Babies choking on cereal in bottles

On another board, someone was saying how she routinely puts cereal in her baby’s bottle as it’s the norm in her country. She was warned against it as research suggests it can be a choking hazard and she countered with: ‘Does anyone have a cite showing where a child has choked on cereal in a bottle?’.

I did a google search and all I could come up with was warnings not to do it as it can be a choking hazard but no actual evidence that it IS a choking hazard KWIM. So I thought I would bring the question to the most knowledgeable teeming millions. Cite anyone?


I doubt it. You start them off with a very little cereal in the bottle. If it can get through the nipple, even the larger cereal-friendly nipple, the baby isn’t going to choke. Boy it sure can make a difference in keeping the baby full and happy longer.

It’s not recommended for reasons other than choking, as far as I know: the infant gut (before about 7 months, I believe) does not have the necessary enzymes to digest cereals, and the child may well be sensitized to grains introduced too early, thus creating an allergy where none would have existed.

I have never heard the choking thing. But since cereal provides precious little in the way of nutrition (other than some carbohydrates, assuming the baby can even digest it), and serves little purpose other than to sit heavily in baby’s stomach when he could be taking something more nourishing, like formula or breastmilk, it seems more a convenience for the parents (to create a quiet, belly-heavy baby) than an advantage to the baby (who is duped into feeling full rather than eating more of a balanced source of nutrition).

The protective tongue-thrust disappears (which bottle-feeding cereal bypasses) about the time the baby can begin to properly utilize cereal grains. Even then, care must be exercised to make sure the baby does not take in too many calories, taking his usual volume. When ‘extras’ are added to the bottle, the baby cannot regulate his caloric intake as accurately as if he is offered formula (or breastmilk) at the usual calorie count. Cereal grains should be offered in a spoon, so baby can take them or refuse them, as his interest or needs dictate.

I don’t have a cite, but I clearly remember reading about this a few years ago in Reader’s Digest.

There was a woman who killed 5 of her babies, one at a time, by smothering them with pillows.

She claimed that at least one of them died by choking on cereal that was pushed through a bottle nipple. The police bought all her excuses, and so the cause of death was listed as SIDS, choking by cereal through a bottle nipple, etc.

She didn’t get convicted until over 20 years later.

This is a WAG, but I’d guess this particular case is where the “cereal through a bottle nipple can choke your baby” axiom comes from.

It was Waneta Hoyt… this article talks about her case, as well as her claim that her baby choked on rice cereal squeezed through a bottle nipple.

Your Tax Dollars At Work.

Official USDA advice on “Feeding Infants” (containing such informational gems as, “Feed the baby when it’s awake, not when it’s asleep”) also notes on page 7, “Do not put cereal or other food in a bottle”–not because the baby could choke on it, but because “…this forces the baby to eat food this way.”


My son’s pediatrician told me to put cereal in his bottle since he was two months old, and I don’t think it’s because he wants my baby to choke! It wasn’t to make him sleep longer, but to keep him from spitting up excessively. Enfamil even makes a formula with rice cereal already in it for the same reason.

Well. There’s a difference between attempting to control excessive reflux (with its accompanying risks of aspiration and failure to thrive) by adding cereal - with the understanding that it, too, carries risks - and ‘fortifying’ a baby’s formula to try to make it go longer between feeds and sleep longer. One attempts to improve the baby’s life. The other attempts to improve the adult’s life. When one weighs risks versus benefits in the case of severe reflux, perhaps cereal wins. But the AAP advises otherwise, in non-medical cases.

I have read that cereal is not a good thing to introduce too early because of the lack of calories compared to breastmilk/formula.

IIRC, cereal only has maybe 20 calories whereas Breastmilk/Formula has over 200 - and filling up a baby with cereal impedes him from getting all the calories he needs to grow. I thought the danger, then was not that the baby would get too many calories, but not enough.

Well, on average, human milk contains 20 calories per fluid ounce. This will vary per day, per time of day, and per woman, but that’s an average. Artificial human milks (formulas), for normal healthy babies, also contain 20 calories per ounce when mixed correctly. (There are exceptions for medical circumstances: one of my twins was born with a severe heart defect and was kept on reduced fluids to manage congestive heart failure, until her heart surgery. Her formula had 28 or 30 calories per ounce, depending on how well she was growing at the time.)

When people add cereal (or an extra scoop of formula powder) to formula or breastmilk, the fluid volume remains roughly the same, but the caloric load is increased. Babies tend to feed until their stomachs are full (except for the ones who drink, throw up a bunch, and go right back to drinking!) Biologically, they’re wired to ‘expect’ the number of calories that would be provided by breastmilk. (And incidentally, ‘fortifying’ formula can cause damage to an infant’s immature kidneys, and this is why ‘fortified’ formula should only be used in the bottle under doctor’s care - there is medical risk involved.)

It’s true, a serving cereal mixed with water is going to have fewer calories in the same volume than would breastmilk or formula. But it’s also going to have less of everything else - less fatty acids (ie, none), less protein (virtually none), vitamins (none), minerals (none except iron, which is poorly bioavailable and interferes with the absorption of the iron present in breastmilk) etc. Clearly, a small infant should not have any significant volume of its daily requirement of breastmilk or formula replaced with cereal mixed with water - there’s just not enough nutrition in it. But here, we’re not really talking about feeding cereal instead of the same volume of formula or breastmilk (I have no problem with that, provided it’s fed with a spoon, offered after the baby has had a feed of formula or breastmilk, and the baby’s natural tongue-thrust defense/reflex is gone.) The problem is when people, in an effort to “fill the baby up and make him sleep”, force-feed extra calories in what ought to be the usual amount of volume. Of course babies sleep more heavily - think about how you feel after you eat a huge Thanksgiving meal. But sleeping heavily because of an overfull stomach is not necessarily good for anybody.

I don’t consider choking to be a risk worth bothering about. However, I do consider the other risks not worth the ‘convenience’, when it is done for convenience or cultural tradition. (And of course, since I breastfeed, I can’t do any such thing. Nowhere to put the cereal in those things.) :stuck_out_tongue: