If you’ve ever felt alone navigating an FPIES diagnosis—or if you’re wondering what FPIES even is—this episode is for you. 

I’m joined by Dr. Taylor Arnold, pediatric dietitian and mom of two children who had FPIES, and Dr. Manisha Relan, board-certified allergist and immunologist. Together, we break down what FPIES actually is, why it’s so often misdiagnosed, how it differs from typical food allergies, and what families can do to manage it confidently. Whether you’re a parent seeking answers or a clinician wanting to deepen your understanding, I hope this conversation leaves you feeling more empowered, prepared, and less alone.

We discuss: 

• What FPIES is, how it differs from typical food allergies, and why diagnosis is often delayed.

• Navigating food introductions, managing reactions, and reducing anxiety around FPIES.

• Practical tips for daycare, social situations, and long-term support for children with FPIES.

To connect with Dr. Taylor Arnold follow her on Instagram ⁠@growing.intuitive.eaters⁠, check out all her resources at ⁠https://msha.ke/growingintuitiveeaters⁠ 

To connect with Dr. Manisha Relan follow her on Instagram ⁠@pedsallergymd⁠, and check out all her resources at ⁠https://www.101beforeone.com/⁠ and her new book: ⁠https://www.amazon.com/Baby-Leads-Way-Evidence-Based-Introducing/dp/1610027620⁠

Additional Resources:

⁠https://fpiesfoundation.org/⁠

⁠https://www.fpies.org/⁠

⁠https://kidswithfoodallergies.org/living-with-food-allergies/what-is-a-food-allergy/food-protein-induced-enterocolitis-syndrome-fpies/⁠

00:00 – Intro & Why This Matters

02:00 – Meet the Experts

03:05 – What FPIES Is and Isn’t

08:20 – Hallmark Symptoms & Why It’s Missed

10:10 – Personal Story: Misdiagnosis & Learning Curve

15:00 – Diagnosing FPIES

18:30 – What Causes FPIES?

20:00 – What Parents & Pediatricians Should Know

23:30 – Figuring Out Food Triggers

25:00 – Managing Feeding Anxiety After Diagnosis

29:00 – Preventing Nutritional Deficiencies

32:00 – Practical Tips for School, Daycare & Social Events

35:00 – Emotional Support for Parents

38:00 – Outgrowing FPIES & What Comes Next

42:00 – Final Takeaways & Encouragement

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00;00;00;05 – 00;00;21;08

Manisha Relan

Food induced. So it’s caused by eating something. Enterocolitis means your gut lining, and syndrome means that there is a huge spectrum of what you can see. For some people, it can be mild, and for some people it can be severe. And it’s a little bit unpredictable. And we can dump more into that. But that’s like the digest.

 

00;00;21;11 – 00;00;31;08

Manisha Relan

So it’s basically a digestive reaction to a food. The tricky part about it. Unlike peanut allergies that you were alluding to, is that it’s not immediate.

 

00;00;31;11 – 00;00;50;23

Dr. Mona

Welcome back to the show. It’s me, Doctor Mona, your trusted pediatrician, confidant and mom friend here to support you through every twist, turn and wait. Is this a stomach bug or something else? Parenting moment? You’re listening to the PedsDocTalk podcast, where we keep things real, science based and totally judgment free. Whether this is your first episode or your hundredth, you’re in for one.

 

00;00;50;23 – 00;01;14;05

Dr. Mona

That might just change how you look at food allergies forever. Today’s conversation is about spies. That’s short for Food Protein induced Enterocolitis syndrome, and if you’ve never heard of it, you’re not alone. This condition is often misunderstood, underdiagnosed, and dismissed as picky eating or repeated stomach bugs. But spice is real, and the more we know about it, the more we can help families get the right answers and the right support faster.

 

00;01;14;08 – 00;01;38;18

Dr. Mona

Whether your child has it, you suspect they might or you’ve never heard of it before. This is an episode for every parent, every pediatrician, every nurse, and every day care provider. Because recognizing the signs could change a family’s life, I’m joined by two incredible guests to walk us through it all Doctor Taylor Arnold, a registered dietitian and the creator of Growing Intuitive Eaters, who brings both clinical expertise and lived experience navigating spice in her own home.

 

00;01;38;20 – 00;02;05;04

Dr. Mona

And doctor Manisha Rylan, also known as Pedes Allergy, MD, a board certified allergist and immunologist who specializes in food allergies and immune related conditions. We’re covering what f pies is and what it isn’t, why the reactions are delayed but intense, how to get a proper diagnosis and why it’s so often missed. How to feed your child safely without spiraling into fear, and how to support families navigating this emotional and medical roller coaster.

 

00;02;05;06 – 00;02;23;22

Dr. Mona

This is one of those episodes you’ll want to share with your pediatrician, your school nurse, your mom group. Because the more people who understand f pies, the more families we can help. Before we jump in, if you love what you’re hearing on the Pizza Talk podcast, make sure to subscribe and download the episode. It helps more parents find us and helps keep these conversations going strong.

 

00;02;23;28 – 00;02;30;27

Dr. Mona

Let’s get into it.

 

00;02;31;00 – 00;02;35;14

Dr. Mona

Thank you so much for joining me today. Doctor Taylor and Doctor Ellen.

 

00;02;35;16 – 00;02;37;28

Manisha Relan

Thank you. It’s a pleasure. Yes, I.

 

00;02;37;28 – 00;03;05;12

Dr. Mona

Am loving this three prong approach. So I asked my followers what they wanted to hear, what they felt like I needed to have on my podcast. And an overwhelming response was f pies. And I don’t blame them because it is something that we’ve been seeing. I see a lot, a lot might be a, you know, relative term, but more than I think people may realize and a lot of my families, the number one thing when they are diagnosed or going through the challenges are I feel so alone.

 

00;03;05;12 – 00;03;23;01

Dr. Mona

I feel like nobody else talks about this. I don’t know anybody who has it. So I just am really excited that we’re going to be able to talk about it from a general pediatrician, approach, but also allergy immunology and nutrition and tailor to, you know, before I go to Manisha, tell us more about your experience with f pies.

 

00;03;23;08 – 00;03;25;24

Dr. Mona

Not only in your career, but also personally as well.

 

00;03;26;00 – 00;03;45;10

Taylor Arnold

Okay. So I had three kids or I had I have three kids, they’re two, four and six, and my oldest who had f pies, they’ve since grown out of it. But, I, I, I’m also really passionate about food allergies, and it’s kind of like I was like thrown into this world in the, in the personal space to having two kids with f pies.

 

00;03;45;10 – 00;04;00;02

Taylor Arnold

So, yeah, it was definitely it surprised me and I, my oldest was actually misdiagnosed and we didn’t catch it right away. So I think that’s, you know, just goes to say how hard it is to identify. And even for someone who is a professional like myself.

 

00;04;00;08 – 00;04;14;29

Dr. Mona

Well, I hope in the conversation we can get into more of that in terms of also, I’m curious as a general pediatrician what it was mistake and ask because I have a feeling I know, but I will ask that later. And then Manisha, tell me your experience with, you know, obviously f pies and obviously the work that you do.

