Food Protein-Induced Enterocolitis Syndrome (FPIES)

What is FPIES?

FPIES is a non-IgE-mediated food allergy typically presenting in infancy. In formula fed infants, FPIES is commonly triggered by cow's milk or soy protein.

Nutritional Management of FPIES

  • After diagnosis of FPIES, continued avoidance of food(s) until physician has determined reintroduction is appropriate
  • Food reintroduction is almost always performed in a controlled setting due to possible severe, acute symptoms
  • Infants with cow’s milk/soy FPIES may be breastfed or use a hypoallergenic formula1,2 such as:
    ⁃ Extensively hydrolyzed formula
    ⁃ Amino acid-based formula

What is a typical FPIES reaction?

The range, severity and duration of symptoms vary from child to child. They may include:

  • Delayed onset vomiting
  • Increase in reflux and runny stools
  • Diarrhea
  • Dehydration
  • Shock

Acute FPIES - Clinical Features2

Mild-to-Moderate Symptoms
  • Vomiting (onset usually 1-4 hours after ingestion of food; can range from 30 minutes to 6 hours)
  • Few, intermittent vomiting episodes (1-3), can be bilious

Decreased activity level


Self-resolving: child is able to tolerate oral rehydration at home

Severe Symptoms
  • Vomiting (onset usually 1-4 hours after ingestion of food; can range from 30 minutes to 6 hours)
  • Projectile (forceful) in nature Repetitive (>4) episodes; bilious and dry heaving

Activity level ranges from decreased to lethargy


Dehydrations requiring intravenous hydration

Chronic FPIES - Clinical Features2

Mild Presentation
  • Lower doses of the trigger food (i.e. solid foods or food allergens in breast milk) lead to intermittent vomiting and/or diarrhea
  • Typically poor weight gain/failure to thrive but without dehydration or metabolic acidosis
Severe Presentation
  • When trigger food is ingested on a regular basis (i.e. infant formula), intermittent but progressive vomiting and diarrhea (blood may be present)
  • Sometimes dehydration and metabolic acidosis may occur

Did You Know?

Tolerance in infants/children with cow milk-induced or soy-induced FPIES have been reported to occur at an earlier age than other foods.2


How EleCare and EleCare Jr can help

EleCare and EleCare Jr are nutritionally complete, hypoallergenic amino acid-based formulas for infant and children who cannot tolerate intact or hydrolyzed protein.

For more information about FPIES, check out:


The FPIES Foundation

The FPIES Foundation gives people living with food protein-induced enterocolitis syndrome the tools and confidence they need to achieve normalcy in their lives.


Kids With Food Allergies (KFA)

Learn how to improve the day-to-day lives of children with food allergies and empower them to create a safe and healthy future.


The Food Allergy & Anaphylaxis Network

Get the facts on what food allergies are – and what they aren’t. And learn how to recognize the symptoms and seek testing from a healthcare professional.


Kaareen’s Story

Learn how EleCare helped one young patient beat the odds and get back to loving life.


Food Allergies

Your child is not alone. In fact, it’s estimated that 4 out of every 100 children in the US have food allergies.

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Eosinophilic Gastrointestinal Disorders (EGIDs)

(EGIDs) are chronic digestive system disorders in which certain food proteins trigger an overproduction of eosinophils (white blood cells that help fight certain infections) in different areas of the digestive tract.

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Short Bowel Syndrome (SBS)

Short bowel syndrome describes a group of problems affecting individuals who have lost the use of a major part of their small intestine.

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Food Protein-Induced Enterocolitis Syndrome (FPIES)

FPIES is an immune reaction in the gastrointestinal system to one or more specific foods. It’s commonly characterized by profuse vomiting and diarrhea.

Read More

Malabsorption and Other Conditions

Nutritionally complete, amino acid-based EleCare and EleCare Jr are helpful in the dietary management of a number of GI conditions that cause malabsorption issues.

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  1. Nowak-Wegrzyn A, et al. J Investig Allergol Clin Immunol. 2017;27(1):1-18.
  2. Nowak-Wegrzyn A, et al. J Allergy Clin Immunol. 2017;139(4):1111-1126.

A Path to Exploring Insurance Coverage Options

EleCare may be eligible for insurance coverage. Our Pathway Plus specialists can help you navigate this process to determine if you have coverage and help connect you to a supplier for product delivery.

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Each health care provider is ultimately responsible for verifying codes, coverage, and payment policies used to ensure that they are accurate for the services and items provided. Providers should consult with the insurance plan for complete and accurate details concerning documentation for claims. Abbott does not guarantee reimbursement by any third-party insurance plan and will not reimburse physicians or providers for claims denied by third-party insurance plans.

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