FPIES

Have you heard of FPIES, or Food Protein Induced Enterocolitis Syndrome?

It is an allergic condition which is generally first seen in babies around 4 to 6 months of age, when a baby starts eating solid foods.

It can happen even earlier in babies who are on infant formula. The symptoms include vomiting so severe it is often described as being like a fire hydrant. This vomiting generally happens about 1 to 4 hours after eating or drinking the food that contains the FPIES food trigger. Diarrhoea is also a symptom in some children. These episodes can be very frightening, as some babies also become pale and floppy and feel cold to touch. Common triggers include (but are not limited to) rice, cow’s milk, chicken and egg.

Although FPIES is an allergic condition, unlike the management of anaphylaxis, adrenaline is not used to treat FPIES. If a child who has been diagnosed with FPIES has severe symptoms such as becoming pale and floppy or cold to touch (in addition to vomiting) it is important to call an ambulance. The main treatment for the baby will be rehydration, i.e. giving the baby fluids through an intravenous drip. The Australasian Society of Clinical Immunology and Allergy (ASCIA) has a helpful dietary guide for patients with FPIES as well as an FPIES Action Plan, which should be completed by your doctor.

If you think your child may have FPIES, please get a referral to see a clinical immunology/allergy specialist. Allergy dietitians can help in making sure that your child is getting enough vitamins and minerals. The good news is that most children will grow out of FPIES by three or four years of age.