 

00;04;15;21 – 00;04;32;06

Manisha Relan

Yeah. F pies is like an integral part of allergy immunology fellowship training. We have done challenges during our training. We see we diagnosed, we manage, we treat and we also cheer the patients on when they outgrow it. So kind of like the full spectrum of it all.

 

00;04;32;10 – 00;04;48;20

Dr. Mona

Yeah. And you know, the point of this conversation, like I said, is to really bring home all different aspects of where a family may end up going if they are diagnosed with f pies or going through the diagnoses process, like you said, Taylor, that sometimes it’s not so clear cut. So Manisha, I wanted to first ask you some questions.

 

00;04;49;04 – 00;05;04;07

Dr. Mona

Can you explain to parents what f pis is, what it stands for, and how it differs from a typical food allergy? Like for example, someone may see like, you know, they eat a they eat some peanut butter and they get, hives or, you know, for, swelling in the face. How it differs from that.

 

00;05;04;09 – 00;05;27;28

Manisha Relan

Yeah, absolutely. Very important. F pis is a very long, word. It’s food protein induced enterocolitis syndrome. So it’s a mouthful. And I try to tell parents like, let’s break it down. Food induced. So it’s caused by eating something. And tro colitis means your gut lining and syndrome means that there’s a huge spectrum of what you can see.

 

00;05;28;05 – 00;05;48;15

Manisha Relan

For some people, it can be mild, and for some people it can be severe. And it’s a little bit unpredictable. And we can get more into that. But that’s like the biggest. So it’s basically a digestive reaction to a food. The tricky part about it, like peanut allergies that you were alluding to is that it’s not immediate.

 

00;05;48;17 – 00;06;17;09

Manisha Relan

So your child eats the food or you because adults can have it too. So it can present in anywhere from infants all the way to adulthood, very common in children younger children under the age of three, I would say infants are diagnosed between 1 to 4 weeks after they’ve been introduced. Cows milk or soy protein. I would say that, solid foods when your child or baby is eating, when you begin to introduce like solid foods.

 

00;06;17;14 – 00;06;38;23

Manisha Relan

So between 4 to 7 months is like a common time. That’s symptoms they present and then unfortunately and thankfully rare at the same time. In children and in adults, it can happen and we can go into which foods trigger. I don’t want to monopolize the whole conversation, but there’s a lot to say. So needless to say, the symptoms develop hours after you eat the food.

 

00;06;38;23 – 00;06;42;07

Manisha Relan

So this is very different than a peanut allergy.

 

00;06;42;07 – 00;07;00;05

Dr. Mona

Yeah, I love that you have a lot to say. And that’s exactly why I wanted this conversation. So it’s okay to have a lot to say. But why is it that the FP reaction may take hours to appear instead of being immediate? Maybe. Obviously people listening may not always be medical trained here, but can you explain kind of like how that would work differently?

 

00;07;00;05 – 00;07;01;12

Dr. Mona

Absolutely. Another allergy.

 

00;07;01;16 – 00;07;19;22

Manisha Relan

Yep. And my simple answer, because I, you know, I can go a lot into science. We can go into the weeds. But my simple answer is that it depends on what kind of immune system shall we activate. So I talk about the immune system very broadly. It’s like our defense system. And just like in our national defense system, we have different levels.

 

00;07;19;22 – 00;07;43;23

Manisha Relan

We have the military with the Navy, we have all of the different fort like Air Force, right. So our immune system also has different types of cells. And the cells at the F PiS reaction, we think, mostly it’s called T-cell mediated. So therefore it’s delayed versus a peanut allergy. That happens immediately. When you eat the food, you get the the hives or the vomiting or other compilation symptoms.

 

00;07;43;25 – 00;08;11;27

Manisha Relan

It’s IgG driven which is immunoglobulin E another mouthful. That more immediate minutes to two hours. The T cells take a long time to get activated. And that means two hours. At the shortest I say one hour, but usually it’s 2 hours to 4 hours and sometimes even longer. So, that’s why it takes a long to get diagnosed, because it takes a long to present.

 

00;08;12;00 – 00;08;20;01

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;08;20;04 – 00;08;37;04

Dr. Mona

Yeah. And you know, you mentioned, obviously some common food triggers, which we’ll get into. What are the hallmark symptoms? And f pies reaction. Obviously knowing that it is a little bit more, delayed, like you’re saying, it could be 2 to 4 hours or more. What would a parent kind of look out for after ingesting a food?

 

00;08;37;04 – 00;08;40;11

Dr. Mona

And they may not know because it’s happening hours later.

 

00;08;40;13 – 00;09;01;28

Manisha Relan

Yeah, I would say the biggest, most common symptom is vomiting. And it’s not just one vomit. It’s not just like to vomit. It’s like continuous episode after episode, like you think you’re done and then it can keep going. It can be four times, five times, six times to the point where it it’s almost, you know, the child is throwing up vomit that’s bile colored.

 

00;09;02;12 – 00;09;24;17

Manisha Relan

And it can be kind of concerning simultaneously. You can also have diarrhea not always present, but can be present. And the loss of all this fluid from the top and from the bottom. Lisa. Dehydration. And so you can also see effects of dehydration where your child is more limp, not active, doesn’t look well, can get pale from the loss of fluid.

 

00;09;24;19 – 00;09;35;14

Manisha Relan

So sometimes, people can mistake it for a viral infection, involving the stomach. So you can think of a stomach bug. You can also be mistaken for sure.

 

00;09;35;17 – 00;09;59;10

Dr. Mona

I was just going to. I was just going to say I’m like, I think this is a good this is a good segue to ask, you know, obviously, like that could be obviously the reason why we see delays. Because it’s it can mimic other things that can happen commonly in children, like you said, like a stomach virus, or like, oh, sometimes kids vomit when they’re trying new foods because, you know, they it elicits the gag reflex, or it’s reflux if a child had reflux in infancy.

 

00;09;59;14 – 00;10;11;02

Dr. Mona

So, Taylor, I, I’m going to jump to you. I’m curious, like how how it presented and it could have presented differently both in the two children that had it and also, kind of what it was misdiagnosed as initially.

 

00;10;11;04 – 00;10;31;06

Taylor Arnold

Yeah. So my well, my first one was actually misdiagnosed as an IGI allergy, because we, we were wondering if it was some sort of allergic reaction. And so we, we went to an, allergist, that’s all ages, which is my first regret. I wish I saw a pediatric allergist because I feel like they didn’t have that sort of knowledge and size.

 

00;10;31;16 – 00;10;55;07

Taylor Arnold

But her skin prick did, show positive for, eggs, which was her reaction. But because skin pricks aren’t always, like, the most reliable tests, he was like, oh, maybe it’s just like a weird presentation of IgG and so delayed. And then later on, we saw a pediatric allergist at our local children’s hospital, and she was like, no, that’s definitely that sounds really like a lot like f bites.

 

00;10;55;22 – 00;11;12;23

Taylor Arnold

So that’s how my first one was misdiagnosed. And then second one, I knew right away, like I suspected right away. And then we trialed the food and it was a reaction. And then my third one actually got a stomach bug, and I had seen f pies so many times, and I was like, dang it, it’s happening again.

