Rice water can replace breast milk and formula? Don't believe it!

“Can rice water replace breast milk and formula when feeding babies?”

Some bloggers online claim that rice soup and lotus root porridge are rich in nutrients and are enough to replace breast milk and formula milk to feed babies, and can make babies grow stronger, which has caused confusion for many parenting families.

Rumor Analysis

This is a rumor.

Whether from the perspective of nutritional structure or health benefits, breast milk can be said to be the most perfect food for babies. Although qualified formula milk is not as good as breast milk, it is enough to ensure the healthy growth of babies. However, if you listen to the blogger's words and feed your baby with rice soup for a long time, it may cause malnutrition or even more serious consequences. The blogger has also been banned by the platform for fabricating rumors without scientific basis.

Recently, a self-media account claiming to be a "dietitian" claimed that "rice soup can completely replace milk powder and breast milk." Netizens who pay attention to nutrition and medical knowledge can of course see at a glance that this argument is unreliable, but some netizens still find it difficult to distinguish the truth from the false.

Picture from Weibo

Infancy is an important period for the growth and development of various important tissues and organs of the human body. It is extremely important to ensure a safe environment and adequate nutrition during this stage. The nutritional content of rice soup and lotus root porridge is far from enough to maintain the healthy development of babies. Once someone is misled by such remarks, it may cause irreversible damage to the growing baby. Therefore, we solemnly compiled this article, hoping that no baby will be actually harmed by these irresponsible remarks.

Breast milk is the best food for newborns

With the support of data provided by a large number of scientific studies, "breast milk is the most perfect food for newborns" has become a consensus in the scientific community. Most countries and international organizations recommend exclusive breastfeeding within the first six months after the birth of a newborn. "Exclusive breastfeeding" means that breast milk is the only food for the baby, without additional water or other liquids, and without adding infant formula or other complementary foods. After the baby is six months old, complementary foods are added while continuing to breastfeed. This diet structure of breast milk + complementary foods is called "partial breastfeeding." Partial breastfeeding is recommended to continue for at least 12 months after birth. The reason why breast milk is unanimously recognized by the scientific community is not only because breast milk is comprehensive in nutrition and can meet the full needs of infants' energy consumption, growth and development, but also because it has many additional benefits. In terms of nutrients, breast milk contains about 87% water, 3.8% fat, 1.0% protein and 7% lactose. Among them, fat and lactose provide 50% and 40% of the energy of breast milk respectively.

In addition to providing energy, the fat in breast milk plays an extremely important role in the growth, central nervous system development, immune regulation, cognitive and motor system development of babies. Lactose helps absorb calcium and other minerals, and is also associated with a lower incidence of lactase deficiency. The protein content in breast milk changes dynamically with different breastfeeding stages. Because it contains a higher proportion of whey protein, it is easier to digest than formula milk and milk. Breast milk protein also includes a variety of biologically active proteins such as bifidus factor, lipase, and amylase, which play a very important auxiliary role in helping babies prevent diseases; breast milk also contains most vitamins and a variety of minerals except vitamins D and K. Clinical studies have confirmed that breastfeeding has not only immediate benefits for the health of babies, but also long-term benefits. A meta-analysis of the Lancet showed that breast milk not only helps babies develop healthily and resist various infections during feeding, but also prevents malocclusion caused by poor mandibular development in babies, and reduces the risk of obesity and diabetes in the future. Therefore, whether from the perspective of nutritional structure or health benefits, breast milk can be said to be the most perfect food for babies.

Formula:

Always imitating, never surpassing

Although the benefits of breast milk are widely recognized, in real life, there are still many families who cannot fully follow the guidelines for breastfeeding due to various factors. At this time, formula milk is needed as a substitute for breast milk. In this regard, parents must not worry too much or even blame themselves, because although qualified formula milk is still not as good as breast milk, it is enough to help the baby grow healthily. Let's talk about it in detail. In fact, as a substitute for breast milk, formula milk has always been trying to imitate the nutritional structure of breast milk. The FDA has specific and detailed requirements for the carbohydrates, proteins, fats, vitamins and minerals in infant formula milk. Some medical organizations recommend that manufacturers should ensure that even when formula milk is the only food source for babies, it must be able to meet all the nutritional needs of babies' growth and development within 4 months. Governments of various countries have detailed regulations and strict supervision on the nutritional ingredients, manufacturing processes, product quality, and ingredient safety in formula milk. This means that as long as the qualified products are purchased through formal channels, their nutritional ingredients are carefully formulated with reference to the ingredients of breast milk to try to meet the growth needs of babies at the corresponding developmental stage. Although it is still not as perfect as breast milk, compared with unmodified cow's and goat's milk and other natural foods, formula milk is definitely the food that is closest to breast milk.

