Key points about food protein-induced allergic proctocolitis in babies
- food protein-induced allergic proctocolitis (FPIAP) is a type of food allergy
- it mainly affects the lower part of the bowel
- the most common sign is blood or mucus in your baby’s poo
- pēpi with FPIAP usually look well and grow normally
- cows’ milk protein is the most common trigger
- many pēpi react through breast milk
- most pēpi grow out of FPIAP in early childhood
What is protein-induced allergic proctocolitis
Food protein-induced allergic proctocolitis is also known as FPIAP. FPIAP happens when a baby’s immune system reacts to food proteins. This causes inflammation in the lining of the bowel.
It is a delayed type of food allergy. Symptoms do not happen straight after feeding. They usually appear hours or days later.
FPIAP does not cause fast allergic reactions like hives, swelling, or breathing problems.
What causes protein-induced allergic proctocolitis
Cows’ milk protein is the most common cause of FPIAP.
Pēpi can have cows’ milk protein through:
- infant formula made from cows’ milk
- breast milk, if the breastfeeding parent eats dairy
FPIAP mainly affects young pēpi as their immune system is still developing.
FPIAP is just one type of cow’s milk protein allergy, there are other types
Cows’ Milk Protein Allergy In Babies
Symptoms of protein-induced allergic proctocolitis in babies
The most common symptoms of protein-induced allergic proctocolitis in pēpi are:
- blood in the poo
- mucus in the poo
Other symptoms may include:
- loose or runny poo
- increased wind
- fussiness during or after feeds
Most pēpi with protein-induced allergic proctocolitis:
- look well
- feed normally
- gain weight as expected
If your baby looks unwell, is vomiting a lot, or is not gaining weight, see a health professional.
Diagnosing protein-induced allergic proctocolitis
There is no single test that diagnoses FPIAP.
A health professional usually diagnoses FPIAP based on:
- your baby’s symptoms
- feeding history
- a physical examination
Symptoms usually improve after removing cows’ milk protein from the diet. A health professional may later guide a careful reintroduction to confirm the diagnosis.
Skin prick tests and blood tests do not help diagnose FPIAP.
Managing protein-induced allergic proctocolitis in babies
Management focuses on removing cows’ milk protein.
Breastfed babies
If your baby is breastfed, you can usually keep breastfeeding. The breastfeeding parent may need to remove dairy from their diet.
Blood in the poo often improves within 1 to 2 weeks. It can take up to 4 weeks to fully settle.
A dietitian can help make sure the breastfeeding parent’s diet stays balanced.
Formula-fed babies
Formula-fed pēpi may need a special formula, such as:
- an extensively hydrolysed formula
- an amino acid formula
Only change formula with advice from a health professional.
How long protein-induced allergic proctocolitis lasts
Most pēpi grow out of protein-induced allergic proctocolitis in early childhood – it usually resolves in 50% of pēpi by 6 months old, and 95% of pēpi by 9 months old. Your health professional will guide safe reintroduction of cows’ milk protein.
