Rice for babies: when to start, arsenic advice and safe leftovers

Babies can eat rice from around 6 months, once they've started solids. It's soft, mild and easy to mash, and iron-fortified infant rice cereal is one of the first foods Australian guidance suggests. The one thing to know is that rice tends to take up more arsenic from the environment than other grains. Agencies in Australia, the UK and the US all say rice can be part of a young child's diet, as one food in a varied diet.

Where they differ is in the detail. The UK says no rice drinks for children under 5, the US has set an arsenic action level for infant rice cereal and advises varying grains, and Australia's food regulator says rice products tested there had low levels. This guide sets out each position, how to prepare rice at each stage, how to store and reheat cooked rice safely, and the signs of a reaction.

When can babies eat rice?

From around 6 months, when your baby shows the signs of readiness described in starting solids.

The Australia's ASCIA guide to introducing solid foods, from Australia, says iron-rich foods, including iron-fortified cereals, should be offered around 6 months and not before 4 months, and that other foods can come in any order. It lists bread, crackers, pasta and iron-fortified cereals as cereal foods, and suggests a variety of grains including wheat, rice, oats and corn. Australia's Pregnancy, Birth and Baby lists iron-enriched infant cereal, such as rice cereal, among the first foods to start with.

The NHS guide to feeding from around 6 months lists rice and baby rice among starchy foods, but the NHS first solid foods guide says babies don't need baby rice to help them move to solid foods or to sleep better. The CDC's solids guide suggests offering a variety of fortified infant cereals, such as oat, barley and multigrain, instead of only rice cereal, because feeding only infant rice cereal can increase a child's arsenic exposure.

If you use infant cereal, the AAP's starting solids page says to choose one made for babies and iron fortified. First foods and iron explains how cereal fits alongside meat, fish, egg, tofu and legumes.

Is the arsenic in rice a problem for babies?

Not if rice is one grain among several. The AAP's page on reducing arsenic explains that rice tends to absorb more arsenic from groundwater than other crops. The UK Food Standards Agency says arsenic has the potential to increase the risk of illnesses, including cancer, but that this doesn't mean you should stop eating rice. Each country's agencies take a slightly different line.

Australia

Food Standards Australia New Zealand (FSANZ) says a 2019 survey of 200 rice and rice-based products in Australia and New Zealand found that inorganic arsenic levels, where present, were low. It says parents and caregivers should not be concerned about the safety of rice-based infant foods. The Food Standards Code sets a limit of 1 mg/kg of total arsenic for cereals, which includes rice and infant cereals. FSANZ's advice is to eat a mixed diet with a variety of foods, and to talk to a health professional if you're worried about arsenic.

Australian advice on rice drinks differs from the UK's. The Royal Children's Hospital Melbourne's toddler guide says calcium-enriched plant milks, such as rice or oat, can be used after 12 months if they're full-fat and your toddler eats other foods such as meat, lentils and eggs. Before 12 months, breast milk or formula is the main drink everywhere; see moving to cow's milk for the switch.

UK

The NHS list of foods to avoid says rice tends to take up more arsenic than other grains, but that this doesn't mean you or your baby can't eat rice. The UK advice is about rice drinks. The NHS Best Start in Life list of foods and drinks to avoid says to avoid them altogether until your child is at least 5 years old, because they can contain too much arsenic.

The Food Standards Agency's arsenic in rice advice says children under 5 shouldn't have rice milk in place of breast milk, infant formula or cow's milk, because young children tend to drink more milk and have a lower body weight. It adds that stricter arsenic limits apply to foods intended for young children. If your child has already had rice drinks, the NHS says not to worry.

US

In August 2020 the FDA finalised an action level for inorganic arsenic in infant rice cereals of 100 micrograms per kilogram, or 100 parts per billion (ppb), and said oat, barley and multigrain cereals can also be a first or early cereal. Its advice on limiting arsenic exposure says iron-fortified rice cereal is a good source of nutrients, but shouldn't be the only source and doesn't need to be the first, and passes on the AAP's advice to feed infants and toddlers a variety of grains.

The FDA's healthy food choices for babies aged 6–12 months suggests whole grains such as whole wheat or barley infant cereal, which it says provide B vitamins that help protect against the effects of arsenic. The AAP also says to avoid brown rice syrup in children's processed foods, and not to use rice milk as a substitute for cow's milk.

Does cooking rice in plenty of water help?