 

00;11;12;29 – 00;11;30;20

Taylor Arnold

But it ended up not being a FPIES. It was just a stomach bug. So yeah, it’s really easy because kids puke all the time. Is there a daycare? And I feel like as an f PiS parent, like once you have a kid who’s diagnosed or even with the same kid who throws up, you’re so tempted to be like, oh, it’s another it’s another trigger food.

 

00;11;30;20 – 00;11;42;01

Taylor Arnold

It’s another kid with FPIES. Which is why it’s so important to get like an outside perspective from an allergist or your pediatrician who knows a lot about f PiS to help you, like parse out whether or not it’s actually a reaction or not.

 

00;11;42;04 – 00;11;53;17

Manisha Relan

Taylor, did you think that there was a difference? Sorry. By jumping in between the vomiting with the FPIES reaction that your other child had, and then the younger child having the stomach, or did you notice? Can you comment on that?

 

00;11;53;17 – 00;12;13;29

Taylor Arnold

Yeah, yeah. So my, with my daughter, because it was delayed, it actually happened like at night. And so, by the time I got into her room, she had already thrown up. But with my son when he trialed the food. This is actually a funny story. So it was four hours, and I in my head, I was like, if we make it to the four hour mark, like, we’re probably good.

 

00;12;13;29 – 00;12;29;05

Taylor Arnold

And so my husband had him in his arm and was like, yay! And was like dancing up and down like we made it. And as he was doing that, she, like project, the idea of loving it like, like a lot of stab is powerful. So it’s definitely more forceful.

 

00;12;29;05 – 00;12;30;25

Dr. Mona

That was the child that had the virus, right.

 

00;12;30;25 – 00;12;33;19

Taylor Arnold

The one that no, no, that was a child with 0507.

 

00;12;33;20 – 00;12;34;11

Dr. Mona

One one.

 

00;12;34;14 – 00;13;04;10

Taylor Arnold

I see. Yeah, I see so with it was more projectile, my kids, my kids f pis was mild compared to, some others, like Doctor Ryland said it was, it wasn’t like dehydration or, requiring er, visit. But we also had a plan, because we suspected FP so we did have Zofran on hand and we administered it right away to, to help prevent any, like excessive fluid loss.

 

00;13;04;10 – 00;13;05;00

Taylor Arnold

So.

 

00;13;05;02 – 00;13;24;19

Dr. Mona

Oh very. No, this is, this is so useful because I, you know, one of I, I’ve had maybe as a general pediatrician maybe seven that I’ve, I like meaning I personally walk through it, walk them through it and a lot of it is again I all of them have had the vomiting. Monica, is there any chance that the vomiting isn’t part of the clinical symptoms?

 

00;13;24;22 – 00;13;55;11

Dr. Mona

Right. Okay. That’s what I thought because all of them had vomiting. But interestingly, I the reason it got put on my radar is not even from medical training because I trained back in, like, the, 2009 ten, we learned a little bit about F times, but I feel like it became more, more common. Now, I don’t know if Monica you’re seeing that too, but I had a really good friend whose son had f PiS and I listened to her experience, and from then is when I was like, was I missing f pose all these years?

 

00;13;55;11 – 00;14;12;14

Dr. Mona

But no, I think I didn’t, but it was like it really put it on my radar. And then after that I was like quickly diagnosing ones like that were like, I think this is this is not it. And I felt like a hero for a lot of these parents because they were going down to other pediatricians who were like, oh, maybe it’s just mom, maybe it’s just a virus.

 

00;14;12;14 – 00;14;28;09

Dr. Mona

Maybe it’s this. I’m like, it seems a little bit unusual. And like you said, Taylor, a lot of those middle of the night vomiting, you know, like, meaning they’ll they’ll eat dinner and then they’ll go to bed and then they’ll have the vomit. And it’s just happening too frequently for it to be a coincidence. And it wasn’t always the first time.

 

00;14;28;09 – 00;14;44;27

Dr. Mona

It was like one time. And then the next time. And I’m like, there’s no reason why your kid, who did not have any other reason to have this, would all of a sudden start vomiting, you know, out of the blue, was there certain foods that were the triggers when you, started when you got that diagnosis? Taylor.

 

00;14;45;00 – 00;15;06;05

Taylor Arnold

Yeah. So my daughter was, eggs, which she only had, like the whole eggs. So, like, some kids who react to eggs can have eggs in baked goods and some can not. And so my daughter could have, like, like a cake with eggs in it, but she couldn’t have scrambled eggs or hard boiled eggs. So hers is actually really easy to manage.

 

00;15;06;05 – 00;15;27;21

Taylor Arnold

My son was wheat, which was so hard because they had like family style meals that his daycare, and it just killed me that all of his little friends could sit at the table and he had to be strapped in so that he didn’t go and like, take his friends, you know, like toast or whatever. And then like the, the teachers, I had to be like, you really got to like, sweep up the crumbs.

 

00;15;27;21 – 00;15;39;07

Taylor Arnold

Like it’s so much that you don’t think about, like, I’m like, training the teachers, like, sweep up the crumbs after every snack and and wipe down the table so that, like, he’s not grabbing some of these goldfish. And it was really hard.

 

00;15;39;07 – 00;15;54;17

Dr. Mona

It was really hard. And I want to dive in deeper to that because I know that’s obviously how you guide families to from the personal experience, but also just like how to navigate the food choices and all of that. Monica, my question for you before I flip it over to Taylor with more questions, there is how is the diagnosis made?

 

00;15;54;17 – 00;16;05;01

Dr. Mona

And Taylor even mentioned too, that skin prick tests don’t really work for this. So how is that diagnosis made? And why don’t skin protests work? Like they would for, you know, other, food allergies?

 

00;16;05;04 – 00;16;28;26

Manisha Relan

Excellent question. So a skin tests don’t work because skin tests. Look at it. Yeah. This allergy and this is clearly a delayed reaction. So it’s a different immune pathway. The problem is that some allergies myself included we will do a skin test because there is something called atypical atthis where you can have both an IgG mediated reaction and a pediatric reaction to the food.

 

00;16;29;14 – 00;16;50;22

Manisha Relan

And it’s it’s rare. It’s a it can be up to 25% depending on the studies you look at for the incidence. Thankfully it’s not very common. But it’s based on history. It’s literally based on being like listening and asking questions and, asking your parents to keep a food diary, a food log of what’s going on and what did they eat, what were the activities.

 

00;16;50;25 – 00;16;53;22

Manisha Relan

So just a lot of thorough history and exam.

 

00;16;53;25 – 00;17;13;08

Dr. Mona

And do we know why FPIES occurs? I mean, from the current data theories, I know the area of food allergies and allergies in general like this, is so fascinating to me as a general pediatrician. And I know, obviously that it is to you, too. That’s why you’re in the specialty. But do we know why? And any data on is there real incidence increases?

 

00;17;13;13 – 00;17;19;00

Dr. Mona

Is it certain countries like anything that you can add? And obviously I understand if there’s nothing that is there right now.

 

00;17;19;03 – 00;17;41;00

Manisha Relan

Yeah. I would say in general our food allergies are on the rise, whether it’s IgG mediated or non IgG mediated like flies. So I myself in the last ten years in practice have been seen an increase and quite a lot in fact and I want to mention this too, I’m not the only one that helps manage FPIES sometimes GI colleagues.

