What should I feed my baby if I need to avoid rice cereal?

DEAR DOCTOR K:

You recently wrote about the dangers of feeding rice cereal to babies. Can you tell me more about this? What should I give my baby instead?

DEAR READER:

For years, rice cereal has been a go-to food for parents when they start their babies on solid foods. My Harvard Medical School colleague Dr. Claire McCarthy, a primary care pediatrician at Boston Children’s Hospital, says it’s time to change that.

In 2012, the Consumer Products Safety Commission (CPSC) issued a report warning about high levels of inorganic arsenic in rice and rice products. Inorganic arsenic is a common ingredient in pesticides and other products used in farming. It can linger in the soil for a long time after it is used — and rice plants are particularly good at absorbing arsenic from the soil.

In high doses, inorganic arsenic is lethal. Even small amounts can damage the brain, nerves, blood vessels or skin — and increase the risk of birth defects and cancer. Babies who eat two servings of rice cereal a day could double their lifetime cancer risk. In addition, studies show that babies exposed to inorganic arsenic, including exposure before they are born, have a higher risk of learning problems.

The FDA has decided to propose a new upper limit for inorganic arsenic in infant rice cereal of 100 parts per billion (ppb).

The FDA and the American Academy of Pediatrics (AAP) suggest the following for young children and pregnant women:

  • Iron-fortified cereals are still a recommended first food for babies. But rice cereal isn’t the only choice. Oat, barley and mixed-grain cereals can provide iron too.
  • Toddlers should eat varied grains as well.
  • Parents should be mindful of the rice (or rice syrup) toddlers may consume in “puffs” and other snacks.
  • Pregnant women should vary their diet and eat other grains besides rice.
  • To decrease the amount of arsenic in rice, cook it as you would cook pasta: Cook one part rice in 6 to 10 parts water and drain off the excess. Cooking it this way can decrease the arsenic content by 40 to 60 percent.

Finally, be mindful that brown rice has more arsenic than white. That’s because arsenic accumulates in the “germ” that is removed from brown rice to make white rice. Cereals and other products made from brown rice are particularly likely to be high in arsenic.

Please understand that I’m not saying that most of us should avoid rice. I eat rice a good deal, and brown rice preferentially. That’s because it has a better glycemic index and also tastes great.

What the FDA and the AAP are saying is that infants and pregnant women should minimize rice intake. The risk to the developing brain of a child from arsenic in rice is not great. After all, billions of living babies and their pregnant mothers have had rice meals and are doing just fine. However, there are better alternatives for pregnant women and infants than rice.