Food Protein-Induced Enterocolitis Syndrome (FPIES) is recognized as a non-IgE-mediated gastrointestinal allergic condition affecting infants. Despite its significance, comprehensive, population-based studies on FPIES have been notably absent, particularly within Australia. A recent study aimed to bridge this gap by investigating the incidence and clinical features of FPIES among Australian infants, providing crucial insights into infant health and potentially influencing perspectives on introducing solids in Australia Food practices.
Incidence and Prevalence of FPIES in Australia
A nationwide survey conducted in Australia from 2012 to 2014, under the Australian Paediatric Surveillance Unit, meticulously tracked new cases of acute FPIES in infants under 24 months old. The study, engaging 1400 pediatricians, identified 230 infants with FPIES. This large-scale effort revealed that the incidence of FPIES in Australian infants under two years of age is approximately 15.4 cases per 100,000 infants annually. The median ages at first episode, diagnosis, and notification were 5, 7, and 10 months, respectively, indicating a condition that typically manifests early in infancy.
Common Food Triggers in Australian Infants with FPIES
The research highlighted key triggers for FPIES in the Australian context. Rice emerged as the most common culprit, responsible for 45% of cases, followed by cow’s milk (33%) and egg (12%). Interestingly, most infants (68%) reacted to a single food, while 20% reacted to two, and 12% to three or more foods. A significant 51% of infants experienced a reaction upon their first known exposure to the trigger food. This data is vital for informing dietary guidelines and strategies for introducing solids to infants in Australia food and nutrition recommendations.
Factors Associated with Multiple Food Triggers
The study also explored factors associated with varying FPIES presentations. Infants with multiple food triggers were found to be younger at their initial FPIES episode (mean age 4.6 months vs 5.8 months for single trigger, P = .001) and were more likely to react to fruits and vegetables (66% vs 21%, P < .0001). Furthermore, there was a trend suggesting that infants exclusively breastfed for over 4 months might have a lower chance of developing FPIES to multiple food groups (23% vs 36%, P = .06). Among infants with multiple food FPIES triggers including cow’s milk, a substantial 64% also had co-associated FPIES to solid foods. Notably, 42% of infants with FPIES to fish also reacted to other food groups, pointing towards potential cross-reactivity or heightened sensitivity in certain cases.
Conclusion: Implications for Australia Food and Infant Health
This comprehensive study underscores that FPIES is not a rare condition among Australian infants, with rice identified as the predominant food trigger. The findings regarding early-onset disease and reactions to fruits and vegetables being linked to multiple food sensitivities are crucial for early diagnosis and management. Understanding these patterns is essential for healthcare professionals and families in Australia, influencing approaches to infant feeding and the introduction of diverse Australia food options to minimize the impact of FPIES.
