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Rice Cereal Allergy


Question

Is an allergic reaction to rice cereal (consistency or contents) related to CdLS? I am in contact with the mom of an 11-month-old who states that four attempts to feed rice cereal have resulted in vomiting and most recently, dry heaves. Pediatrician had first thought the flu. I am sending mom allergy information. Can you provide any suggestions?

Answer of our experts

We have had a few children who had profound allergy to rice. We did challenges for them with the help of an allergist

My first question is whether this is the first solid that they have given her? If so, it may be a swallowing problem with the solids. Kids often gag when they get a different consistency. If this is the first solid she has had, I would try another cereal. If it happens again, I would go at it from a swallow angle (usually those evaluations are done by speech or occupational therapists). If it only happens with rice I would talk to a pediatric allergist. I would not keep re-challenging without their help, since if this is an allergy, it may get worse

Fructosemia (a rare liver disease where one can't take fructose sugar) can also present with vomiting to rice cereal (most brands have fructose added). If she had only gotten a formula that had no fructose, this could be an etiology as well

CP/TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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