 

00;17;41;03 – 00;18;06;03

Manisha Relan

So the gastroenterologist, can also manage, depending on where you are in the community across the country, some pockets of GI docs feel more comfortable because it’s such a delayed reaction. It’s all heavily in the the presentation of vomiting. Right. So you may not end up in an allergist office right away. So it’s just slow and I don’t know if maybe the GI seeing more as well in their experience, but we don’t know why exactly.

 

00;18;06;03 – 00;18;09;11

Manisha Relan

Mona. Everything, all of the conditions are on the rise.

 

00;18;09;13 – 00;18;31;29

Dr. Mona

Yeah, I, I’m very interested too. Obviously, any time there’s a research study or conference, I’m like, let’s. I, like, make a beeline to two things. I mean, I love everything, but I’m always interested in autism research just because I find it very fascinating. And then also anything in the allergy world. And so I’m always going to be seeking out my allergist immunologist colleagues to help me stay up to date on all of this information.

 

00;18;32;09 – 00;18;48;12

Dr. Mona

And Taylor going to you now, I know, obviously, thank you so much for sharing your personal story. And you know, the how it was, diagnosed. What do you wish parents and clinicians would know about f PiS having gone through the experience you have, as a mom of two kids with it?

 

00;18;48;28 – 00;19;06;22

Taylor Arnold

Well, I think there’s two separate buckets. I wish I wish pediatricians had more of, like a general knowledge of it. Because I find that there are some that are like super up to date with, like the food allergy stuff and f PiS and then some who, like, have never heard of f PiS or like, yeah, I’ve never diagnosed it.

 

00;19;06;25 – 00;19;37;24

Taylor Arnold

And it can be really frustrating to like have your kid have these vomiting episodes that are really stressful and scary and it’s just, oh, it’s a systemic bug without like, more digging. So that’s what. So I hope this podcast, maybe we’ll like, reach a lot of ears in, yes, awareness because I find even like on my Instagram posts, when I share about f PiS, like every time I do that, I get at least 1 or 2 comments that say like, I took this to my doctor and we got a diagnosis.

 

00;19;37;24 – 00;20;01;29

Taylor Arnold

And so I think awareness like this is really important absolutely makes a difference. And parents, I wish that they knew that it’s important to get a knowledgeable provider in on the care. If if you know your pediatrician, is it familiar, get in with an allergist or a gastroenterologist. And then if you’re struggling, especially with solids introduction a dietitian can be really helpful with that.

 

00;20;02;02 – 00;20;24;02

Taylor Arnold

But definitely getting support is so important, which I know is easier said than that. Yeah, sometimes wait times can be like crazy long in some places. So and then my, all my, my other tip is don’t go looking on Facebook groups for information because Facebook groups like some of the advice I had to leave because I was like, this is this.

 

00;20;24;04 – 00;20;27;00

Dr. Mona

Is this like general groups or FP moms, groups.

 

00;20;27;00 – 00;20;29;12

Taylor Arnold

Of PiS, F, PiS groups, even.

 

00;20;29;12 – 00;20;30;27

Dr. Mona

Those groups? I was just going to ask.

 

00;20;30;27 – 00;20;31;14

Taylor Arnold

Okay, well.

 

00;20;31;19 – 00;20;34;11

Dr. Mona

What do you feel like was was worrisome or like anxiety.

 

00;20;34;14 – 00;20;52;17

Taylor Arnold

Asking questions about like, is this a reaction? Yeah. And a lot of people will be like, yes, yes, yes. And then that food is eliminated from the kids diet when, when like they really need to be evaluated by a medical professional. Because what if it’s a what if it’s a stomach bug? And now we have one less food that a kid with an already restricted diet is eating.

 

00;20;52;17 – 00;21;12;21

Taylor Arnold

Or like I even saw. Like you can only introduce like one food, every three days or one food a week when you have PiS. And so this kid already has a very restricted diet and now we’re restricting heavily. And kids with f PiS can still like do solids. Introduction like and introduce new foods on a regular basis.

 

00;21;12;21 – 00;21;34;08

Taylor Arnold

They don’t have to have these like long delays. There are like higher risk foods and lower risk foods depending on their trigger foods. But they can still continue to introduce solids. So I see like parents looking there for information because they lack support, because it can be hard to find a provider and then we have unnecessary restriction of the child side, which can have a lot of consequences.

 

00;21;34;08 – 00;21;49;25

Dr. Mona

So yeah, I was just I’m very interesting about the Facebook groups because I joined one when my son had a stroke when he was born and he had seizures. So I joined one and I left probably in like a week because of the anxiety it caused me. Like it was very you would think that that would be very supportive, but it wasn’t.

 

00;21;49;25 – 00;22;07;09

Dr. Mona

And so I was just curious if it was after the diagnosis or just a general group, because I could imagine a general grouping even worse, like, oh no, my kid vomits all the time. Like kind of like dismissive of like, no, this isn’t real. I’m curious. Did you end up seeing a GI doctor as well, Taylor or was it the allergist?

 

00;22;07;09 – 00;22;14;24

Dr. Mona

Jen because I know you, obviously with both the children, you had different stories a little bit because of your awareness after the first. Yeah, but who did you end up seeing for? The care.

 

00;22;14;27 – 00;22;40;10

Taylor Arnold

With my first one, we saw an allergist, and then with my second one, he actually started with Cosmo Protein Allergy. So he had a lot of GI issues to begin with. And so we were already with his GI doctor, and I was like, hey, guess what? I’m pretty sure we have something else going on. And so we we continued to see her, and then we also got an allergist on board to mostly to plan and, talk about the reintroduction.

 

00;22;40;26 – 00;22;58;26

Taylor Arnold

And like medication management. So the prescribing up the nausea medication. So we had, we had both for my second one and then the third one, I did schedule with the same allergist because I was freaking out that I had three fives up not being a reaction. So that was good.

 

00;22;58;28 – 00;23;13;17

Dr. Mona

And I do have more questions about, obviously, how to approach those meals and, you know, introduction salads and all of that. But before we do that, Manisha, how do they how do we determine which foods to avoid. Like so just say like Taylor’s example, right. She had the egg concern. And maybe at that point you didn’t know how.

 

00;23;13;17 – 00;23;28;15

Dr. Mona

What are the steps into figuring it out, given that you’re not doing skin protests or anything like that to figure out where to start with a food avoidance? Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;23;28;17 – 00;23;53;13

Manisha Relan

Oh yeah, well, the most common foods are cows milk and soy when it comes to the early infants. And then when it comes to solid foods, it’s usually cereal grains. Is the most common. And then as but any food, it can be vegetables, it can be fruits, it can be, get, as Taylor mentioned, and seafood, even so, I’ve also seen it a peanut.

 

00;23;53;13 – 00;24;13;02

Manisha Relan

I mean, I’m a specialist, so I see a lot of rare and uncommon things. Once we know the trigger food and based on history and sometimes a food diary is sometimes we don’t know right away. And we have to do challenges and introduce. And we walk through that. We look at what are the most common foods, and we know what the most common solid food triggers are.

 

00;24;13;08 – 00;24;34;22

Manisha Relan

We look at what’s in the same shared family. So cereal grains you know what reacts right. And oh what’s your allergic to rice. You probably are having a reaction of five to rice. You may be also similarly affected with oats of medieval delay that oh maybe will work you know toward introducing buckwheat first or quinoa first and less less reactive foods.

