Ask A Dietitian: Soy Formula, Rice Milk Pose Some Risks For Babies and Small Children

Posted by Cris on | May 25, 2011 | No Comments

Karen Wright, lead dietitian at The Food Clinic Pte Ltd., answers questions from sneezywheezy.com readers each month.  This month, readers who’s kids have milk allergies wanted to know if rice milk is safe, whether goats milk is okay for kids with dairy allergies, and whether soy formula contains too much ‘estrogen’ for boys. To send in your questions, click on the “Ask A Dietitian” Tab at the top of our home page.

I’ve been told (by other parents) that rice milk is not recommended for children under 4 years of age. Why is this, if indeed that is true?

This is true due to the levels of naturally occurring arsenic in rice drinks. Arsenic is naturally present in the environment. It is therefore present in the soil and water – both sea and fresh – and in almost all plants and animal tissues. As a result, arsenic occurs naturally at very low levels in many foods and it is not possible to avoid it completely. How harmful the arsenic is depends on the chemical form in which it is present. The organic form is less harmful than the inorganic form which can cause cancer by harming our genetic material (DNA). Rice and rice products have higher levels of the inorganic form of arsenic compared with other food.Arsenic enters the food chain mainly through crops absorbing contaminated irrigation water. (The FAO states that arsenic enters the food chain mainly through crops absorbing contaminated irrigation water; the way rice is grown in water makes it particularly vulnerable) Current recommendations state that people should consume as little of this form of arsenic as is reasonably possible.

As a precaution, toddlers and young children between 1 and 4.5 years old should not have rice drinks as a replacement for cows’ milk, breast milk, or infant formula. This is because young children drink a relatively large amount of milk relative to their body weight. As a result the intake of arsenic will be greater in a child below 4.5 years than that of older children and adults relative to their bodyweight.

There is no immediate risk to children who have been consuming rice drinks; however to reduce further exposure to arsenic, rice milk and drinks should not continue to be offered to toddlers and young children.

If your child is allergic to cows’ milk, you are strongly advised to seek advice from your health professional or dietitian on suitable replacements.

Other groups of people do not need to change their diet as their exposure to inorganic arsenic from rice drinks is lower relative to their bodyweight.

Children under a year old should drink breast milk or infant formula milk. Cows’ milk or alternatives are not suitable as a drink until an infant is 12 months old.

My child is intolerant to dairy, and gets very bad cramps and diarrhea when she drinks milk. People keep telling me that goat’s milk won’t cause the same reaction. Should I try her on goat’s milk?

Most babies and children with cows’ milk allergy are also likely to react to goats’ milk and sheep’s milk. This is because some of the proteins in these types of milk are similar to those found in cows’ milk. The levels of lactose are also similar in these milks, so milks based on goats’ milk protein are also unsuitable for babies and children that are lactose-intolerant.

For babies not allergic to cows’ milk, it should also be noted that milks based on goats’ milk protein have not been approved for use by many countries for babies under a year old. Goats’ and sheep’s milk are not suitable as drinks for babies under a year old as they do not contain the correct balance of nutrients to meet a baby’s needs, for example they do not contain enough iron. As long as they are pasteurised, goats’ and sheep’s milk can be used once a baby is a year old.

From six months, you can use a little pasteurized full-fat milk (from cows, goats or sheep) to mix foods for cooking.

My one-year-old son is allergic to milk and I’ve been giving him soy formula. But I just read that soybeans contain a compound that mimics estrogen.  Should I worry about giving my son soymilk?  Will this have a negative impact on his development, or his hormones?!

Soy milk naturally contains compounds called phytoestrogens which are similar to the hormone oestrogen but less potent. There has been lots of research about the benefits of soy in our diets in relation to adult health and for this reason soy based foods are often promoted as the healthy alternative.

However, the use of soy infant formulas in babies has been the subject of controversy as some animal studies have shown potential adverse effects on the use of soy formulas in young animals. Babies are more vulnerable to the effects of phytoestrogens due to their small body size and immature body systems. As they often rely on the formula as their sole source of nutrition they are exposed to a greater amount of phytoestrogrens relative to their body weight. A committee in the UK that looks at the safety of chemicals in foods has advised that although there is no clear evidence of harm from using a soy formula there is some potential risk particularly in infants under 6 months of age. They advise that soy formulas should not be used for babies under 6 months. The advice from other countries may differ.

For babies over six months the risk is thought to be significantly reduced as the amount of exposure to soy will be less as other foods are consumed in the weaning diet and the baby’s body systems are more mature. However, it is also worth mentioning that a proportion of milk allergic children can have adverse reactions to soy, and therefore it may not be suitable as a replacement for cow’s milk. In Australia and Asia soy formulas are used more widely in children with cows’ milk protein allergy than in the UK or Europe. Therefore, if your child is tolerating the soy formula and your paediatrician doesn’t feel there is any likelihood of your child being allergic to soy then you can continue to use the soy formula as your soon as your child  is over 6 months of age. If there is a chance that your son is also allergic to soy, ask your paediatrician or dietitian about a suitable milk alternative.

In summary always discuss the most suitable alternative to breast milk, if you are unable to continue to breast feed, or cow’s milk formula for your baby or child with your pediatrician or dietitian who specializes in allergies when your child is diagnosed.

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