and equitability of the scheme. The study will explore milk and dairy provision and use and engagement of the NMS within EYS. Milk and dairy intakes of children aged 0-5 years will be quantified, on days they do/do not attend settings, exploring the role and contribution of the family diet, EYS provision and NMS in dairy intake. The operation of the NMS will be explored from multiple perspectives (EYS, caregivers, milk agents). The cost effectiveness of the scheme, social return on investment, and the potential impact of alternative delivery models will be assessed. Methods Data collection tools will be developed and piloted by the research team and PPI group (work package (WP) 1). Groups of children potentially at risk of low milk/dairy intake, will be established from an existing large dataset (WP2). A large (>11,000) stratified random sample of settings will be contacted via email and asked to complete a survey exploring use of the NMS and provision of milk and dairy, with 20-30 EYS completing a more in-depth qualitative interview. Two hundred purposively sampled EYS will send a survey to all their children s caregivers, with 4 families per setting (with input from EYS staff) completing 2 x 24-hour recalls, for days their child does/does not attend an EYS. Two hundred families not using EYS will be recruited for comparison. Health economic modelling will evaluate social return on investment and alternative models for the scheme. Timelines for delivery The study will start in April 2025 with a final report produced in September 2027. Some work packages will run concurrently, with rolling recruitment of EYS and other participants throughout the project. Anticipated impact and dissemination The main output will be recommendations for DHSC, which may lead to a change in the NMS or how it operates. DHSC s response to recommendations will have significant impact on stakeholders (EYS, milk agents, milk suppliers, caregivers and young children). Other outputs will include peer-reviewed articles, industry article(s) for EYS and accessible visual representation for caregivers. Dissemination will be via publications, email, SHU website, conference and social media.
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