Prevalence and Parental Perceived Efficacy of Rice Cereal in Bottles Used as a Natural Sleep Aid for Infants Aged 0-11 Months

Purpose: The American Academy of Pediatrics (AAP) recommends against the routine use of rice cereal in the bottle (RIB) to improve infant sleep patterns. The AAP also states that the use of RIB is a choking hazard and may lead to excessive weight gain. Additionally, RIB as a milk thickening agent can cause a change in stool consistency and result in constipation. Despite the lack of scientific evidence and AAP warnings, it is unclear to what extent parents use RIB as a sleep aid for their children. Methods: An anonymous online survey was distributed via Amazon MTurk to parents of children aged 0-11 months (n=384). Parents were asked demographic questions, the frequency with which they use RIB as a sleep aid for their infant (Never, Seldom, Sometimes, Most Times), effectiveness of use (No, Moderately, Extremely), and whether side effects were observed (Yes/ No). Parents were then asked if they discussed the use of food/ drink as sleep aids with their child’s pediatrician (Yes/No). Results: Of 384 survey participants, 376 responded to all questions. The mean age of our sample was 6.87 months (SD = 2.79), with 80.3% of the participants identifying as White, 9.3% identifying as Black, and 10.4% identifying as Hispanic. Overall, 43% of all parent respondents stated that they had used RIB at some point as a sleep aid for their infant (14% Seldom, 21% Sometimes, 8% Most Times). Of those who reported that they used RIB, 73.3% found this intervention to be effective, while 10.6% stated that their child experienced a side effect after using RIB. Overall, 64% of parents indicated that they did not discuss food/drink as sleep aids with their pediatrician and, of those parents who stated that they used RIB as an infant sleep aid, 46.6% reported that they did not talk about RIB with their pediatrician. Conclusion: A concerning amount of parents stated that they have used RIB to promote sleep for their infants. Pediatricians must inform parents of the dangers associated with RIB and reinforce the concepts of good sleep hygiene as an alternative to non-supported, possibly dangerous practices.