 

00;24;34;22 – 00;24;42;21

Manisha Relan

And so it really is individualized, which is why seeking that medical professional, who knows AFIs is really important.

 

00;24;42;23 – 00;24;47;13

Taylor Arnold

But you can continue to introduce solid foods. You have to stop introducing them, right?

 

00;24;47;13 – 00;24;50;13

Manisha Relan

Oh my gosh, did you see me shaking my head? I have to shake.

 

00;24;50;14 – 00;24;52;23

Dr. Mona

You were saying about the week like the week today.

 

00;24;52;23 – 00;24;53;17

Taylor Arnold

And so we don’t.

 

00;24;53;21 – 00;25;10;17

Dr. Mona

Know. So this is a great segue because my question is, you know, there is a lot of already without any food allergy, right? Meaning if there’s no food allergy, guys, I already know this, that parents have a lot of anxiety about the introduction of solid food time. Meaning do I do a baby load weaning? How do I what if the kid doesn’t eat?

 

00;25;10;17 – 00;25;31;24

Dr. Mona

There’s so much other anxiety around eating. And then you of course add the concern of a fear of of allergies that I see. But also once there is a diagnosis of something like f pies. So, Taylor, how do you help or how can we help parents sort of navigate that anxiety about introducing new foods and maybe clarifying again, some of the misconceptions or mistakes you see people making?

 

00;25;31;26 – 00;25;34;28

Dr. Mona

This is for people once they have enough pies. Diagnosis.

 

00;25;35;01 – 00;26;03;08

Taylor Arnold

Yeah. I find that parents like lists. And so we have like high risk, moderate risk, low risk like lists from the literature. And so I think that’s comforting to be handed that tool. Like if, if the kid has had, like Doctor Whalen said, like an, an allergy to like rice. Okay. Now we have we know certain for sure high risk food and then we have other like just general high risk for f pies food.

 

00;26;03;08 – 00;26;27;17

Taylor Arnold

So like for really nervous like let’s prioritize a high iron food in the low risk category and introduce a couple of those things to keep the variety going. And once we get confidence up, we can move to the moderate risk. And then of course, making sure that we have a plan for reaction from the provider, like what to do, what to look out for, when to administer medication, when to to go to the emergency room if necessary.

 

00;26;28;01 – 00;26;30;03

Taylor Arnold

But I think the list is really helpful.

 

00;26;30;03 – 00;26;51;04

Manisha Relan

I agree, and I would say I would also encourage that. You will forget to talk to your doctor when you’re in the visit with your questions. So reach out to them after, I mean, write them all down. And these Facebook groups, I joined one as an allergist just to see what was in my community. I didn’t even last that long.

 

00;26;51;09 – 00;27;16;28

Manisha Relan

Oh, such anxiety as well as just a professional reading. What? Other, you know, folks are comfortable telling advice. Yeah, without knowing anyone full of history and me thinking, oh my gosh, what if it’s not necessary? Yeah, you don’t need to wait. There is a chronic form of f PiS there. Let’s acknowledge that for a quick second because I know there are some people that will not react for a very delayed amount of time.

 

00;27;17;01 – 00;27;39;14

Manisha Relan

That is very rare. So for most FP families it is not important to stress about the fear because that will overtake you. Keep a journal. Just keep a journal that will give you so much more control and power. Because if you’re tracking the foods, we’ll track the symptoms. We will find it. If we know exactly what’s going in the baby’s body.

 

00;27;39;16 – 00;27;57;26

Dr. Mona

And, Taylor, do you feel like. I mean, you obviously have experience being a dietitian. Do you feel like some of the families that you’ve seen that have dealt with that, like, do you feel like it would behoove them to have a nutritionist or dietician with them through this process, or did you get that? Did you get another dietitian helping you too?

 

00;27;57;28 – 00;28;11;27

Dr. Mona

Like, I’m just curious, like, because, you know, obviously I know, you know, but sometimes when it’s your own kid, you’re like, hey, do I, extra because I, you know, you already said it perfectly that I think there could be a misconception that, well, my kid’s going to be nutrient deficient, right? That I can’t create these nutritious meal plans.

 

00;28;11;27 – 00;28;24;14

Dr. Mona

And it’s hard when you think about I have to restrict certain foods, but how? I mean, how can they get that list and sort of know that? Would that be obviously, I don’t think Allergists or GI doctors are well-versed in that compared to a nutritionist.

 

00;28;24;17 – 00;28;41;15

Taylor Arnold

Yeah. I mean, I know I think, I think the the list is like from a very well known article. I can send you the link if you want to put it posted. I read the scientific article with this podcast. But yes, I think it’s very important for some families to you to utilize a dietitian. So I don’t think it’s necessary for all.

 

00;28;41;15 – 00;28;59;28

Taylor Arnold

It depends on the family. It depends on how much guidance that they need. But if if the parent is struggling with like because because these kids who have. I still need to prioritize the other things with starting solids. We still want to see prioritizing iron. We still want to see prioritizing like omega threes and lots of that. We want to explore lots of different proteins with fiber.

 

00;29;00;04 – 00;29;23;23

Taylor Arnold

We want to get like textures in. So if the family is afraid of with which totally justified because allergic reactions are scary. But if the family is afraid of like introducing new foods. So we’re really holding back on where we’re eating, what we’re eating, that’s the point where you need to get additional support because like introducing these allergens is still important for reducing IgG risk.

 

00;29;23;29 – 00;29;39;01

Taylor Arnold

So like if we if the kid ate pies and we’re like, I’m not going to introduce any of the allergens now we’re increasing the risk for other types of allergies. So we still need to manage like the f pies. But there’s other things that are important for just starting solids in general that also are important for that kid too.

 

00;29;39;06 – 00;29;53;07

Taylor Arnold

And if that’s just too much to keep track of and put together, or it’s too stressful, that’s where I’m getting a dietitian who is like a pediatric dietitians, who is experience in starting solids and f pies like myself can be really helpful to guide you through that.

 

00;29;53;09 – 00;30;11;14

Dr. Mona

Did your children because of the f pies? You know, obviously having having to, you know, curtail menus and all that. Did you tend to see more selective eating? I know it’s not always the reason why someone may be picky or selective. And if so, or if not, how would you manage sort of the picky eating tendencies that children may have with f pies?

 

00;30;11;17 – 00;30;22;03

Taylor Arnold

Yeah. Yes. My the kid who is the wheat allergy is my pickiest eater. I don’t I, I’m sure it was a combination of things.

 

00;30;22;03 – 00;30;24;13

Dr. Mona

Yeah. I mean, it’s always it’s not gonna be one thing, right?

 

00;30;24;14 – 00;30;54;13

Taylor Arnold

Yeah. And, you know, I don’t think the Cassville protein allergy helped either. Like it was all a combo or stuff. But we do know that f like, if a kid has an adverse reaction to food that can increase the risk for our food because, like, if it’s a traumatic reaction, the kid can start to become picky. And if we head down that road to where we’re heading into like extreme picky eating, extreme limiting of the diet we can be in, like eating disorder or pediatric eating disorder territory, which with f pies would probably be more of the pediatric feeding disorder world.