The FDA says it can. Cooking rice the way you cook pasta, in 6 to 10 parts water to 1 part rice and then draining the excess, can reduce inorganic arsenic by 40 to 60 percent, depending on the type of rice. The trade-off is that in enriched white and parboiled rice, it also cuts the added folate, iron, niacin and thiamine by 50 to 70 percent. The FDA says rinsing rice before cooking has little effect on arsenic and washes those added nutrients off. The Australian and UK pages we checked don't give advice on cooking methods.

What this means at home

• Offer rice as one grain among several, alongside oats, pasta, bread, barley and corn.
• If you use infant cereal, rotate rice with oat, barley, wheat or multigrain.
• Don't give rice drinks as a milk drink.
• Check toddler snack labels for rice syrup.

How do I prepare rice for my baby at each age?

Cook rice until it's very soft, and change the texture as your baby's eating skills grow.

Around 6 months. The CDC says to mix infant cereals and mashed, cooked grains with breast milk, formula or water so they're smooth and easy to swallow. The NHS says starchy foods can be cooked and mashed with a fork or blended. Pregnancy, Birth and Baby says 1 to 2 teaspoons is plenty when your baby first starts solids.

8–9 months. Pregnancy, Birth and Baby says most babies can manage finger foods at about 8 months, and that lumpy food should be introduced by 9 months to lower the chance of feeding problems later. The NHS lists cooked starchy foods, including rice, among finger foods. Many families press soft, sticky rice into small balls or flat patties that are easy to pick up.

12 months and beyond. Australia's ASCIA says to aim for soft, cut-up or roughly mashed family meals by 12 months. Rice dishes the family eats work well, as long as your child's portion is served before salt or salty sauces go in.

Cook rice in plain water until the grains squash easily between your fingers. The NHS says not to add salt to your baby's food or cooking water, and not to use stock cubes or gravy because they're often high in salt. Let cooked rice cool right down before serving, and cool any leftovers quickly, as described below.

Should I put rice cereal in my baby's bottle?

No. The AAP says not to put baby cereal in a bottle because your baby could choke. The NHS says babies don't need baby rice to sleep better, and baby sleep myths explains why cereal doesn't help with night waking. Once your baby has started solids, offer cereal from a spoon. If you're worried about reflux, talk to your GP or health visitor rather than thickening feeds yourself.

Are rice cakes and rice crackers okay for babies?

Plain ones can be one snack among several once your child is eating a range of foods. The NHS first solid foods guide says children from 12 months may need 2 healthy snacks between meals, and lists unsalted, unsweetened rice or corn cakes alongside fruit, vegetables, yoghurt, cheese and toast fingers. Australia's ASCIA lists crackers among finger foods for babies who are ready.

The AAP says the arsenic in rice is concentrated in rice syrup, which is sometimes used to sweeten toddler snacks or puffs, and suggests avoiding brown rice syrup in children's processed foods. None of the Australian, UK or US pages we checked sets a weekly limit for rice cakes, so the practical approach is to read labels, choose unsalted and unsweetened ones, and rotate them with other snacks.

Pick plain varieties for safety too. The CDC's choking hazards list includes crackers or breads with seeds, nut pieces or whole grain kernels.

How do I store and reheat cooked rice safely?

Rice needs more care than most leftovers. The UK Food Standards Agency's home food fact checker explains that uncooked rice can contain spores of a bacterium called Bacillus cereus, which can survive cooking. The longer cooked rice sits at room temperature, the more likely it is that bacteria or their toxins will make it unsafe.

The NHS Best Start in Life guide to storing and reheating food gives these rules for rice:

1. Cool it within 1 hour. The FSA suggests dividing it into smaller portions, and not leaving it to cool in the rice cooker, steamer or pan.
2. Put it straight in the fridge or freezer once it's cool.
3. Eat refrigerated rice within 24 hours.
4. Reheat it only once, until it's steaming hot all the way through, then let it cool before feeding your baby. Stir microwaved food to remove hot spots.
5. Defrost frozen rice in the fridge, then reheat it until steaming hot, as the FSA advises.
6. Throw away half-eaten portions rather than saving them, as the NHS advises.

Australia's Pregnancy, Birth and Baby gives the same principle for all baby food: never reheat food that has already been reheated, or that has sat at room temperature for more than 2 hours.

Can babies be allergic to rice?

