Hi all. My 6 month old daughter has had food sensitivities since birth. She was exclusively breastfed up until about 5 months, and I have been on a restricted diet for the majority of that time (excluding the top 8 allergens) for MSPI and other suspected allergies. She's always been a good eater, though, and has been gaining weight normally.
At five months, we started to introduce solids. We introduced rice cereal first, which (a) she didn't care for, and (b) constipated her. We switched to oatmeal, which she loved and did well on for about two weeks (we usually fed her about 5 pm). In the third week since introducing oatmeal, she started vomiting in the evenings shortly after going to bed--usually just once--and had bouts of diarrhea off and on. Then, about a week ago, we added pears to her oatmeal and she had a severe reaction about 2 hours after she ate (about an hour of repeated vomiting, followed by an hour or so of vomiting bile and dry heaving. She was also very lethargic, falling asleep in her bath and on her changing table, which she never does). We took her to the ER and were told it was likely a virus, given pedialyte, and sent home. The next day, she again had severe diarrhea.
Because of her food allergies, I suspected that the "virus" may actually have been an allergic reaction, so we waited several days to try pears again. This time, we offered just pears (mixed with fresh breastmilk only) around 11 am, and had no reaction after several hours. At that point, we felt comfortable that the vomiting had been a virus, and went ahead and gave her oatmeal around 5 pm. Around 7 pm, the vomiting started again. First, an hour of vomiting foods followed by an hour of bile and dry heaving. And, again, very lethargic.
I've done my research and it seems like her symptoms are textbook FPIES, but I'm a little confused about the trigger food -- oatmeal or pears? I know oatmeal is a more common trigger, but is it likely that she would tolerate oatmeal at first and then have a reaction a couple of weeks later? Or is it more likely that the pears are the culprit, and the reaction was just more delayed the second time around? Any experience would be helpful--I'm terrified to give her either one again but feel like it's the only way to pin this down!