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Food protein-induced enterocolitis syndrome (FPIES), is a delayed (non-IgE mediated) gut allergic reaction to a food(s), usually presenting in the first two years of life, with an estimated incidence in this age group of 1 in 7,000 children.

Typical symptoms of FPIES include severe vomiting, diarrhea and dehydration two hours after eating. These symptoms can lead to other complications, including changes in blood pressure and body temperature, lethargy, and failure to thrive.

This feature of recognition, combined with the common resolution of FPIES with age, suggests that FPIES, like IgE-mediated food allergy, is an inappropriate adaptive immune response to foods.

Results: The majority of children were female (50.7%), white (86.2%), and atopic (54.8%), with median age two years (range two months-19 years). The most common food groups avoided were grains (60.0%), cow's milk (52.4%), vegetables (42.7%), and fruits (38.0%). Avocado was the most commonly avoided fruit.

Milk intolerance Cow's milk protein is one of the most common causes of food sensitivity in a baby who is breastfeeding. Cow's milk protein intolerance is a reaction by the body's immune system to a protein found in cow's milk. A milk allergy or milk protein intolerance is different from lactose intolerance.

Proteins in breast milk may cause FPIES in exclusively breast‐fed infants, but it is very rare and few cases have been reported so far.

Food protein-induced enterocolitis syndrome (FPIES) is a rare food allergy that affects the gastrointestinal (GI) tract. Unlike most food allergies, symptoms of FPIES do not begin immediately after eating. Instead, it can take hours before severe symptoms begin.

Please note, most 'substitutes' for dairy products are soy based, or nut (almond), and may be high risk depending on the type of FPIES and associated factors. Breastfeeding typically has no added risk, confirm with your Allergist.