Overview
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Key numbers
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- breathing, and cough (RR = 1.10; 95% CI: 1.00–1.22); fever requiring a prescription medicine (RR = 1.22;
- 95% CI: 1.02–1.45) and allergy diagnosed by a physician (RR = 1.20; 95% CI: 1.06–1.36). No clear
- level of 100 μg/kg34. The US Food and Drug Administration (FDA) proposed the same guidance for infant rice
- plementary Table S1). Our study group included a roughly equal distribution of male (54%) and female (46%)
- infants (Table 1). Among infants who were introduced to rice cereal in the first year of life, the average age
- at introduction was 5.2 months (SD: 1.3 months) (Supplementary Table S2). At the 4 month, 8 month, and
- 12 month time periods, rice cereal was consumed in 11.7%, 69.6%, and 68.6% of infants respectively (Supple-
- mentary Table S2). Overall, 96.5% of infants were reporting as having at least one infection or symptom of any
- duration reported up to age 18 months, 91.4% having at least one lasting 2 or more days, 65.2% having at least
- one involving a doctor’s visit, and 52.3% having at least one resulting in a prescription medication (Supplemen-
- tary Table S2). For allergies, 13.5% of infants were reporting as having at least one allergy, and 7.9% having at
- least one diagnosed by a doctor (Supplementary Table S2). Sample sizes and proportions of each outcome for
- each follow-up interval are reported in Supplementary Table S3. Household tap water arsenic concentrations
- were generally low, with a mean 2.2 μg/L (SD: 7.1; range: 0.0 to 92.3), but with 11.1% of the study population
- health care provider visit or a medication prescribed (Fig. 1, Supplementary Table S4). Relative risk estimates for
- upper and lower respiratory tract infections requiring a prescription medicine increased by 4% (RR = 1.04; 95%
- CI: 1.00–1.09) and by 19% (RR = 1.19; 95% CI: 1.02–1.39) for each month earlier that rice cereal was introduced.
- A 10% increase in the relative risk of acute respiratory symptoms requiring a prescription medicine (RR = 1.10;
- 95% CI: 1.00–1.22) and 22% increase increase of fever symptoms requiring prescription medicine (RR = 1.22;
- 95% CI: 1.02–1.45) were observed for each month earlier that rice cereal was introduced. For reported allergies
- diagnosed by a doctor, the relative risk estimate was 20% higher for each month earlier that rice cereal was intro-
- duced (RR = 1.20; 95% CI: 1.06–1.36), and for this outcome, the relative risk estimate was similar to any reported
- our models are provided in Supplementary Table S5. Results for crude analyses are provided in Supplementary
- are becoming more widespread3. In the USA, an estimated 42.8% of infant hospitalizations in 2003 were due
- childhood food and skin allergies from 1997 to 201142. In a 2017 CDC survey, 13% of children under the age of
- Highest level of educational attainment, No. (%) 537
- Arsenic in water (μg/L), mean (SD) 552 2.2 (7.1)
- Water Arsenic > 5 μg/L, No. (%) 552 61 (11.1)
- Ever breast fed at 4 months, No. (%) 537
- participants included in the analyses, 482 participants (84.3%) had data at least one time-period of rice cereal
- during pregnancy was missing for 20 (3.50%) mothers, relationship status was missing for 34 (5.94%) mothers,
- education was missing for 35 (6.12%) mothers, and pre-pregnancy BMI was missing for 12 (2.10%) mothers.
- Birth weight was missing for 17 (2.97%) and breast-feeding status was missing for 59 (10.31%) infants. Other
- solid food consumption at 8 months was missing for 1 (0.23%) infant. A total of 20 (3.50%) participants
- 18 years had been told they had asthma, 11% a respiratory allergy, 6.5% a food allergy, and 13.5% a skin allergy43.
- (N = 545), early introduction of solid food was related to an increased risk of infant wheeze, but not other res-
- after 4 months of age (N = 615)45. Introduction of wheat after 6 months of age compared to before or equal to
- (N = 1612)46. While research linking infant rice cereal exposure to later health outcomes is lacking, our results
- Figure 1. Adjusted Risk Ratios (95% CIs) for Each Month Earlier of Introduction of Rice Cereal According to
- Outcome Severity, N = 572 infants. RR indicates risk ratio for health outcomes according to reported severity.
- The circles indicate RR at each severity level for each outcome. The lines indicate the 95% confidence intervals.
- Abbreviations: RR risk ratio. Sample size N = 571 for fever analyses.
Methods (brief)
- least one diagnosed by a doctor (Supplementary Table S2). Sample sizes and proportions of each outcome for
- Variable Sample size Mean (SD) or No. (%)
- calculated using different sample sizes due to missing values. Sample sizes were 321, 373, and 464 for 4 months,
- Abbreviations: RR risk ratio. Sample size N = 571 for fever analyses.
- the availability of prospective cohort data of carefully collected repeated measurements of infection occurrences,
- were ascertained from a review of the delivery medical records. Home tap water samples were collected and ana-
- lyzed by inductively coupled mass spectrometry to detect arsenic species57. The Committee for the Protection
- in household tap water samples (μg/L) in our analyses. For interpretability, we exponentiated the coefficient
Implications
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Update history
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