 

00;30;54;22 – 00;31;19;21

Taylor Arnold

But the management is the same thing that we would do for a picky eater who doesn’t have pies we want to work on, like low pressure exposure, making it fun. Lots of texture. Introduction. We can do like, low pressure food exposures away from the table so the child doesn’t feel like pressured to eat. And then if it’s ever like a super stressful situation, you’re always worried about food, getting a dietitian or feeding therapist involved.

 

00;31;19;21 – 00;31;41;02

Taylor Arnold

Because because FP is often present in infancy, like by the seven month ish point, that’s also a sensitive period for texture introduction. Yeah. So if we’re not getting texture introduction by like 910 months, we’re increasing rice for texture version later on down the road. So it’s all like a lot of things to do at once. And spice just makes it wait.

 

00;31;41;04 – 00;31;59;08

Taylor Arnold

And so don’t hold back on getting the support. And even if you’re like, I might need it, get on the waiting list. Because sometimes be nervous can take a while to get into. So talk to your pediatrician, ask them to to get you on a waiting list. And like if the time comes and you don’t need the appointment, you can cancel.

 

00;31;59;10 – 00;32;17;20

Dr. Mona

I love that and we’ll get into more of that kind of final message I would have from Jen being a Gen PS as well. And then Doctor Taylor did allude to, our food avoidant restrictive food intake disorder, which is actually something we’re going to have an entire podcast episode about me and her, so stay tuned. We didn’t have time to it right now, but we are going to do that, me and her, because I that’s another thing.

 

00;32;17;20 – 00;32;33;12

Dr. Mona

I get a lot of questions on how that differs from picky eating, quote unquote, and how it’s not just picky eating, it’s so much more. And then my other question for you is you talked about obviously being a mom and having to do the, communication with the daycare and like, the wheat, you know, the crumbs and all of that.

 

00;32;33;18 – 00;32;53;14

Dr. Mona

What are some other practical tips for families dealing with social situations like daycare, school or family gatherings? I and I know how hard this must be. You know, obviously not personally going through it, but hearing it, I mean, already there’s so much stress with everything else we do as mothers and fathers and caregivers. But now adding the is my child safe to it, right?

 

00;32;53;14 – 00;32;57;02

Dr. Mona

So what would be some practical tips? And it might involve lists which I love.

 

00;32;57;05 – 00;33;13;16

Taylor Arnold

Yes. So first, if it’s like a daycare, like get in there and ask to train the teachers. Yeah. You don’t have to be an allergist or dietitian to train the teachers. If you are a mom and your kid has a phys, you know way more than the general population. Or if you’re a parent, you could I have, you know, way more than the general population.

 

00;33;13;22 – 00;33;34;22

Taylor Arnold

Get in there. Explain to the teachers what happens is what’s going to happen if they have a reaction, why it’s important to be careful and what they’re allergic to. And like you got to clarify, like if it’s, you know, they’re allergic to grains, which grains where do you find them. Because if if you say, oh, my kid has like a rice allergy, flies rice reaction.

 

00;33;34;24 – 00;33;52;14

Taylor Arnold

Like it’s not just rice itself. Rice is in teething crackers. Rice is in puffs, rice is in chips. Rice can be in noodles. And so you have to, like give a list of where these common foods are if you’re not the one preparing the food. Second is like think about when they’re toddlers food sharing. How can we mitigate that?

 

00;33;52;14 – 00;34;18;06

Taylor Arnold

How can we stop that? You know that maybe the toddler needs to be the highchair for longer. Maybe we need to have a separate table, like there’s got to be some way because a lot of daycares will eat family style. There’s got to be some way to prevent, the kid reaching over and grabbing, like, a sandwich from their friends lunchbox and then, be prepared to, like, send in food, bring lunchboxes, bring snacks, bring the the allergy free cupcake to birthday party everywhere you go.

 

00;34;18;09 – 00;34;37;06

Taylor Arnold

Like I packed snacks. Always. Because you never know when you’re going to be in a situation where it’s going to be snack time or food, you’re going to stay out longer than you thought. And having those safe foods on hand is really important so that you don’t feel like you’re stranded without something to feed your kid. And also feels less.

 

00;34;37;09 – 00;34;54;22

Taylor Arnold

It feels less sad. Like, yeah, it feels less sad to give your kids allergen free cupcake than for them to have no cupcake. It’s I mean, it’s it’s really hard as a parent to, like, see your kid strapped in or see your kid having the different like, but but like having those alternatives can make it a lot easier for.

 

00;34;54;22 – 00;35;07;12

Dr. Mona

You and inclusive. Yeah. No, absolutely. Yeah, I could imagine especially the birthday party or the, you know, cupcakes at a birthday party. I mean, every kid is eating it and excited about it, and it gives them a chance to feel part of something, but keeping them safe at the same time.

 

00;35;07;14 – 00;35;23;25

Taylor Arnold

And one more thing I would add is like, announce it and tell everybody, like your kid to say, I’m allergic to wheat. Yeah, like tell the host, hey, just say, you know, so-and-so has lurched wheat. Here’s what this means. Here’s what they can’t have. Yes, I need you to prepare something different. I’m going to bring something ahead of time.

 

00;35;23;25 – 00;35;34;24

Taylor Arnold

Like just let them know everything, but also teach your kid once they’re toddler age. If they still have f pies to say I’m allergic to wheat or like an allergy band if they can’t say it. Something along those lines.

 

00;35;34;28 – 00;35;35;20

Dr. Mona

Yeah.

 

00;35;35;22 – 00;35;56;29

Manisha Relan

I was going to say, what I when I cancel my, my my patients are in the office. I say, what is in your control? I always ask the parents to come back to that because I feel like that helps me, ground me. So I there’s so many things that we cannot control. We can’t give in to that fear, but we can control education and being prepared.

 

00;35;57;13 – 00;36;14;05

Manisha Relan

And that’s kind of what you, you gave a beautiful, like list of things that the parents can do. The biggest thing about education is that there is not enough time in a doctor’s office to visit, to teach you every single detail. A lot of my visits run late because I like to over educate for how much.

 

00;36;14;07 – 00;36;15;17

Dr. Mona

I love it. I know.

 

00;36;15;19 – 00;36;16;05

Taylor Arnold

It’s.

 

00;36;16;08 – 00;36;17;19

Dr. Mona

Your system, not us.

 

00;36;17;26 – 00;36;19;01

Manisha Relan

It’s so true.

 

00;36;19;03 – 00;36;19;17

Dr. Mona

That.

 

00;36;19;20 – 00;36;42;29

Manisha Relan

Also retaining information like you’re a human being who’s never, ever heard the food protein enterocolitis syndrome before. And so how are you supposed to remember all those words and write them down frantically? So I always recommend asking your doctor for any resources so that you can further educate yourself and be prepared. There’s actually like emergency action plans online already.

 

00;36;42;29 – 00;36;59;23

Manisha Relan

They’re great. Websites are know for the emergency room and not for daycare. Like people have done this. Yeah, you’re not alone. So like help ask us to direct you to resources and I’ll share some with you. Monitor, add to the show notes. Some of my favorite websites.

