"The day I poisoned my daughter."

How this woman became one of those “hovering mums”…

When my daughter Isla was 5 months old, I fed her ‘poison’ without realising it.

One day at lunchtime, I mixed baby rice cereal with breast milk and spooned the mixture into Isla’s mouth. She puckered up her face and spat it all out. I persisted and, using the old airplane trick, I managed to get a spoonful of cereal in her mouth. I was satisfied.

That afternoon, Isla woke from her nap screaming. I raced to her cot to find her lying in a puddle of vomit.

Eventually, what remained in her tummy exploded inside her nappy. She must be getting sick, I thought. I waited a few days and, when no illness developed, I fed Isla rice cereal once more. And although she didn’t seem overly pleased by the taste, she swallowed two spoonfuls. Progress.

A couple of hours later, Isla began vomiting profusely.

She continued to vomit until she brought up bile. She must be getting really sick this time, I thought as I rushed her into the car. On the way to the doctor’s, while Isla heaved and spluttered in the back seat, I wondered whether the rice cereal was to blame. But when I told the doctor about my concerns, he assured me that rice was hypoallergenic. So, I dismissed my niggling instincts and accepted his diagnosis that Isla had gastro. But the ‘gastro’ symptoms mysteriously disappeared overnight.

I was so utterly convinced that rice cereal was a safe, essential first food for babies, that I fed it to Isla again.

After all, health practitioners recommend it, generations of mothers have relied on it and, well … everyone in my Mother’s Group was feeding their babies the same thing. Of course, you can guess what happened next. Cue vomit.

It was around this time that the dermatologist treating Isla’s eczema (atopic dermatitis) referred her to an allergist, as eczema is often linked to food sensitivities.

To assess whether Isla had any Immunoglobulin E (IgE)-mediated allergies, the allergist performed a skin-prick test. Isla’s test results showed positive reactions to cow’s milk, egg, almond and peanut. The allergist explained that if Isla ingested these foods, she would likely experience the itching, swelling, hives and vomiting that characterise a mild to moderate allergic reaction. We would need to administer antihistamine immediately. While the allergist prepared an Action Plan for Anaphylaxis and showed me how to use an EpiPen^®, I told him about the ‘gastro’ symptoms Isla had exhibited after eating rice cereal.

“How long after you gave her rice cereal did she vomit?”

“A couple of hours.”

“Hmmm,” he said. “And this happened how many times?”

“Er … three times.”

“It sounds like Isla has FPIES to rice.”

Food Protein-Induced Enterocolitis Syndrome, or FPIES (pronounced ‘F-Pies’), is a rare cell-mediated allergy that affects the gastrointestinal tract. Unlike IgE-mediated allergies, which usually trigger a rapid immune response, an FPIES reaction is isolated to the gut and leads to delayed vomiting and diarrhea, typically 2-4 hours after the offending food is ingested.

In extreme cases, an FPIES reaction can cause pallor, lethargy and shock. Because FPIES reactions pose the risk of dehydration, treatment may include intravenous fluids administered in hospital. A range of foods can trigger a FPIES reaction, including cow’s milk, soy, oats, barley, sweet potato, chicken. And rice.

This is where the story gets complicated, and simultaneously clearer. Patients with FPIES typically return negative results in standard skin and blood allergy tests, so there was no way of confirming the allergist’s clinical diagnosis that Isla had FPIES to rice other than feeding it to her. So I accepted the diagnosis, with a measure of relief, because it confirmed what I had suspected all along.

I left the allergist’s office with a resounding question in my head: what on earth was I going to feed Isla? So many of the foods the rest of the family loved would be harmful to her. Goodbye cow’s milk, yoghurt and cheese. Farewell rice crackers, Nutella and peanut butter. So long sausages, quiche and risotto. No … not risotto! The family favourite.

That day was the beginning of my allergy awakening. I understood, then, why some mothers hover over their children at social gatherings; why some mothers read food labels like they are riveting novels; why some mothers seem more ‘nuts’ about food than others.

I understood those mothers because I had become one of them. I was now keenly aware that certain foods were poison to my child. And like the astute mother who keeps household chemicals out of reach of her children, it became my mission to keep cow’s milk, egg, nuts and rice away from Isla. For my little girl, ingesting these foods could prove fatal.

Our society is becoming increasingly respondent to allergens such as wheat, dairy, egg and, in particular, nuts. But many people (like me, rewind 2 years) continue to believe that rice is hypoallergenic. It’s because of this myth that rice flour is used as a food thickener in sausages and meat patties, in the coating of frozen foods, in biscuits, crackers and a whole array of other everyday foods. Rice flour is probably used in a range of take-away foods, too, but I haven’t been able to confirm this because it isn’t mentioned on allergen lists.

When Isla was 2-and-a-half, she participated in a modified oral food challenge where she ate rice under the supervision of her allergist, in hospital. After feeding Isla a cup of boiled rice, and waiting an uneventful four hours, she was discharged. Isla no longer had FPIES to rice.

I rushed home to make risotto, but I thought perhaps Isla had eaten enough rice for one day. So I made it the next day instead. I fed Isla a spoonful, she puckered up her face, and spat it out. All over me. I probably deserved it, for feeding her rice cereal not once, but three times.

If you have any concerns about your child and allergies, please see your local GP. For more information on FPIES, please go here and here.

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