Total Elimination Diet Round 2 – For FPIES

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Do you suspect your nursling is reacting to something you are eating by breastmilk? Dr. Sears has an elimination diet that is great when IgE allergies are suspected. But what do you do if that doesn’t work, or you suspect FPIES? Many of the foods on the Dr. Sears list are high risk for FPIES. So then you need to build a custom Total Elimination Diet (TED). Most babies tolerate their mother’s milk fine. But some babies have high levels of sensitivity, and some women pass more intact proteins via breastmilk. Enzymes can be used in addition to eliminations in some cases. For more information about TEDs and other FPIES topics, get a copy of The FPIES Handbook.

Please consult with a doctor and registered dietitian to ensure adequate nutrient intake.

Start by looking over the FPIES Food Surveys.

Avoid any foods known to be a problem for your child.

Then pick foods:
1 meat, including the organs
2-4 vegetables (different colors)
1-3 fruits
1-2 starches/pseudograins
0-1 sweetener
Pure salt

Starch can be any grain, pseudograin, legume, potato, or squash. In particular sweet potatoes, rice, oats, green peas, and winter squashes are higher risk for FPIES. So that leaves things like quinoa, millet, lentils, white potatoes, buckwheat, and any pseudograin.

If at anytime while making diet changes your nursling symptoms get worse, then you need to swap out ingredients in one or more categories. Within 3-4 days you should see sight improvement, and by 2 weeks there should be noticeable improvement.

It’s really hard to pick one ideal TED, since every baby/child has a different list of triggers.

But this would be an example of a starting point for a Total Elimination Diet:

Grassfed lamb- including organs for important nutrients
Brussel Sprouts
Rutabaga or Beets
Sea Salt

Learn more in The FPIES Handbook.

8 thoughts on “Total Elimination Diet Round 2 – For FPIES

  1. Oh, this is so hard I feel for the moms that have babies with food allergies. It’s so hard to eat some of these super strict diets. I’ve known moms that could only eat a few types of foods. It can also be expensive too.

  2. This saved my life and my child’s life. This got us to baseline in about a week. Thanks so much for writing this up. We would have been still having reactions for all I know, if it wasn’t for this. Before this, for about 6 months, I gradually eliminated: soy,dairy, eggs, some nuts, some veggies and fruits… some grains, then salicylate… then amines, then histamine… I was down to 6 foods. 6 wrong foods. If I knew about this up front, It would have saved us 6 months of suffering and 6 months of not sleeping, not growing…. A few simple swaps and BAM we hit baseline. It may seem daunting to go on a total elimination diet at first, but I lived on 4 items for several months, and have a friend who lived on potato and salt… After you figure it out you will know either one of 2 things: you will know what is safe for you to eat or, that nothing is safe and you need additional medical intervention. For example, my child has reflux even in baseline. Once you are in baseline or as close to it as possible, then you can deal with the whatever is left, if anything… If you are having the problems I had, then you are not thinking clearly, you are sleep deprived and stressed and starving. This is a great way to get to the end of the line and get a resolution quickly. I am so grateful to whoever wrote this up. I didn’t know that you could be allergic to proteins/that’s not written up in allergy standards of documentation, such as RPAH diets, etc. I mean, I should have known because my dog had IBS, but it didn’t click… And our GI was not helpful. He told me that it will all get better after we start a grain and told me to feed oatmeal directly at 6 months almost landing us in the ER.

  3. Hi Joy, I am on the Infant Reflux: Support for GERDlings site/group. I have been eating ground lamb, ground turkey, chicken, salmon, white potatoe, avocado, blueberries, peeled pear, and olive oil. My 8wk old is on a compounded soy free Zantac. His poop still has mucous and seemed to get even more watery once I started the diet. Should I try the diet you just listed? Including grains? And how do you eat the lamb organs? Also, I noticed on the list you created about food success, that lamb was down in the 80’s for success. Why is that the meat suggested?
    I find it hard to believe that he’s sensitive to so many things. Could it just be that his gut needs to be healed?

    • Anything with a pass rate greater than 80% is considered low risk for FPIES. Sorry I am just now seeing this. I have been busy with the book, and neglected my blog. Has anything improved over the last month?

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