 

00;36;59;25 – 00;37;16;00

Dr. Mona

I love it, and like we talked about already, I hope this an episode like this is awareness and education for people. One people who are like, is it or is it not? But also people who have other kids have PiS and they’re like, I have felt so alone, and I’m on this Facebook group and they’re telling me to introduce this or not, and now I don’t know.

 

00;37;16;06 – 00;37;31;03

Dr. Mona

And then also for pediatricians and you know, like I had mentioned earlier, I was not very aware at all until it was my friend who had a son with it. And I was like, what is this thing I need to know about this? And then ever since then I was like, I’m not. I’m I could learn even more about it.

 

00;37;31;03 – 00;37;49;29

Dr. Mona

Maybe, you know, obviously be even more, aware of what it is, but it’s definitely on my radar. And I know colleagues who are still practicing that are like, oh yeah, is that very common? I’m like, I see it. So yeah, you should know about it. We definitely should know, even if it’s not super common. But it is something that we are seeing the rise of, like you said, and many.

 

00;37;49;29 – 00;38;06;22

Dr. Mona

So I would love to, you know, kind of wrap up with you also about what is the long term outlook. I know you had alluded to the fact that there is a chance of out growing, how can you know, visits look like in terms of reassessing for reintroducing foods or, you know, how does that process look like for families?

 

00;38;06;26 – 00;38;29;11

Manisha Relan

Yeah. And I will tell you, right off the bat, most often of as a very favorable diagnosis, an outcome most fight is outgrown around H3. Sometimes, as early as 18. I’m sorry. Pardon me, 12 to 18 months after the initial reaction took place. So I’ve seen some kiddos outgrow it before, even H3. Sometimes it happens as a happy accident.

 

00;38;29;11 – 00;38;53;01

Manisha Relan

It has to be something that we talk about because I alluded it’s a syndrome. So when I guide people on reintroduction, I have to know what the actual earlier symptoms and presentation looked like in terms of are we going to do this at home, or would you be better suited in a clinic with an IV, access already obtained before you get too dehydrated to the point where I am not going to be struggling to get meds and fluids into you.

 

00;38;53;01 – 00;39;14;20

Manisha Relan

So in my fellowship, that’s how we used to do it. We used to do a one day hospital stay and, in less than a day really. But we could also check labs and monitor for the delayed reaction, for most foods or outgrown the adult foods. The later foods are like the seafood. So shellfish, fish and egg.

 

00;39;14;23 – 00;39;32;01

Manisha Relan

So if you develop that in late childhood or adulthood, it’s less likely to be outgrown. Just like most, IgG food allergies that are also developed in adulthood or less likely to be outgrown. So, overall very favorable. And most tolerate the food again.

 

00;39;32;02 – 00;39;48;04

Dr. Mona

So and in case we get this question, which of course I wish people could ask questions as we do these podcasts, but I think a common one that would come up is there is no treatment per se. Right? Obviously they’re they’re outgrowing it on their own, but there’s no like immunological therapies or things that are given to the child.

 

00;39;48;04 – 00;39;49;17

Manisha Relan

It’s just elements.

 

00;39;49;19 – 00;39;59;20

Dr. Mona

You know, supplements like I know I think it’s really important. Is there anything that they can do besides going to an allergist waiting this out, reintroduction of food following that, that they can do?

 

00;39;59;22 – 00;40;03;19

Manisha Relan

I think I would just like to reiterate no okay. No, no, no.

 

00;40;03;21 – 00;40;07;04

Dr. Mona

But if they’re on a Facebook group and they’re like, oh, take this, you know, this company.

 

00;40;07;04 – 00;40;09;01

Taylor Arnold

No, no, because I know.

 

00;40;09;04 – 00;40;18;06

Dr. Mona

There’s probably the next couple of years there’ll be some fear based marketing on some supplement. Like you said, doctor Tailor, that’s like, oh, if you have f PiS or food allergies, take this. And I’m very concerned about that.

 

00;40;18;06 – 00;40;21;10

Taylor Arnold

So don’t waste your money. Yeah. Couple hours.

 

00;40;21;10 – 00;40;49;14

Manisha Relan

And we know the most important thing you can do for your child is diet diversity okay. Honestly, you know, encouraging them to eat often also taking their probiotic, getting their other nutrients and making sure they’re healthy and every other way you can control that is more important. And I would say they’re symptom management. So I have met patients of other providers who were diagnosed with f five but didn’t have a actual plan in terms of what to do when the symptoms develop.

 

00;40;49;14 – 00;41;02;11

Manisha Relan

So that is like frustrating. There are, as Doctor Taylor also alluded to, medications out there. Antiemetics, medications to help your child stop vomiting so they don’t get dehydrated. Really important to ask for that doctor.

 

00;41;02;14 – 00;41;06;09

Dr. Mona

Do you do you do you feel that from Jen? Peter from a fellow allergist as well?

 

00;41;06;16 – 00;41;10;05

Manisha Relan

Well, I got it from fellow allergy, okay? I was like, what in the world.

 

00;41;10;10 – 00;41;25;04

Dr. Mona

Is there a way that a family can know, besides obviously talking to their general pediatrician, that there’s an allergist that is more aware an f PiS versus not like, is there a I don’t think there’s obviously no certification or anything like that, but how can they know that their allergist is well versed in this topic?

 

00;41;25;04 – 00;41;43;24

Manisha Relan

I have an I have a thought and I think, Doctor Taylor hit that on the head, which is pediatric. Yeah, yeah. Board-certified pediatric. So, yeah. Making sure that there are pediatrician trained for. So we are very well versed. Yeah. In all presentations of most common looking know kid things.

 

00;41;43;26 – 00;42;01;03

Dr. Mona

Very good to know. Yeah. Well I love that because I agree there’s there’s so many experts. Right. But not everyone is an expert at important things like this. And so, yeah, I think, you know, I want to ask you both your final messages for everyone listening. And one of my final messages would be that sort of advocacy piece.

 

00;42;01;15 – 00;42;28;02

Dr. Mona

I hope people listen to this and understand, like, hey, yeah, my kid has been having this happen. Or maybe they’ll listen to this and it will happen and they’ll be like, wow, no, I know, and, I hope that you take this information to your general pediatrician. If your general pediatrician isn’t feeling, you’re not feeling like they’re, well versed or they’re not listening to you and you’re like, something’s not right, you can either see another clinic clinician at that practice or self-refer or ask, hey, I, I appreciate you, but something is not sitting right with me.

 

00;42;28;02 – 00;42;47;18

Dr. Mona

Do you have a allergy, a pediatric allergist that I can see, to talk to, and then we can kind of touch base from there? I can’t stress this enough, but your pediatrician, like the general pediatrician, should be on your team to figure out what is going on. If you are concerned, my philosophy as a general pediatrician is letting go of ego.

 

00;42;47;18 – 00;43;06;02

Dr. Mona

I think a lot of my colleagues have ego, which I don’t understand, but if a family member or if someone’s coming into me and they’re like, I believe you, but something’s not sitting right, I will do whatever I can. Referral bloodwork, imaging to reassure because sometimes parents need that. And so even if you’re feeling like, I don’t know, I maybe not.

