My 8 month old daughter seems to have a sensitivity to rice and vomits every time I give it to her. Our pediatrician said she might have FPIES. Can you tell me more about what this means?

FPIES, or food protein-induced enterocolitis syndrome, is a food allergy that occurs in the gastrointestinal tract and is primarily present during infancy. The most common triggers for it are cow’s milk and soy formula, although it can also be caused by solid foods.

FPIES symptoms include profuse, projectile (and typically repetitive) vomiting. There is often diarrhea that may accompany it, which may in turn lead to dehydration and/or lethargy within 1-4 hours following the food ingestion.

A FPIES diagnosis is typically based upon the history or story of what happens when your child ingests a particular food. It’s also important to note if there is improvement following the withdrawal of the suspected trigger food.

I would suggest a consultation with a pediatric allergist given your pediatrician’s suspicion for FPIES. The allergist can gather a complete history of what happens when your child ingests this particular food, and make appropriate recommendations from there. The allergist may also order further testing to help evaluate and rule out other causes. This could include blood work, stool studies, radiographic studies (i.e. x-ray or abdominal ultrasound as examples) and possibly food allergy testing depending on the presenting symptoms.