A seven month old, exclusively breast fed female infant, presented to the Allergy and Immunology clinic with a history of repetitive projectile emesis after consuming prune puree at four and a half months of age. She was born after full term gestation from spontaneous vaginal birth after an uncomplicated pregnancy, with a birth weight of 3.253 kg. Before presenting to the Clinical Immunology and Allergy clinic, she was diagnosed with idiopathic epilepsy at 3 months of age, and was started on phenobarbital 5 mg/ml with complete resolution of her seizures. She began complimentary feeding with wheat based cereal at four months of age with good tolerance. She was subsequently introduced to various fruit purees, including pear, strawberry, banana, peaches, orange, and apple with good tolerance. She was given prune puree mixed with wheat cereal, and within 2 h, had repetitive projectile emesis. There was no diarrhea, nor any symptoms consistent with IgE mediated food allergy. No other specific triggers were identified. Following emesis the infant displayed signs of lethargy for 2 h, however, recovered at home without any medical intervention. She was given prune puree again 2 weeks later with no other foods, and developed repetitive, projectile emesis. No history of allergic rhinoconjunctivitis, or asthma was identified. The infant had a background history of mild atopic dermatitis, more frequently seen in young children with FPIES. Investigations revealed negative skin prick testing to prune puree. On the basis of her history, a clinical diagnosis of FPIES to prunes was made, and the infant had no further episodes of vomiting strictly avoiding prunes and plums in their diet. She has not developed FPIES or IgE mediated hypersensitivity to any other foods. After a patient centered discussion, the decision was made to strictly avoid plums and prunes, and to challenge the infant to prunes when she reaches 3 years of age.