Rice Cereal Info Needed

[BouchieMama]

I have a friend who is becoming a Physician's Assistant. Last night we somehow got into an argument about rice cereal. She insists that her nephew will be just fine if they start him on rice cereal at 3 months. I told her that I was pretty sure that it wasn't a good idea to offer anything until they are 6 months old because it can cause sensitivities. Then she starts on the whole thing about acid reflux and that's what they recommend for AR and formula companies couldn't put rice in the AR formulas if it wasn't okay for them. I told her that I was pretty sure that rice cereal wasn't actually effective for acid reflux. Of course, her response is "well, it's in journals." She's one of those people that you can't argue with, so I ended it there. However, I'm still fuming. I know that she thinks I feel this way just because I'm "crunchy" and she thinks her side is "scientific." Anyway, I'm pretty sure I read some information about this here somewhere, but I can't seem to find it. So, I'm wondering if you ladies can point me in the right direction to find information about the realities of rice cereal. If I'm wrong, I'll admit it, but if she's going to be working with families, she needs to have correct information not just what they ped she worked with told her. Thanks!

[JessicaRabbit]

Spitting up/vomiting is very common for refluxers. Rice Cereal can be made thicker which can help keep it down .... that is why it is commonly suggested.
DS was diagnosed with AR at appx 1 MO .... Most of my research and conversations with his pediatrician recommend that you not offer any solids until LO is 6 months. Some will tell you that you can start earlier if your baby is bigger but, my DS is 21lbs at 4 1/2 months and still EBM.
"Crunchy" or not .... the Good Lord designed you as the BEST resource for the care of your child ... it isnt my business but, you shouldnt have to argue or defend your decisions with your friend.
here is an article that might help ... I am sure there is more information on it if you search this site.
Good luck! and try not to let it get under your skin too badly - your friend probably has good intentions.

[Mommie of 2]

As far as the acid reflux issue, I don't have that info.

However, if she thinks that rice cereal is actually nutritious for babies, she should take a look at the nutritional info on the side of the box. Its all right there, and its not very good. If you're objective and take a good look at it, you realize that most of the vitamins are added, and aren't even originally in the cereal. Also, if you direct her to the AAP's website, she'll find that the AAP actually doesn't even recommend starting solids until sometime between 4 and 7 mos., depending on which branch you go from (the AAP is kind of split on this issue with some saying after 6 mos. and some saying after 4 mos.)

Not to mention the fact that if you think about it logically, if you add cereal to 3 mo. olds diet, the baby will start to replace BM or formula with the cereal...and since the cereal isn't very nutritional, there is a greater risk of malnutrition, since baby's fist is only about the size of their closed fist when their newborns, it can't be too much bigger at 3 mos.

Sorry I don't have the info regarding AR, as that may be the real issue here, but I know lots of mommies post on these threads that have AR babies, so maybe one of them will pop in with info they've found.

[@llli*number4]

Hi there the links below are just a few i keep on hand ,but are a good start for you to have. If you feel the need to show dear SIL - good luck my suggestion is print them out and just give them to her and not entertain any more argument and let her look at the info herself and choose to follow through with further research or not... KWIM??? I'll look around for something I have on reflux and cereal...


LLL Solids

Kellymom 1st Foods

Kellymom - Delaying Solids

Here's one I found on Kellymom/reflux - toward the bottom you'll find the following quote.. there's more but I juts thought to add this bit... (take note of the parts I underlined... hmmmm)

What about thickened feeds?
Baby cereal, added to thicken breastmilk or formula, has been used as a treatment for GER for many years, but its use is controversial.

Does it work? Thickened feeds can reduce spitting up, but studies have not shown a decrease in reflux index scores (i.e., the “silent reflux” is still present). Per Donna Secker, MS, RD in Gastroesophageal Reflux Disease , "The effect of thickened feedings may be more cosmetic (decreased regurgitation and increased postprandial sleeping) than beneficial." Thickened feeds have been associated with increased coughing after feedings, and may also decrease gastric emptying time and increase reflux episodes and aspiration. Note that rice cereal will not effectively thicken breastmilk due to the amylase (an enzyme that digests carbohydrates) naturally present in the breastmilk.

Is it healthy for baby? If you do thicken feeds, monitor baby’s intake since baby may take in less milk overall and thus decrease overall nutrient intake. There are a number of reasons to avoid introducing cereal and other solids early. There is evidence that the introduction of rice or gluten-containing cereals before 3 months of age increases baby's risk for type I diabetes. In addition, babies with GERD are more likely to need all their defenses against allergies, respiratory infections and ear infections – but studies show that early introduction of solids increases baby’s risk for all of these conditions.

[babygirlsmom1005]

As a mom to a stage 4 refluxer with complications of aspiration and required surgery to fix the reflux due to damage to her lungs.....blah, blah, blah, I have done a lot of research on GERD.

Rice Cereal to help reflux THEORY only (confirmed only a theory by my DD's pedi - who is also a neo-natle specilist, GI, Pulmoligist and Cardioligist)......In theory it will weigh down the milk or formula in their stomach keeping it from coming back up/going back up the esphogas. In reality, it does not digest as quickly as breastmilk, which will increase the length of time that it sits on babies stomach, so increases the length of time the baby will reflux from that one feeding (ie: instead of digesting breastmilk in 2 hours, it takes longer to get the rice cereal out of the stomach and it will reflux just as easy as anything else....just like adults have reflux after eating foods, weight of a feeding does not matter....). Also rice cereal seperates (I did my own experiment on breastmilk and rice cereal, it seperates after sitting on the counter).

The only reason I could ever come up with for use of rice cereal medically (this also confirmed by her team of doctors & thearpist) is from aspiration when swallowing. Where the milk has to be thickened to get down the esphogas and not go down into the lungs, other than that, will do NOTHING for reflux and can make it worse by refluxing the cereal which will cause more pain than just refluxing fluids.

[BouchieMama]

Thanks Mamas for all of the info and hugs. I worked in childcare before and always thought the rice cereal just made their puke grosser. I'm going to follow up on all of the links/information. I guess that I'm just aggrevated that physicians don't necessarily practice evidence-based care. I'm amazed at how many Mamas I work with are given "advice" by their peds/obs/fp docs that is really just an opinion or as the pp said "theory." Any more info will be appreciated - I'll keep checking back.