Infant Food Protein-Induced Enterocolitis Syndrome: Symptoms, Causes, Treatment Options, and Nurturing Guidelines
In the first few months of an infant's life, cow's milk, soy proteins, grains like oats and rice, and eggs are the most common culprits for food-related issues. This condition, known as Food Protein-Induced Enterocolitis Syndrome (FPIES), affects the gastrointestinal tract of babies and young children, causing symptoms that can be severe and potentially life-threatening.
FPIES is not like other food allergies and does not show up on a typical food allergy test. Symptoms may include lethargy, blue skin color, dehydration, high or low body temperature, low blood pressure, weight loss, poor growth, shock-like symptoms, and delayed growth. Severe diarrhea and vomiting are the most common symptoms, typically occurring 2 to 3 hours after eating a trigger food.
Doctors may find it challenging to diagnose FPIES due to its rarity and similarity to other illnesses. However, if symptoms appear, it is likely that the food the child ate was the trigger. It's important to note that a child who reacts to one particular grain may also develop an allergy to a different grain.
Cow's milk is the most predominant trigger worldwide, implicated in approximately 35–67% of cases and about 50% of FPIES cases overall. Soy is particularly common in the US, triggering reactions in about 36–40% of affected infants. Grains, including oats, rice, and barley, are frequently reported triggers globally, with rice and oats repeatedly mentioned as typical FPIES triggers. Eggs are another common protein trigger noted in several studies.
In rare cases, a breastfed baby might react to breast milk due to trigger foods in the woman's diet. For formula-fed babies with FPIES, hypoallergenic formula free from soy, dairy, grains, or other potential allergens can be used.
Identification and management of these triggers require careful clinical evaluation and supervised food challenges by allergy specialists. Parents may be asked to keep a food journal to help identify and eliminate potential triggers. In some cases, a supervised oral food challenge (OFC) might be suggested by doctors. During an OFC, doctors feed the infant a trigger food and monitor them in a safe, clinical environment.
It's crucial for parents to seek immediate treatment if a child with FPIES experiences chronic and severe symptoms. Most children grow out of FPIES by the time they are 3 to 5 years old. However, it is possible for a child to have FPIES beyond 5 years of age, but controlling diet and eliminating triggers can help them lead a healthy life.
While FPIES may present differently in every child, with symptoms varying in severity and timing, understanding the common food triggers can help parents and healthcare providers work together to manage this condition and ensure the child's wellbeing.
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- Despite cow's milk, soy proteins, grains like oats and rice, and eggs being common in infant diets, they can also be the primary cause of Food Protein-Induced Enterocolitis Syndrome (FPIES), a severe and potentially life-threatening condition that affects the gastrointestinal tract.
- Unlike typical food allergy tests, FPIES is not easily diagnosed due to its rarity and symptoms that mimic other illnesses, such as lethargy, blue skin color, dehydration, and delayed growth.
- Soy, a common protein in the US, triggers reactions in about 36–40% of affected infants, while cow's milk is implicated in approximately 35–67% of FPIES cases worldwide.
- Identification and management of FPIES triggers require careful clinical evaluation, supervised food challenges, and the elimination of potential allergens from the child's diet based on parents' food journals.
- In some cases, a supervised oral food challenge (OFC) might be suggested by doctors to confirm a food as a trigger.
- Healthcare providers and parents can work together to manage FPIES by understanding common food triggers, such as grains like rice and oats, eggs, and soy, and by keeping the child on a hypoallergenic formula if needed.
- A child with FPIES might continue experiencing symptoms beyond 5 years of age, but controlling their diet and eliminating triggers can help them lead a healthy life.
- In addition to managing FPIES, parent's attention should also extend to other aspects of their child's health, such as mental health, eye health, hearing, and skin care, to ensure their overall wellbeing and fitness.
- Proper nutrition, cardiovascular health, and therapies and treatments for chronic medical conditions like type-2 diabetes, chronic kidney disease, and rheumatoid arthritis are essential for a child's long-term health.
- Lastly, maintaining a balanced diet, regular exercise, and mental health support contribute greatly to a child's overall health and wellness, ensuring they grow up to be happy and well-adjusted individuals.
