FPIES food challenge information

Food Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE mediated food allergy most commonly presenting in infants.

A food challenge takes approximately 5-6 hours in total.

Prior to the challenge we usually place an intravenous(IVI) cannula to ensure we are able to treat profuse vomiting with IVI fluid if it occurs. The challenge involves eating a dose of the food followed by a 4-hour wait to observe for an FPIES reaction.

If your child has a reaction in food challenge you may need to stay longer to ensure the reaction has resolved. Bring a change of clothes, in case of vomiting.

A parent or legal guardian must accompany the child to the food challenge to give Medical Consent. A grandparent, unless they are a legal guardian, cannot attend in place of a parent.

Only one parent or legal guardian can attend a food challenge as the ward area is small. Unfortunately siblings can't attend.

The food challenge ward is a busy environment with an average of 10-15 children eating a variety of different foods.

Your child may witness another child having an allergic reaction during the food challenge. If you feel this might distress you or your child, please talk to the nurse before your child's appointment.


Before the food challenge

Your child should not have any antihistamine or oral steroids for 3 days prior to the food challenge.

This includes cold medications and antihistamines such as Claratyne, Phenergan, Zyrtec and Telfast, or oral steroids such as Redipred or Predmix.

If your child is taking asthma preventer medications such as Singular, Flixotide or Seretide they should continue taking this medication to ensure asthma is well controlled for food challenge.

On the day of the challenge

On arrival, please go to Ward C1N, Medical Day Unit, Level 1, Sydney Children’s Hospital.

The clerical staff will ask you to complete admission paperwork before going to the food challenge room.

Bring some fun activities for your child to do, as it is can be a long day and your child will not be able to leave the Ward. Free WIFI is available.

Challenge foods

The hospital provides cow’s milk but all other foods required for challenge you will need to bring on the day.  

  • For egg challenge: please bring one cooked egg (boiled, fried, scrambled, omelette)

  • For rice challenge: please bring a small serving of cooked rice (boiled, fried, steamed, rice cereal or rice cakes-unflavoured

  • For fish or chicken challenge: please bring a small serving size of cooked fish or chicken (boiled, fried, steamed)

  • For fruit/vegetable challenge: please bring a normal serving size of either cooked or raw fruit or vegetable



Food to bring

Please bring your child’s favourite food to mix with their challenge food. For egg or seafood challenges, add savoury food like pasta, rice crackers or sandwiches.

Please also bring a normal diet for lunch, morning/afternoon tea for you and your child


In an emergency

Severe reactions to medicines are very rare if your child has tolerated the challenge dose in hospital.

If you are worried your child is having a severe reaction to the medicine, please call an ambulance (000) or present to your nearest Emergency Department without delay.

Last updated Monday 25th March 2024