28/03/2026
When most people think about food allergy, they often picture sudden reactions like hives or breathing difficulties. Sometimes allergies can be more subtle and trickier to recognise because reactions are delayed hours to days after exposure to an allergen. (Check out my previous post on non-IgE mediated allergies!)
Two of these types of allergies are (Food Protein Induced Allergic Proctocolitis) and (Food Protein Enterocolitis). These allergies typically present in babies in the first months of life, and usually before solids are introduced. In contrast to other forms of allergy, FPIAP and FPE reactions can be triggered by exposure to food proteins in breast milk, as well as to direct ingestion in formula. Because FPIAP and FPE are non-IgE mediated allergies blood and skin allergy testing is not helpful.
What do these allergies look like?
🌿 FPIAP
• Blood or mucus in the stool
• Diarrhoea
• Otherwise happy, thriving baby
🌿 FPE
• Diarrhoea, vomiting and/or abdominal pain
• Bub is often unsettled
• Can be associated with slow weight gain
Common triggers include cow’s milk protein 🥛 (this is the most common - and also includes milks from other animals like goats 🐐), soy, and very occasionally other foods.
Management is very individualised to the child an family, but may include:
✔️ Careful monitoring without any dietary changes
✔️ Removing the trigger food from the infants diet
✔️ Maternal dietary modification if breastfeeding
✔️ Using a specialised formula when needed
The reassuring part is that FPIAP and FPE do not cause long term harm, are not associated with anaphylaxis, and usually resolve within the first few years of life.
If you are worried your baby has one of these conditions it is important to seek advice from a health professional experienced in diagnosing and managing these allergies. This helps avoid unnecessary food restrictions (for you and bub), prevents inappropriate testing, and hopefully reduces stress for families.