Feeding your baby solids for the first time can be a nerve-wracking time if allergies run in your family. New moms and dads look out for the typical allergy signs of rashes and itches when introducing new foods, but not all food allergies present the same way, and some are very difficult to diagnose. One very specific type of food allergy, food protein induced enterocolitis syndrome, affects the gastrointestinal system and can cause severe distress in babies and children.
Dr. Purvi Parikh, an allergist and immunologist with Allergy and Asthma Network (www.aller
What exactly is it? How does it differ from a typical food allergy?
Food protein induced enterocolitis syndrome is a food allergy that involves the gastrointestinal tract and leads to profound vomiting, diarrhea, lethargy, and dehydration. The child may have a low blood pressure as a result of her symptoms, and often the allergy is misdiagnosed as an infection or sepsis.
This is different from typical food allergy in that there is not usually rash, hives, or breathing abnormalities. Also, typical food allergies occur within an hour of eating, while food protein induced enterocolitis syndrome is a delayed food reaction that can occur hours after ingesting the allergen.
How common is it?
Food protein induced enterocolitis syndrome is overall a rare disease. Exact worldwide incidence is unknown, but some studies have pointed around .35 percent incidence. But it is on the rise as all allergic and immunologic conditions are.
What should parents be on the lookout for?
Initial symptoms are vomiting, diarrhea, and lethargy within a few hours of feeding. Babies can also take on a pale complexion from dehydration. If symptoms persist more than a few days, likely it is not an infection and is a chronic condition that should be investigated.
How is it diagnosed?
Food protein induced enterocolitis syndrome is a clinical diagnosis. We do not have good allergy testing that is standardized for this syndrome since it is a delayed allergic reaction and most of our current allergy tests can only assess immediate allergic reactions. This is why clinical history is extremely important.
How is it treated?
Food protein induced enterocolitis syndrome is treated by avoiding the offending allergen and usually all symptoms resolve. The good news is there is a chance your child may outgrow it after some years, but re-introduction of the food should be done in a supervised setting with intravenous access in the event another reaction occurs.
These reactions can be very severe and life threatening, so re-introduction should not be attempted without a doctor’s guidance, preferably, a board certified allergist or immunologist.
For more information about the allergy, visit FPIES.org.
Danielle Sullivan, a mom of three, is a writer and editor living in New York City. Sullivan also writes about pets and parenting for Disney’s Babbl
