Tiny Case Study: A Mother's Intuition Shapes a Family's Journey with FPIES


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Our gut health report gives you deep insights into your baby's gut health. See a sample

From choosing the right birth plan to weeding through an avalanche of dietary advice, parenting is an adventure like no other. When it comes to your child's health, you'll do whatever it takes to ensure their well-being. Sometimes, your experiences are so profound you could fill the pages of a book. That's precisely what happened to Angelika Sharma, a member of our Tiny community. During the pandemic, she welcomed her baby girl Annika and later wrote a book about navigating her daughter’s severe food allergies.

During a candid conversation with our team, we dove into Angelika's story of resilience and perseverance. She shows us that a mom's intuition is like a secret superpower, finding a way forward. If you're a parent grappling with your baby's food allergies, we hope you come away with helpful insights that empower you on your journey.

When a solid food milestone goes awry 

Starting solids is a big deal for parents—it's one of those signs that your little one is growing up. Angelika was excited about this new chapter with Annika, introducing wholesome foods like avocado, banana, and sweet potato. Little did she know, her excitement would soon turn into concern as Annika immediately started showing signs of a rare and complex condition called Food Protein-Induced Enterocolitis Syndrome (FPIES).  

FPIES is a rare, distinct allergic condition affecting infants and young children. According to the American Academy of Pediatrics, FPIES occurs in about 0.5% of infants in the US [1]. We know that FPIES is more common in babies who have been exposed to antibiotics during pregnancy and infancy, increasing their levels of unfriendly bacteria [2].

Unlike typical IgE-mediated food allergies, which often present immediate symptoms like hives or swelling, FPIES reactions are delayed. They frequently culminate in violent vomiting, diarrhea, and potentially life-threatening dehydration hours after consuming the trigger food. This delay can make FPIES particularly difficult to diagnose and manage. 

For Angelika’s family, the initiation into their FPIES journey had a Groundhog Day-like quality, with the same agonizing outcome.

"The first few spoonfuls, she seemed just fine. And then, suddenly, she would violently vomit. It was like a water fountain coming out of her, like long-distance walls covered. It was so bad and hard to watch. We bathed and changed her into fresh pajamas. And then it happened again. And again. And again. Until we were out of clean bedding," Angelika recalled.

Navigating a misdiagnosis, the FPIES maze, and food trials during a pandemic 

When Angelika brought Annika to the doctor, they dismissed her symptoms as a common stomach bug. But Angelika’s intuition told her something more was going on. Unlike a bug, Annika's symptoms weren't improving. Each allergic episode was a little scarier than the last. 

Angelika and her husband brought Annika to the emergency room twice in the following months for dehydration from FPIES and anaphylactic shock from her IgE-mediated allergy to egg. They were referred to a pediatric gastroenterologist who was the first to suggest that it might be FPIES despite offering limited options. "It happened during COVID, so no vaccines yet, and I'm there with a six-month-old baby with no mask. Anxious times for us," Angelika shared.

One of the most complex parts of Angelika's journey was feeling helpless. Annika was born through an intervention-free vaginal birth and exclusively breastfed. Angelika thought she had done everything right. So, it was bewildering and emotionally crushing to see her daughter struggle with each episode of FPIES.

Annika's growing distrust of food made mealtime more challenging. And because FPIES isn't straightforward, she followed pediatric advice to do food trials: "For the next two years, I kept finding more and more triggers. You only eat safe foods you already know they can eat, so you're constantly cooking from scratch." 

To support her daughter’s needs, Angelika even quit her job and took to freelance writing.  “This way I am flexible enough to be there if she has doctor appointments, specialist visits, is sick or were to have a reaction, I am available. This was a big life change for me and certainly an identity shed,” she shared.

Then, a breakthrough. A Tiny Health ad appeared on Angelika's feed, resonating with her hunch about Annika's persistent gut issues. The baby microbiome test confirmed her suspicions: Annika's gut bacteria were out of balance. "My instincts had always told me it was her gut because she hadn’t had one normal diaper her entire life. Because of her persistent bowel issues, it was just never solid," Angelika said.

Big revelations from a Tiny baby gut test

Annika's first Tiny Health microbiome test results revealed a striking imbalance: only 27% of her microbiome contained beneficial bacteria, and an overabundance of variable microbes was found—over 38% of her sample, in particular, was the variable bacteria species Phocaeicola vulgatus

A snapshot of Annika's first gut test revealed a significant lack of beneficial microbes and an overabundance of certain species, dominated by the variable bacteria Phocaeicola vulgatus.

