Table 7.
Empiric guidelines for selecting weaning foods in infants with FPIES [1]
| Ages and Stages | Lower risk foodsc | Moderate risk foodsc | Higher risk foodsc |
|---|---|---|---|
|
4–6 months (as per AAP, CoN)
If developmentally appropriate and safe and nutritious foods are available. ➢ Begin with smooth, thin, purees and progress to thicker purees ➢ Choose foods that are high in iron ➢ Add vegetables and fruits |
Vegetables | ||
| Broccoli, cauliflower, parsnip, turnip, pumpkin | Squash, carrot, white potato, green bean (legume) | Sweet potato, green pea (legume) | |
|
6 months (as per WHO)
Complementary feeding should begin no later than 6 months of age. ➢ In the breast fed infant, high iron foods or supplemental iron (1 mg/kg/day) is suggested by 6 months of age. ➢ Continue to expand variety of fruits, vegetables, legumes, grains, meats and other foods as tolerated. |
Fruits | ||
| Blueberries, strawberries, plum, watermelon, peach, avocado | Apple, pear, orange | Banana | |
|
8 months of age or when developmentally appropriate. ➢ Offer soft-cooked and bite-and-dissolve textures from around 8 months of age or as tolerated by infant. |
High iron foods | ||
| Lamb, fortified quinoa cereal, millet | Beef, fortified grits and corn cereal, wheat (whole wheat and fortified), fortified barley cereal | Higher iron foods: Fortified, infant rice and oat cereals. |
|
|
12 months of age or when developmentally appropriate. ➢ Offer modified tolerated foods from the family table-chopped meats, soft cooked vegetables, grains and fruits. |
Other | ||
| Tree nuts and seed buttersc (sesame, sunflower, etc.) cThinned with water or infant puree for appropriate infant texture and to prevent choking |
Peanut, other legumes (other than green pea) | Milk, soy, poultry, egg, fish | |
This table should be considered in the context of the following notes:
aExclusive breast feeding until 4–6 months of age and continuing breast feeding through the first year of life or longer as long as mutually desired by both mother and child [17]
bIf an infant tolerates a variety of early foods, subsequent introduction may be more liberal. Additionally, tolerance to one food in a food group (green pea) is considered as a favorable prognostic indicator for tolerance of other foods from the same group (legumes) [18]
AAP, CoN American Academy of Pediatrics, Committee on Nutrition, WHO World Health Organization
cRisk assessment is based on the clinical experience and the published reports of FPIES triggers