Rice cereal: iron for babies, and a myth about sleep

In a double-blind trial in exclusively breast-fed US infants who ate iron-fortified rice cereal every day from 4 to 9 months, 2 babies in each group had mild iron deficiency (4.2 percent) and none developed iron deficiency anemia. The trial compared two forms of added iron, both with vitamin C, and 69 of the 95 infants finished. Most research on rice cereal is about this infant kind, the dry fortified flakes mixed into milk. A tablespoon of it (4 g) holds about 2 mg of iron, all of it added, by USDA survey figures. Mixing rice cereal into formula did not lower calcium absorption (58 versus 57 percent) or iron absorption (5.8 versus 6.3 percent) in a crossover study of 14 infants, with iron measured in only 9. Zinc is where it falls short. In 18 breast-fed boys aged 7 months, a pureed beef meal delivered 16 times more absorbed zinc than a fortified rice cereal meal, from one test meal with 9 babies per group.

How much is actually in it

• A tablespoon of dry infant rice cereal (4 g) carries about 2 mg of added iron, while a cup of plain crisped rice cereal (25 g) has about 90 calories. — US survey foods Baby Toddler cereal, rice, dry and Cereal, rice crispy, plain Evidence E source
  Infant rice cereal dry: iron 53.01 mg per 100 g, 1 tbsp 4 g; crisped rice: 358 calories per 100 g, 1 cup 25 g

What your body absorbs

• In a randomized crossover study in 14 infants, mixing rice cereal into formula did not lower calcium absorption (58% vs 57%) or iron absorption (5.8% vs 6.3%). — Healthy infants studied at 2-week intervals, formula vs formula with 6.5 g/dl rice cereal (n = 14) Evidence B source
  Calcium absorption 58% vs 57%; iron absorption 5.8% vs 6.3% (p = 0.06)
• In a double-blind RCT in breast-fed infants eating iron-fortified rice cereal daily from 4 to 9 months, electrolytic iron and ferrous fumarate worked equally well and no infant developed iron deficiency anemia. — Exclusively breast-fed US infants, cereal daily from 4 to 9 months (n = 69) Evidence B source
  Mild iron deficiency 4.2% in each group; no iron deficiency anemia; iron from cereal about 1.1-1.2 mg/kg/day
• In 7-month-old breast-fed infants, a pureed beef meal delivered 16 times more absorbed zinc than an iron-fortified rice cereal meal. — Breast-fed male infants aged 7 months, beef (n = 9) or rice cereal (n = 9) test meal (n = 18) Evidence B source
  Fractional zinc absorption 0.41 (beef) vs 0.36 (cereal); absorbed zinc 16-fold higher with beef (P = 0.0002)

What cooking and storage change

• In randomized crossover trials in 80 adults, oats soaked overnight in milk produced a 33% smaller blood glucose rise than cooked cream of rice cereal. — Adults without diabetes, two centers, Toronto and Winnipeg, 40 per center (n = 80) Evidence B source
  Glucose iAUC 33% lower after overnight oats than cream of rice; 24% lower with sugar, nuts and seeds added

What it does to your health

• In a randomized crossover trial in 30 healthy adults, cream of rice cereal raised blood glucose more at its peak (47 mg/dL (2.61 mmol/L)) than old-fashioned oats (2.19) or steel-cut oats (1.93). — Healthy adults, 18 men and 12 women, 23 g available carbohydrate per test meal (n = 30) Evidence B source
  Glucose peak-rise 2.61 (cream of rice) vs 2.19 (large-flake oats) vs 35 mg/dL (1.93 mmol/L) (steel-cut oats)

Safety, limits and interactions

• In 25 infants referred for reflux, coughing was more frequent after feeds thickened with rice cereal than after unthickened feeds of equal calories. — Infants from birth to 6 months referred for gastroesophageal reflux (n = 25) Evidence B source
  Coughing more frequent after thickened feeds (size not given in abstract)
• Observational data from 56 infants with reflux or dysphagia found urinary arsenic did not differ between those thickened with rice or oat cereal and other thickeners. — Infants under 1 year with reflux or oropharyngeal dysphagia, single US center, 2021-2023 (n = 56) Evidence C source
  Median total urinary arsenic not different between groups (p = 0.086); below ATSDR toxicity limits
• The FDA set an action level of 100 micrograms per kg (100 ppb) of inorganic arsenic for infant rice cereal in 2020. — Infant rice cereals sold in the US Evidence E source
  Action level 100 ug/kg inorganic arsenic, nonbinding guidance

What people believe that the data does not support

• In an RCT of 106 infants, adding rice cereal to the bedtime bottle from 5 weeks did not help babies sleep through the night compared with starting at 4 months. — Infants randomized to bedtime cereal from 5 weeks or from 4 months, sleep recorded weekly 4-21 weeks (n = 106) Evidence B source
  No significant difference in proportion sleeping 8 (or 6) consecutive hours

Who this works differently for

• In an RCT of 41 formula-fed infants, adding rice cereal from 16 to 26 weeks did not change growth, sleep or bone mineral content but raised parathyroid hormone. — Healthy term formula-fed infants, formula alone vs formula plus cereal from 16 to 26 weeks (n = 41) Evidence B source
  No difference in growth, sleep or BMC; serum PTH significantly higher at 26 weeks in cereal group

