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Understanding FPIES

Managing Egg Allergy

Kathy Beck – Accredited Practicing Dietitian – Understanding FPIES as part of our Feeding your child with Food Allergies webinar series.

Have you heard of FPIES, or Food Protein Induced Enterocolitis Syndrome? Kathy Beck discusses FPIES as part of our Feeding your Child with Food Allergies webinar series.

FPIES 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. However, it can happen even earlier in babies who are on infant formula. In this webinar Accredited Practicing Dietitian Kathy Beck will talk through some FPIES basics and provide some tips for introducing foods to an infant with FPIES.

Understand more and learn how to manage FPIES day to day. Kathy will also share information on how to make sure your child’s nutritional needs are met. 

Webinar recorded: Tuesday, 23 February 2021

Understanding FPIES Full webinar

1. Is the FPIES Action Plan something that parents can take with them to the doctor if they think their child is having a reaction?

2. I have previously heard of acute and chronic FPIES. What is the difference? How do I know what type my baby has?

3. I've seen references to FPIES persisting in older children. How strong is the evidence for this? Our daughter was diagnosed with FPIES as a toddler and as a young teenager now, still cannot tolerate soy, chicken or too much grain. She's not coeliac and is not at risk of anaphylaxis.

4.You mentioned earlier that a doctor will decide on when to do a challenge if they think a child might have outgrown an allergy, how do they make that decision? Is it because the child hasn’t had a reaction for a number of years? Do they have some sort of test that indicated that maybe the child’s outgrown it?

5. I’ve been advised to introduce all new foods to my baby as if they are a potential allergen - 1/8 tsp, 1/4 tsp, 1/2 tsp, 1 tsp then 2 tsp and if that’s tolerated over five days a food is considered safe. This means at eight months it’s taking a long time for him to build up a varied diet. Is this overkill? Or should I stick to it? He is FPIES to rye, banana, avocado and chickpeas.

6. Would you recommend seeing a dietitian for someone that has FPIES to four foods?

7. Is there much research around FPIES? Especially around "cure"?

8. Kathy, you said earlier that some with FPIES also have IgE mediated food allergy, and I’m just wondering whether we need to explain that a little bit further so that there might be people listening in who don’t understand what IgE mediated food allergy is.

9. If our 8month old only presents with diarrhoea likely due to rice, is that still FPIES?

10. If FPIES generally occurs on the 3rd+ time exposed to the allergen, how can I introduce 1 food daily (as mentioned) and know for sure which the allergen is?

11. Is FPIES more prevalent in children/babies in the last 5-10years, or is there just more awareness of it?

12. Thanks Kathy. I want to clarify your previous answer to a question. Is it recommended to introduce 1 new food a day (aligned with typical solids intro advice) if the child has 4 known FPIES foods and it is overkill to go slower?

13. Do we understand what it is in the foods or what it is in the person’s make up that causes the FPIES reaction?

14. My son who is 12 months FPIEs to rice, oats and dairy. He also has a lot of food sensitivities (gassy, eczema, itchy throat is some) to other foods is that common with FPIEs kids?

15 .Do you think there is any correlation between FPIES and leaky gut syndrome?

16. Going back to basics, if someone thinks their baby has got FPIES, but they haven’t seen anyone about it and their GP hasn’t picked it up, what should they be doing?

17. Have your heard of FPIES presenting in a breastfed baby as mucous or bloody poos when the mother consumes the allergen?

18. What will a food challenge look like? Our son is 18 months old, FPIES to egg. Understand the challenge will be a way off but interested to hear what it will entail please.

19. What’s the best way to help to recover after a FPIEs acute reaction? My son usually will continue with silent reflux and sleep issues for few weeks after a reaction.

About Kathy Beck…

Kathy Beck

Kathy Beck is an Accredited Practicing Dietitian working privately in paediatric food allergy in Queensland. Recently retired from Queensland Health after almost 40 years' service, Kathy is now a proud volunteer surf life saver, regular ocean swimmer and scuba diver.

Kathy’s passion is supporting families with infants and children living with food allergy to have a better quality of life when attempting to avoid allergens and adequately substitute foods to achieve a nutritionally adequate intake. 

Kathy is the Chair of the Dietitian Committee of the Australasian Society of Clinical Immunologists and Allergists (ASCIA) which aims to provide up-to-date educational resources for dietitians and families living with food allergy.