Being a pandemic baby, Annika also had a complete absence of unfriendly, immune training microbes that little ones are often exposed to in their environment. This new insight and her Action Plan gave Angelika something to hope for.

Annika’s baby gut test detected absolutely no disruptive bacteria that help train a baby’s immune system [3].


Course correcting Annika’s gut imbalances with personalized support

Next, Angelika scheduled a consultation call with Tiny Health’s medical director, Dr. Taylor Soderborg, who helped her customize her Action Plan for improving Annika’s microbiome. Together they reviewed the priority findings in Annika’s report. 

They looked at the probiotic species found in the coconut yogurt Annika enjoyed. Taylor recommended a Bifidobacterium supplement along with HMOs and walked her through the possibility of Angelika taking these supplements herself so that Annika’s gut might benefit through her breastmilk. With so many allergies and sensitivities to navigate, Angelika was relieved to find recommendations for probiotics that were allergen free. She also found value in practical diet suggestions, like trying pomegranate and carrot, as well as fermented foods to try.  

Tiny Health’s personalized Action Plan provides unbiased recommendations for probiotics, supplements, dietary changes, and lifestyle tips to restore balance to the microbiome.

This focused approach brought about noticeable improvements. "Within six weeks, Annika's diapers were normal," Angelika recounted—the first time since she was born almost two years ago. That moment of deep relief confirmed that Angelika was on the right path. And it was the inspiration for her new mantra, "The proof is in the diaper." 

"Working with Tiny Health was so incredibly helpful. It changed everything. In Annika’s follow-up test, her good bacteria level was way up. The action plan worked—the overabundant [bacteria] had decreased,” Angelika said.

After implementing changes, Annika’s gut microbiome shifted over time toward a greater percentage of beneficial bacteria, with greater diversity in species.

The ripple effect of improving your baby’s gut

Beyond digestive issues, Annika's speech had been delayed. But the next time Angelika and her daughter visited the speech therapist, they couldn't explain how she was suddenly talking in complete sentences.

“I also saw her other symptoms resolving—her inflammation, gas, and irritability were gone. And it all coincided with her improved gut health," Angelika said. 

Annika's condition didn't come with a guidebook, so connecting with other parents struggling on the same path helped. To make the exhausting days less isolating, Angelika found solidarity and helpful tips from resources like The FPIES Foundation for a broad range of FPIES specific resources in the early days, and The Natasha Allergy Research Foundation for day-to-day useful allergy content.

When Annika's gut issues improved, Angelika wanted to offer hope to families unable to find answers through conventional channels. She understood the challenges of sleepless nights, constant worry about food triggers, and the frustration of limited information. "I wrote A Mother's Guide to FPIES to help other parents in the same situation. It's the book I wish I'd had."  

Angelika's deepest wish for her daughter is simple: "I want her to have a happy, healthy life and that she never has to fear food again." This hope includes a world where Annika fully outgrows her dietary allergies.

These day’s Annika’s quality of life is just like any other 3-year-old’s, aside from avoiding certain allergens. And now that Annika is potty trained, Angelika’s favorite saying, “The proof is in the diaper,” takes on a whole new meaning. It reminds her how far they've come on their FPIES journey and how grateful she is for trusting her instincts and persevering.

Ready to test your instincts? 

Navigating food allergies or FPIES on your own can feel overwhelming. If you’re wondering about your little one’s gut health, our Baby’s Gut Program may help you uncover underlying imbalances contributing to your child’s chronic conditions. And with 1-on-1 consultations with microbiome specialists, we're committed to supporting you with personalized guidance every step of the way.

It’s important to note that Tiny Health gut microbiome tests cannot detect specific food allergies or sensitivities. However, they can identify imbalances that may contribute to symptoms—like they did in Annika’s case. 

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[1] A. Nowak-Wegrzyn et al., "Food protein-induced enterocolitis syndrome in the US-population-based study," J. Allergy Clin. Immunol., vol. 144, no. 4, pp. 1128-1130, Oct. 2019. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923683/. [Accessed: February 18, 2024].

[2] J. Boyer, L. Sgambelluri and Q. Yuan, "Association of Antibiotic Usage With Food Protein-Induced Enterocolitis Syndrome Development From a Caregiver’s Survey," JPGN Reports, vol. 2, no. 4, p. e132, 2021. Available: 10.1097/pg9.0000000000000132.

[3] T. Vatanen et al., “Variation in Microbiome LPS Immunogenicity Contributes to Autoimmunity in Humans,” Cell, vol. 165, no. 4, pp. 842–853, May 2016, doi: 10.1016/j.cell.2016.04.007.