Addressing breastfeeding myths | womenshealth.gov

Addressing breastfeeding myths | womenshealth.gov

Rethinking Rice Cereal with Babies

Rethinking Rice Cereal







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©iStockphoto.com/SylvieBouchard


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by Deborah Pike Olsen
November 09, 2013

When it’s time for babies to eat food other than breast milk or formula, many parents reach for baby cereal—particularly rice cereal. For years, pediatricians have recommended that babies’ first food be iron-fortified cereal, particularly rice, which has a low risk for allergic reaction.

Recently, concerns have been raised about the levels of arsenic in rice and rice-based products, including baby cereal. New research on the topic from the U.S. Food and Drug Administration (FDA) has led that agency and others, including the American Academy of Pediatrics (AAP), to take a closer look at rice cereal and offer more recommendations on introducing solids to your baby.

What is arsenic?
Arsenic is a chemical element in the earth’s crust, present all around us, in both organic (naturally occurring) and inorganic forms. Both forms can be found in water, air, soil, and foods. Organic forms are released from volcanoes and through erosion of mineral deposits; inorganic arsenic, the more toxic form, is added to the environment through human activities such as burning coal, oil, gasoline, and wood, mining, and the use of arsenic-containing compounds in pesticides, herbicides, and wood preservatives.

The Environmental Protection Agency (EPA) describes inorganic arsenic as a carcinogenic (cancer-causing) agent. Several studies have linked inorganic arsenic with increased risk of skin cancer, as well as cancer of the prostate, liver, bladder, kidney, nasal passages, and lungs. For children, long-term exposure may cause lower IQ scores; exposure in utero and early childhood may increase mortality risk in young adults. Low level exposure can cause nausea, vomiting, stomach pain, circulatory problems, damage to blood vessels, a “pins and needles” feeling in the hands and feet, and redness and swelling of the skin.

Experts currently don’t know what level of arsenic is dangerous to public health. Since 2011, the FDA has analyzed samples of rice and rice products. As FDA Commissioner Margaret A. Hamburg, MD explains, the agency is “committed to ensuring that we understand the extent to which contaminants such as arsenic are present in our foods, what risks they may pose, whether those risks can be minimized, and to sharing what we know.”

Research
The FDA has monitored arsenic levels in food for nearly two decades, with the latest analysis being its most ambitious and far-reaching effort to date. The report provides data on 1,300 samples of rice products, 200 first reported in 2012 and an additional 1,100 tested in 2013. Products included in the analysis ranged from over-the-counter cookies and rice snacks to infant formula and baby cereal, ready-to-eat and hot cereals, rice “milks,” and more.

The FDA measured levels of inorganic arsenic and total arsenic for each product type. The FDA focused on rice because, unlike other crops, rice readily absorbs arsenic from the environment.



Results
FDA researchers found that arsenic levels varied widely from sample to sample within the same product. For the various products, levels ranged from 0.1 to 7.2 micrograms of inorganic arsenic per serving. However, serving sizes also varied.

In the absence of dietary limits, it is hard to know how to interpret these results, but the full text is available online. Readers can consider the relative risks of such products as rice cakes, rice milks, brown rice, and more. (Note that brand details about samples are not provided.)



Recommendations
The Illinois attorney general’s office conducted similar testing in 2012 in conjunction with Consumer Reports. Based on the “troubling” results, Consumer Reports and Illinois Attorney General Lisa Madigan have called on the FDA to set federal maximum levels for arsenic in food, especially baby food, and to caution the public about eating large amounts of rice and feeding it to small children. In fact, the next step in the FDA’s process will be risk assessment.



In the meantime, parents can take the following steps to minimize the risk of arsenic exposure for themselves and their children:
•Choose a different first food for babies. Former chair of the AAP’s nutrition committee Dr. Frank Greer notes that the group has “been trying to move people away from the use of rice cereal for the first weaning food … because it does not really provide that much nutrition.” Some experts suggest starting with meat, poultry, or tofu, which are iron-rich foods. Currently, the AAP’s position on introducing solids is that there is not sufficient evidence to show that introducing solids in any particular order is beneficial. Instead, the organization suggests babies should be offered a wide variety of nutrient-rich foods, including a variety of grains, within the first year to reduce exposure to arsenic from rice. Other good first-food options include sweet potatoes, squash, carrots, avocado, apples, pears, bananas, and peaches.
•For babies with gastroesophageal reflux (GERD) tendencies, consult a pediatrician. While rice cereal has traditionally been recommended as a thickener for these infants, the FDA notes that “wheat, barley and other grain-based infant cereals also readily absorb liquid and are similarly effective for infants with esophageal reflex tendencies.” Parents should talk with their child’s doctor.
•Avoid rice milk for children younger than age 5. Some of the highest levels of arsenic were found in products marketed as “rice milk.”
•Eat a balanced diet, with a variety of grains. Everyone should consume a varied diet. For nutrition guidance, the ChooseMyPlate website can be a good place to start.
•Limit rice consumption. Consumer Reports provides specific recommendations of servings per week for children and adults, noting, “for infants, children, and pregnant women, risks may be heightened.”

The Maternal Bond — News Room - UNC Health Care

The Maternal Bond — News Room - UNC Health Care