Rice soup is not only nutritionally deficient,

And there are additional risks

The self-media accounts that promote the use of rice soup instead of breast milk and formula milk powder constantly imply in their words that formula milk powder and breast milk are not as good as the rice soup cooked by themselves. Is this true? If you have read the previous article patiently, you can actually draw a conclusion in your mind. The nutritional structure of rice is very different from that of breast milk. For adults, eating only rice is far from enough nutrition, let alone developing babies with delicate stomachs and special nutrition needs? 90% of the energy supply in breast milk is fat and lactose, while the main component of rice is starch, with very little fat. The protein in rice is also mainly gluten, which is different from whey protein and casein in breast milk, which are easier to digest and absorb. Not to mention the difference between the biologically active ingredients, vitamins and minerals in breast milk and rice. No matter what kind of rice, no matter how it is cooked, the nutritional structure of rice will not change essentially, so if rice soup is used instead of breast milk or formula milk powder for a long time, it is easy to cause malnutrition in babies. This is not an exaggeration. In some impoverished areas abroad, rice soup is used as the main complementary food in addition to breastfeeding, which has led to worrying child malnutrition and an increased risk of child mortality. Clinically, there are also cases of hypoproteinemia, slow weight gain and other serious malnutrition symptoms caused by using rice soup instead of breast milk or formula milk. Epidemiological surveys have also found that the use of carbohydrates, including rice, for alternative feeding increases the risk of bladder stones in infants. In addition to the problem of unreasonable nutritional structure itself, boiling rice soup also has the risk of excessive inorganic arsenic. The National Health Service (NHS) of the United Kingdom recommends that infants and children under the age of 5 should not use rice milk instead of breast milk or infant formula (and milk after one year old) because rice milk may contain excessive arsenic. This may have little to do with the origin of rice, because rice naturally absorbs more arsenic than other grains. The arsenic content in rice and rice products is a topic of concern in many countries and regions. Infants and young children are in an important period of growth and development. Exposure to excessive inorganic arsenic may face higher health risks, which is why rice and rice products have received extra attention. Of course, this does not mean that babies cannot eat rice or rice products. Choosing rice or rice products with arsenic content within the safe range and eating them in moderation rather than using rice as the only or main food is safe enough. In summary, regarding the argument that "rice soup can completely replace milk powder and breast milk", this article's opinion is:

1. Breast milk is the best food for newborns. When conditions permit, infants under 6 months old should be exclusively breastfed as much as possible, and complementary foods should be added on the basis of breastfeeding after 6 months;

2. Formula milk is a substitute for breast milk and is currently the best food to replace breast milk. It is not as good as breast milk but better than other foods.

3. Rice soup cannot replace breast milk and formula milk. Babies over 6 months old can eat rice and rice products appropriately, but be careful to be vigilant against excessive arsenic. For example, when babies are added to complementary foods after 6 months old, they can eat iron-fortified rice cereal.

As of the time of writing this article, the social media platform has already banned the publisher of the content "rice soup can replace breast milk" and deducted advertising revenue, which can be regarded as preventing the further spread of harmful information. I hope that those who have been misled can read this article to avoid harming the health of their babies.

Picture from Weibo

The health information on the Internet is mixed, with a lot of useful knowledge, but also a lot of outdated or wrong views. I hope that those who are weak in medical knowledge can have the opportunity to get more access to correct medical information, and I also hope that everyone can think more and be more vigilant when seeing "health tips" that deviate from the norm, so as to protect themselves and their families.

Looking in the mirror of rumors

In today's online space, there are always some bloggers who "will never stop until they say something shocking". They may lack relevant knowledge, or they may just want to attract attention and stand out. They always ignore the adverse impact on the public and publish some radical remarks that deviate from mainstream scientific theories in order to gain traffic. We should remain skeptical and use rationality to see which view has more evidence and better quality. Take the rumor made by the blogger this time as an example. There are enough and in-depth studies on breast milk and formula milk powder, and there is more evidence that long-term feeding only on rice soup will cause malnutrition and health problems for infants, but the blogger did not provide strong evidence to support his point of view. Therefore, we should believe in the mainstream scientific conclusions and choose breast milk and formula milk powder when feeding babies.

