FPIES, FPIAP and milk protein allergy: what the names mean
Parents of a baby with a food allergy often meet several names that sound alike. Here is what each one means, and how they are related.
This page will not tell you which of these a child has. Only a doctor can make that diagnosis. If you are ever worried about your child, get medical help straight away.
Milk protein allergy (CMPA)
Cow's milk allergy is also called cow's milk protein allergy, or CMPA. It means the immune system reacts to the proteins in cow's milk.
It comes in two main kinds. In the immediate kind, called IgE-mediated, reactions usually start soon after the food. In the delayed kind, called non-IgE-mediated, reactions come hours to days later and mainly affect the gut. Some conditions involve both kinds; doctors call them "mixed".
The delayed kind is the most common milk allergy in babies and young children. FPIES and FPIAP are two of its forms.
Lactose intolerance is something else: it does not involve the immune system, so it is not an allergy.
FPIES, FPIAP and FPE
All three names begin "food protein-induced". The rest of each name says which part of the gut is inflamed.
- FPIES
Food protein-induced enterocolitis syndrome
It can affect the whole gut.
What FPIES is - FPIAP
Food protein-induced allergic proctocolitis
The inflammation is in the rectum and the last part of the colon, the lowest part of the gut. It is the most common of the delayed forms.
- FPE
Food protein-induced enteropathy
A third, less common form. It mainly affects the small intestine.
What they have in common
Cow's milk causes most cases of all three, but other foods can cause them too.
The usual allergy tests look for IgE, so they are generally negative in all three.
All three are diagnosed mainly from what happened: the symptoms, and how they changed when the food was taken out and, where the doctor plans it, given again.
Some researchers think of them as one family, which differs by the part of the gut affected.
Only a doctor can tell them apart
The names describe different conditions, which settle at different speeds and usually last for different lengths of time. A child can also have more than one kind of food allergy at the same time.
That is why the diagnosis, and the plan that follows it, belong to the child's doctor. Because the diagnosis rests on what happened, a written record of each food, when it was given and what followed is worth bringing to the appointment.
A free printable log and chart
Every food on one page, a box for each exposure. Free, no sign-up.
Download the printable (PDF)Tummy Tales keeps the same record
- Works out the time between a meal and a reaction
- Reminds you, in your own words, at the time you choose
- Makes one plain report for the appointment
Do they go away?
Most children outgrow FPIAP between their first and second birthdays, according to a children's hospital's guide for parents, and a review of the research agrees.
For FPIES, see the guide below. Whether a child has outgrown either is for their doctor to decide.
Does FPIES go away?