The bottom line

Cereal in the bedtime bottle does not buy a full night. In a 1989 trial of 106 infants, researchers started it at 5 weeks in one group and at 4 months in the other, and the earlier start made no significant difference to how many babies slept 8 hours straight. The trial tested sleep, not whether such an early start is safe. Sleep came from caregiver records on one night a week, in 1989. In another trial of 41 formula-fed babies, adding rice cereal from 16 to 26 weeks changed neither growth, sleep nor bone mineral content, the only outcomes it reported besides one hormone. Parathyroid hormone came out higher in the cereal group at 26 weeks, and what that means for the baby was not shown. For adults, cooked cream of rice is a fast carbohydrate. In a crossover trial in 30 healthy adults, with equal carbohydrate in every bowl, it raised blood glucose to a peak of 47 mg/dL (2.61 mmol/L) above baseline, against 2.19 for old-fashioned oats and 1.93 for steel-cut oats. In trials in 80 adults, overnight oats soaked in milk gave a 33 percent smaller glucose rise than cream of rice. Both were single meals. A cup of plain crisped rice cereal (25 g) has about 90 calories. Who should be careful. In 25 infants referred for reflux, feeds thickened with rice cereal brought more coughing than unthickened feeds of equal calories, and the abstract gives no size for the difference. These babies were under specialist care, and the study gives no support for thickening feeds at home without a doctor. Rice carries arsenic, and in 2020 the FDA set an action level of 100 micrograms of inorganic arsenic per kg for infant rice cereal, as nonbinding guidance to industry. In one US clinic, 56 babies with reflux or swallowing problems had similar urinary arsenic whether thickened with rice or oat cereal or with other thickeners (p = 0.086). Only 10 of them were on the cereals, and each gave one urine sample.

Sources

1. rcer-daily-r1-11 · food composition and portion data
   Baby Toddler cereal, rice, dry (FDC 2708493): Iron, Fe 53.01 mg per 100 g, 1 tablespoon 4 g; Cereal, rice crispy, plain (FDC 2708455): Energy 358 kcal per 100 g, 1 cup 25 g
   USDA FNDDS 2021-2023, FDC 2708493 and FDC 2708455 · checked 2026-09-30
2. rcer-daily-r1-01 · RCT
   Mean (+/- SD) percent absorption of calcium from F was 58% (+/- 13) and from F + R 57% (+/- 18). Absorption of iron from F was 5.8% (+/- 7) and from F + R 6.3% (+/- 4) (p = 0.06).
   J Pediatr Gastroenterol Nutr, 1998 · checked 2026-09-30
3. rcer-daily-r1-02 · RCT
   With each cereal, 2 infants had mild ID, a prevalence of 4.2%, but no infant developed ID anemia. There were no differences in iron status between study groups.
   J Nutr, 2011 · checked 2026-09-30
4. rcer-daily-r1-03 · RCT
   Fractional absorption of zinc did not statistically differ between the beef (0.41 +/- 0.11) and cereal (0.36 +/- 0.05) test meals, although the trend showed that beef had higher fractional absorption than cereal. The higher intake of zinc from the beef versus cereal test meal resulted in a 16-fold greater amount of absorbed zinc ( P = 0.0002).
   J Pediatr Gastroenterol Nutr, 2002 · checked 2026-09-30
5. rcer-daily-r1-07 · RCT
   Mean glucose iAUC was 33% less, after ONO than CR (mean difference was 39 (51-27) mmol × min/l, p < 0.0001) and 24% less, after ONOsns than CRsns (mean difference was 43 (65-21) mmol × min/l, p = 0.0003).
   Eur J Clin Nutr, 2019 · checked 2026-09-30
6. rcer-daily-r1-08 · RCT
   Glucose peak-rise (primary endpoint, mean (sem) mmol/l) after OFO, 2·19 (sem 0·11), was significantly less than after CR, 2·61 (sem 0·13); and glucose peak-rise after SCO, 1·93 (sem 0·13), was significantly less than after CR, HNC, 2·49 (sem 0·13) and IO 2·47 (sem 0·13).
   Br J Nutr, 2019 · checked 2026-09-30
7. rcer-daily-r1-05 · RCT
   Coughing was more frequent after thickened feedings than after unthickened feedings.
   J Pediatr, 1992 · checked 2026-09-30
8. rcer-daily-r1-09 · cohort
   The median total urinary arsenic concentration did not differ between groups (p = 0.086) and levels between groups were well below the Agency for Toxic Substances and Disease Registry (ATSDR)'s toxicity limits.
   Sci Rep, 2025 · checked 2026-09-30
9. rcer-daily-r1-10 · agency guidance
   We intend to consider the action level of 100 µg/kg or 100 ppb inorganic arsenic as an important source of information for determining whether infant rice cereal is adulterated within the meaning of section 402(a)(1) of the FD&C Act (21 U.S.C. 342(a)(1)).
   FDA 2020, Inorganic Arsenic in Rice Cereals for Infants: Action Level, Guidance for Industry · checked 2026-09-30
10. rcer-daily-r1-04 · RCT
    One hundred six infants were randomly assigned to begin bedtime cereal feeding (1 tablespoon per ounce in a bottle) at 5 weeks or at 4 months of age. ... There was no statistically significant trend or a consistent tendency of one group to have a higher proportion of sleepers than the other.
    Am J Dis Child, 1989 · checked 2026-09-30
11. rcer-daily-r1-06 · RCT
    We found no significant differences in growth or sleep pattern, nor in BMC between groups. Serum PTH concentration was significantly increased in the cereal group at 26 weeks.
    J Am Coll Nutr, 1996 · checked 2026-09-30