References

[1] Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 361: Breastfeeding: maternal and infant aspects. Obstet Gynecol. 2007 Feb;109(2 Pt 1):479-80. doi: 10.1097/00006250-200702000-00064. PMID: 17267864.

[2] https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breastfeeding-primary-care-interventions

[3] European Society for Paediatric Gastroenterology, Hepatology & Nutrition (ESPGHAN); European Academy of Paediatrics (EAP); European Society for Paediatric Research (ESPR); World Health Organization (WHO) guideline on the complementary feeding of infants and young children aged 6-23 months 2023: A multisociety response. J Pediatr Gastroenterol Nutr. 2024;79(1):181-188. doi:10.1002/jpn3.12248

[4] Martin CR, Ling PR, Blackburn GL. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients. 2016;8(5):279. Published 2016 May 11. doi:10.3390/nu8050279

[5] Andreas NJ, Kampmann B, Mehring Le-Doare K. Human breast milk: A review on its composition and bioactivity. Early Hum Dev. 2015;91(11):629-635. doi:10.1016/j.earlhumdev.2015.08.013

[6] Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. doi:10.1016/S0140-6736(15)01024-7

[7] https://www.fda.gov/regulatory-information/search-fda-guidance-documents/guidance-industry-demonstration-quality-factor-requirements-under-21-cfr-10696i-eligible-infant

[8] Institute of Medicine (US) Committee on the Evaluation of the Addition of Ingredients New to Infant Formula. Infant Formula: Evaluating the Safety of New Ingredients. Washington (DC): National Academies Press (US); 2004.

[9] Reinbott A, Jordan I. Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia. World Rev Nutr Diet. 2016;115:61-67. doi:10.1159/000444609

[10] Keller MD, Shuker M, Heimall J, Cianferoni A. Severe malnutrition resulting from use of rice milk in food elimination diets for atopic dermatitis. Isr Med Assoc J. 2012;14(1):40-42.

[11] Massa G, Vanoppen A, Gillis P, Aerssens P, Alliet P, Raes M. Protein malnutrition due to replacement of milk by rice drink. Eur J Pediatr. 2001;160(6):382-384. doi:10.1007/s004310100746

[12] Halstead SB. Epidemiology of bladder stone of children: precipitating events. Urolithiasis. 2016;44(2):101-108. doi:10.1007/s00240-015-0835-8

[13] https://www.nhs.uk/conditions/baby/weaning-and-feeding/foods-to-avoid-giving-babies-and-young-children/

[14] Gu Z, de Silva S, Reichman SM. Arsenic Concentrations and Dietary Exposure in Rice-Based Infant Food in Australia. Int J Environ Res Public Health. 2020;17(2):415. Published 2020 Jan 8. doi:10.3390/ijerph17020415

[15] Carignan CC, Punshon T, Karagas MR, Cottingham KL. Potential Exposure to Arsenic from Infant Rice Cereal. Ann Glob Health. 2016;82(1):221-224. doi:10.1016/j.aogh.2016.01.020

[16] Silva A, Pereira A, Silva L, Pena A. Arsenic in Portuguese Rice: Is There Any Risk?. Foods. 2022;11(3):277. Published 2022 Jan 20. doi:10.3390/foods11030277

[17] Burló F, Ramírez-Gandolfo A, Signes-Pastor AJ, Haris PI, Carbonell-Barrachina AA. Arsenic contents in Spanish infant rice, pureed infant foods, and rice. J Food Sci. 2012;77(1):T15-T19. doi:10.1111/j.1750-3841.2011.02502.x

[18] Karagas MR, Punshon T, Sayarath V, Jackson BP, Folt CL, Cottingham KL. Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life. JAMA Pediatr. 2016;170(6):609-616. doi:10.1001/jamapediatrics.2016.0120

Planning and production

Author: Doctor Feidao Duanyu

Review | Ruan Guangfeng, Deputy Director of Kexin Food and Health Information Exchange Center

Planning丨Ding Zong

Editor: Ding Zong

Proofread by Xu Lailinlin

Note: The cover image is a copyrighted image. Reprinting it may cause copyright disputes.