It’s your baby’s fourth time vomiting after you gave just a teaspoon of rice cereal with her milk two hours ago. She’s been having dry heaves and seems to be getting weaker every few hours. You realize that you should have brought her to the doctor earlier, so you rush out to the clinic. Is this just the typical stomach flu, or something else entirely?
Possible reasons why your child is vomiting rice cereal include 1) incomplete digestion for their age, 2) high arsenic levels, 3) food allergy, or 4) a rare allergy syndrome called FPIES. Other reasons for vomiting, in general, include acid reflux, overfeeding, infection, and surgical conditions.
What is rice cereal?
Rice cereal is a mixture of rice flour, soy oil, calcium, iron, and some vitamins. This mixture is dehydrated during production and then sold commercially.
At home, it is then prepared by mixing with water or milk, forming a porridge. Rice cereal was previously recommended as one of the first foods you can give to your child by 6 months old.
Can rice cereal be given to babies?
Rice cereal is commonly introduced as one of the first complementary foods to give to a child. This is because all rice cereals sold in the United States are iron-fortified. Iron stores slowly decrease in infants by the time they reach 6 months old.
Babies usually have enough iron in the first few months of life since they receive some from their mothers’ breast milk, but they need iron supplementation once they start eating.
So why do some babies vomit rice cereal, while others tolerate it well?
Why Your Baby Throws Up Rice Cereal
They can’t digest rice completely
Is it possible that you have given baby cereal too early? Recent studies have stated that there are six types of enzymes needed to digest starch properly.
One of these enzymes, known as pancreatic amylase, is either absent or present (but in inadequate amounts) in infants. This makes it difficult for children less than 6 months of age to completely digest starches such as rice, leading to gastric upset such as vomiting and diarrhea.
However, experts have said that further research is needed to determine more specific mechanisms for starch digestion in infants.
There might be too much arsenic
Arsenic is naturally found in the soil and water; rice plants can retain arsenic as it is being grown. There have been circulating reports of high arsenic levels in baby food products, including rice cereals. Too much arsenic in baby food can cause gastrointestinal symptoms such as nausea and vomiting.
The Food and Drug Administration advises that the safe amount of arsenic in all kinds of food should be less than 100 parts per billion (PPB). Before buying your rice cereal, check that information on arsenic levels is clearly labeled on the food container and that it’s a safe amount for your child.
Your baby could be allergic to rice
Your child may have a food sensitivity or a food allergy. Signs of allergies to food include swollen lips or eyes, vomiting, loose stools, rashes, and being very irritable.
If you see these symptoms, immediately stop giving your baby food and take him or her to the nearest available doctor. Note what food your child has eaten for the last 24-48 hours.
This can help your doctors diagnose whether your child really has a food allergy and possibly which specific food your child reacted to.
If the allergy is severe enough, your infant could have difficulty breathing and become difficult to wake up. Infants with these severe symptoms should be brought to the hospital immediately.
Watch out for FPIES
A rare but important condition to consider in your child is food protein-induced enterocolitis syndrome, also known as FPIES. It’s a rare type of allergy disorder with the same signs and symptoms as food allergies or stomach flu. According to research, it’s seen in only 0.34% of infants. This makes it hard to diagnose FPIES.
Symptoms of FPIES include severe vomiting after food intake, diarrhea, body weakness, pallor, swelling, dehydration, and difficulty breathing. Foods causing FPIES are cow’s milk, rice, wheat, soy, fish, and chicken.
Symptoms usually start 2-3 hours after the food is given. If your doctor is suspecting FPIES, your child may be referred to a specialist for further evaluation.
Other reasons your baby’s vomiting
Maybe it’s just a coincidence
Sometimes, the cause may not have been specifically due to rice cereal. Just to make sure we’ve touched on all the possibilities, let’s explore other reasons why babies vomit.
Too early to start
Most healthcare experts recommend not giving solid foods to babies until they turn 6 months old. Other than the possibility that their digestive enzymes are not enough, all the nutritional requirements of babies younger than 6 months old are already found in their milk.
Infants also have the tongue-thrust reflex, wherein they push their tongue out when they feel a solid object in their mouth. This is to prevent any solid foods from entering their mouth and potentially causing them to choke.
Your child could have reflux
There’s a small chance that your baby is having infant reflux if their vomit is not forceful in nature. Infant reflux is due to overly relaxed muscles of the esophagus, which is the long tube connecting the mouth to the stomach.
When these muscles aren’t tight enough, food can move back upwards from the stomach up until the mouth.
Did you feed your baby too much?
Take a moment to check if you are overfeeding your baby. If you’re just starting with complementary feeding, make sure that you decrease formula milk a little, or stop breastfeeding a few minutes early, so that your baby has enough space to try foods after drinking.
Make sure you aren’t force-feeding your child, and if he or she isn’t receptive to the food, give them a few minutes before trying again, or delay complementary feeding for a few days.
Could there be an ongoing infection?
A common reason for vomiting in infants is gastroenteritis, which is an infection in the stomach.
Viruses and bacteria can enter the stomach through contaminated food or water, or dirty hands and objects placed in your child’s mouth. Infants would usually look dehydrated and have a fever and loose stools as well.
Let’s rule out causes that need surgery
Although rare, some babies vomit because of a surgical condition. Some of the common reasons include pyloric stenosis and intussusception.
Pyloric stenosis is the thickening of one of the muscular valves regulating the passage of food between your stomach and the intestine.
On the other hand, intussusception happens when a part of your child’s intestine is pulled back towards the inside of another part of the intestine (termed ‘telescoping’), blocking the flow of food or fecal material in the intestines.
What you can do: advice for parents
How can parents help their child recover from vomiting?
First Aid for vomiting
Don’t give any solid food or liquids to your child for an hour (termed ‘bowel rest’).
Afterward, try to give a tablespoon of oral electrolyte solution (ORS) every 15 minutes. Something like Pedialyte would work. For breastfed babies, continue breastfeeding but in short intervals.
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If they continue to vomit, pause and allow them to recover for 30 minutes before trying again.
Allow your infant to drink a little more if vomiting doesn’t return in the next 4 hours. Give milk as usual if there is no vomiting for 8 hours, and solids as usual if there are no new episodes for 24 hours.
If your baby looks dehydrated (sunken eyes, dry lips and mouth, less urine), continues vomiting despite bowel rest, develops brown- or red-tinged vomit, is very irritable or drowsy, it is best to bring them to the nearest hospital for further management.
Let’s give complementary foods the right way
Your child should be at least between 4-6 months old before trying solid food. Giving complementary foods too early to your infant could set them up for obesity in childhood.
It’s also important not to give these foods through the milk bottle so that your child realizes how taking in milk is different from eating table foods.
How do you know if your child is ready to try solid foods?
When they reach the proper age, watch out for signs that your child is ready to try solid foods. These include 1) able to sit without support, 2) seems interested in table food and 3) can grasp objects with his or her hand.
There are many reasons why your child vomits rice cereal. It may have been too early for them to take food. There could be high arsenic levels present.
Sometimes it is due to a food allergy or FPIES. Consider other reasons for vomiting, such as acid reflux, overfeeding, infection, and surgical conditions.
When faced with vomiting, ensure your child has bowel rest and slowly give oral rehydration solution until he or she tolerates it. If the infant shows signs of dehydration or is persistently vomiting, bring them to the nearest hospital.