 

00;43;06;02 – 00;43;37;15

Dr. Mona

I don’t want to inconvenience someone. This is your kid. Please know that you can get you need to advocate for them. And the worst case is that or the best case is that it’s nothing. And you know, you got your you got evaluated, but you want to get this stuff early. You know, early intervention. And like Taylor had mentioned, I you know, with introduction of solids and then the avoidance of foods, I want to make sure that you have the right plan so that you’re not avoiding things unnecessary because you read it somewhere, and that you’re also addressing issues like picky eating and things like that so we can give the child the best

 

00;43;37;15 – 00;43;52;21

Dr. Mona

opportunity for food and introduction and advancement and, nutrients and enjoying the feeding experience, albeit with this allergy, and, you know, intolerance, I would say, but, Taylor, I’ll go to you first. What would you say is your final uplifting message for everyone tuning in today?

 

00;43;53;11 – 00;44;15;13

Taylor Arnold

My, well, final uplifting message. Gosh, It’s you. The first time you hear about a phase will be overwhelming, but you’ll be a pro in no time. You will be shocked with yourself at how soon you become a pro at food allergies, at upsize, at managing. You’ll be telling everybody about it. Educating the world and maybe you’ll help somebody else get their diagnosis.

 

00;44;15;13 – 00;44;40;23

Taylor Arnold

But it comes it. It comes faster than you think. And also I want to encourage parents that like if you need support, like if you need that of a therapist, if it’s so stressful to you, don’t feel like that’s just this crazy thing. It’s not like having a kid with allergies is hard. And, that might be a crucial component of this journey is you getting your own support as a parent.

 

00;44;40;23 – 00;44;47;00

Taylor Arnold

But you can do it. It’s it’s doable. It’s hard, but it’s doable. And you’ll be a pro in no time.

 

00;44;47;03 – 00;45;11;23

Dr. Mona

Yeah, you’ll know more than the doctors. And that’s good. That’s like, I knew so much about stroke and seizures. I mean, I was I was a pediatrician, but you will know and it’s and that’s awesome. And it’s okay to say, hey, I learned this and I I’ll be honest, I learned so much from my, my patients, my patients with parents, kids with cerebral palsy, like any issue that I’m seeing in this world, I love being able to ask my family is like, hey, what what is something what happened at the specialist?

 

00;45;11;23 – 00;45;24;21

Dr. Mona

Or, you know, what is something that you wish I wouldn’t have known. And it’s I wish a lot of my colleagues would do that because it is so much growth for us to be able to be better for the next patient who may have that issue. And so I love that. Taylor. What would you say many show?

 

00;45;24;27 – 00;45;47;05

Manisha Relan

I would say that, always be prepared and not scared, you know, like it’s easy to fall into the fear part of it. And even I don’t know everything. So if you need a second opinion, I have a list of board certified allergist that I trust in my community. Ask me and I’m happy to give it to you, but I refer patients out if their f pis is very complicated.

 

00;45;47;05 – 00;46;12;29

Manisha Relan

If they have multiple solid foods, it’s rare, but it happens and I’m not afraid. I’m in private practice, and I’m not afraid to email an academic physician who is an international expert, Nafis, and just say, hi, can I run this by you? And, and we do it for patient advocacy all the way through and through. So listen to your heart and listen to your intuition on that in terms of, you know, a little pun for Doctor Taylor.

 

00;46;15;05 – 00;46;40;22

Manisha Relan

But but really make sure that you feel comfortable. Your questions have been answered. Don’t be afraid to ask more questions after the visit and know where your reputable resources are, because I think there’s so much misinformation mis guidance with supplements as we alluded to earlier. So we’re going to drop some good websites for you, to access some of that and, find a pediatric allergist or pediatric gastroenterologist, like, that’s what we’re here for.

 

00;46;40;23 – 00;46;42;18

Manisha Relan

Get us up in the video to anyone, and I.

 

00;46;42;18 – 00;46;49;29

Dr. Mona

Will be dropping those links. That way you all have them. Manisha, where can everyone go to find you, your social media channel, if you can tell us that?

 

00;46;50;01 – 00;46;53;25

Manisha Relan

Yep. I am Peach Allergy and on Instagram.

 

00;46;53;27 – 00;46;54;20

Dr. Mona

Thank you.

 

00;46;54;20 – 00;47;09;08

Taylor Arnold

And Taylor I’m growing intuitive eaters on Instagram and YouTube. And then I’m doctor Dot Taylor and on TikTok and I will send you a link. I have a whole longer video of like the long story of our journey and allergies. So I’ll send that to you too.

 

00;47;09;08 – 00;47;27;25

Dr. Mona

Yeah. I want, you know, I’m so glad that we can put all that information so everyone feels less alone and feels again empowered, prepared, and not scared. I love that that’s helpful. Thank you both. I will be attaching their Instagram, social media handles, Instagram, TikTok, for for whatever we have here, so that you can check them out, stay up to date.

 

00;47;28;12 – 00;47;46;11

Dr. Mona

Obviously there a wealth of information in their specialties. And obviously Taylor having gone through the personal experience as well. And thank you both for joining me. This was an amazing conversation. I felt that it was so needed, and I was right on that. This was a perfect idea to have the three of us on. And I’m just so glad that we could do this today.

 

00;47;46;14 – 00;47;46;17

Taylor Arnold

Yeah.

 

00;47;46;23 – 00;47;48;21

Manisha Relan

Thank you. Thank you for having us.

 

00;47;48;25 – 00;48;07;18

Dr. Mona

Cause of course, I’m sure there’ll be other topics to have a, three for one again. But thank you. The more you know. Right. What an amazing conversation. And I really wanted to get this conversation out there, because so many people in my community are always asking me, Doctor Mona, can you talk about pies? I feel so alone.

 

00;48;07;18 – 00;48;23;07

Dr. Mona

My child has it. I’ve never heard about it. So I want to promote this awareness. I want to close out today by getting a little personal. As a pediatrician, I’ve seen a lot. I’ve been practicing for ten years at the time of this recording, but I’ll be honest, I’ve missed enough FPIES diagnosis before. I thought it was just a stomach bug.

 

00;48;23;12 – 00;48;46;10

Dr. Mona

It didn’t fit the classic allergy picture, and I didn’t have pies in the forefront of my mind. But my understanding deepened when a close friend went through it with her child. Seeing the emotional toll, the confusion, the frustration, it shifted something in me. Now I know what to look for. And after today, you do too. Whether you’re a parent navigating this firsthand or a provider, teacher or friend, you’re now part of the awareness that helps families feel seen sooner.

 

00;48;46;12 – 00;49;09;08

Dr. Mona

And if this episode brought up concerns for you, advocate, bring it up with your provider. Ask the questions. Push for clarity. No one knows your child better than you. I’d love to hear what resonated most for you today. What’s one takeaway you’re leaving with? Let’s keep the conversation going over on Instagram. Share it on your stories and tag us at the PedsDocTalk podcast at at Growing Intuitive Eaters and at Pete Allergy, MD.

 

00;49;09;10 – 00;49;28;28

Dr. Mona

So we can spread the word. You never know who in your circle needs this info and comment on our post. And don’t forget subscribing. Downloading and sharing helps us podcast reach even more families. Your support is what keeps these honest, meaningful conversations going. Thank you for being here. I appreciate you more than you know. Stay well and I’ll catch you all next week.