Rice isn't one of the common allergy foods. It isn't on Australia's ASCIA's list of the foods behind most allergic reactions: cow's milk, egg, peanut, tree nuts, wheat, soy, sesame, fish and shellfish. Australia's ASCIA also suggests rice as one of the alternatives for babies who are allergic to wheat. Other foods can still cause reactions, so watch your baby the first few times.

FPIES: a delayed reaction to watch for

Rice is one of the most common triggers of a different kind of food allergy. Australia's ASCIA's FPIES fact sheet, from Australia, says food protein-induced enterocolitis syndrome (FPIES) is a delayed gut allergy estimated to affect 1 in 7000 children under two. The most common triggers in babies are rice, oat, cow's milk and egg.

• What it looks like: repeated vomiting, usually 1 to 4 hours after eating the food. Some babies also become floppy, pale and cold, and have diarrhoea.
• What it doesn't cause: hives, welts, swelling or anaphylaxis.
• What happens next: a doctor diagnoses it from the history, as there are no blood or skin tests that confirm it. Australia's ASCIA says most children outgrow FPIES by 3 years of age.

If your baby has FPIES to rice, Australia's ASCIA's dietary guide says to avoid introducing oat unless their allergy specialist advises it, while other grains such as wheat and corn can be introduced. If your baby already eats oats without problems, keep them in.

Signs of an immediate allergic reaction

Most allergic reactions happen within minutes to two hours, according to Australia's ASCIA. Its anaphylaxis FAQ separates milder signs from anaphylaxis, the most severe type.

Australia's ASCIA classes lip swelling as mild to moderate, while the NHS urgent-help guide lists swollen lips among reasons to call an ambulance, so this guide treats sudden lip swelling as an emergency. Redness only around the mouth, with no other signs, is not usually an allergic reaction, according to Australia's ASCIA.

These steps follow the Australia's ASCIA first aid plan for anaphylaxis from Australia, which says if in doubt, give the adrenaline device. For milder signs with normal breathing, stop the food, watch closely and get medical help today; Australia's ASCIA says to get specialist advice before offering it again.

What if my baby gags or chokes on rice?

Rice isn't on the CDC's or the AAP's lists of choking hazards, but Pregnancy, Birth and Baby notes that babies can choke on any food of any texture. Gagging is common while babies learn new textures. It's noisy, and your baby keeps breathing. Choking is usually quiet: your baby can't cough, cry or breathe properly. Choking vs gagging explains the difference.

If your baby can't breathe, cough or cry, shout for help and call 999. The NHS first-aid steps for a choking baby are up to 5 back blows, then up to 5 chest thrusts, repeated until the food comes out or help arrives. If your baby becomes unresponsive, start CPR and follow the call-taker's instructions. Get medical help afterwards, even if the food came out.

The Royal Children's Hospital Melbourne in Australia recommends that anyone caring for children does a first-aid course, and the AAP's choking-prevention advice recommends a certified CPR and first-aid course. Doing one before or soon after starting solids lets you practise. Keep your baby sitting upright and supervised for every meal.

What's worth noting?

A quick note of which grains your baby ate each day makes it easy to see whether rice is crowding out the others. If your baby vomits after a meal, note the food, the time they ate and the time the vomiting started. A gap of 1 to 4 hours after rice or oats is worth mentioning to your doctor.

When should I get help?

Call 999 now if your baby:

• has difficult or noisy breathing, a wheeze or a persistent cough
• has sudden swelling of the lips, tongue or throat
• has a hoarse voice or cry, or becomes pale, floppy or drowsy, or collapses
• is vomiting and becomes pale, floppy or cold, or is much sleepier than usual or hard to wake
• is choking and can't breathe, cough or cry
• has had no wet nappy or wee for 12 hours

Get medical help today if your baby:

• has hives or welts beyond the mouth area, or swelling of the face or eyes, with normal breathing (stop the food and watch closely for anaphylaxis signs)
• vomits repeatedly a few hours after eating rice or oats, even if they seem well afterwards
• has vomiting or diarrhoea with fewer wet nappies than usual (see signs of dehydration)
• is under 12 months with vomiting or diarrhoea and you're worried; the NHS food poisoning page says to get urgent advice for babies this age, so call your GP or NHS 111
• needed back blows or chest thrusts, even if they now seem well

Talk to your GP or health visitor if:

• your child has been having rice drinks as their main milk and you'd like help switching
• your baby has reflux and you're thinking about changing feeds
• your baby is allergic to wheat or several foods and you need help keeping grains varied (Australia's ASCIA suggests an allergy dietitian)