Egg allergy is one of the most frequently encountered food allergies in the pediatric population. This condition occurs when a baby’s immune system mistakenly identifies the proteins in egg white or egg yolk as harmful. The body launches an immune response, typically involving the release of histamine, which results in various physical symptoms. Since eggs are a common ingredient in foods introduced during the first year of life, understanding this allergy is important for infant safety.
Understanding the Frequency of Egg Allergy
Egg allergy is among the most common food allergies affecting children, often second only to cow’s milk allergy. The prevalence is estimated to be about 1.3% among children younger than five years old in the United States, peaking at around 2% in children between one and two years of age. The allergy typically begins when eggs are introduced into the diet, often between six and fifteen months of age. While common in infancy, the prognosis is favorable, as studies indicate up to 80% of children may outgrow the allergy by the time they reach school age.
Identifying Allergy Signs and Diagnosis
Reactions to egg protein are typically mediated by Immunoglobulin E (IgE) antibodies and manifest rapidly, usually within minutes to two hours after ingestion. Symptoms can affect multiple body systems, ranging from mild skin irritations to severe, life-threatening reactions. Mild reactions often involve the skin (hives, welts, facial flushing, or worsening eczema) or the gastrointestinal tract (vomiting, abdominal pain, and diarrhea). Respiratory symptoms may include a runny nose, sneezing, coughing, or wheezing. The most serious reaction, anaphylaxis, is a multi-system response that can constrict airways and cause a sudden drop in blood pressure.
A medical professional, such as an allergist, confirms the diagnosis using a combination of methods. The process begins with a detailed medical history, including the specifics of the reaction and the timing of symptoms. Diagnostic tools typically involve skin prick tests and blood tests that measure egg-specific IgE antibodies. The skin prick test involves applying egg protein extract to the skin to check for a localized reaction, but a positive result does not always confirm a clinical allergy. The definitive method for diagnosis is an oral food challenge, which is conducted in a medical setting under direct supervision.
Immediate Management and Treatment
Once an egg allergy is confirmed, the primary strategy is the strict elimination of all egg products from the child’s diet. This includes obvious sources and hidden ingredients in many processed foods, such as baked goods, pastas, and sauces. Parents must become diligent label readers, watching for alternative names for egg like albumin, lysozyme, ovalbumin, and globulin. Cross-contamination is a significant concern, as trace amounts of egg protein transferred from utensils or shared fryers can trigger a reaction. Some children may tolerate eggs in a highly baked form, but this must only be determined by an allergist.
Parents should work with their pediatrician and allergist to develop a personalized Allergy Action Plan outlining the steps for treating an accidental exposure. For severe reactions like anaphylaxis, the first-line treatment is an injection of epinephrine. Training in the proper and immediate use of this device is a necessary component of the management plan. Since eggs are a source of protein, vitamins, and minerals, consulting a pediatric dietitian is important to ensure nutritional balance. Safe substitutes in baking can include mashed banana, applesauce, or a mixture of ground flax seed and water.
Current Guidelines for Egg Introduction
Current pediatric recommendations favor the early introduction of allergenic foods to prevent the development of allergies. For infants who are not considered high-risk, eggs can be introduced as soon as they begin eating solids, typically around six months of age. Introduction should not be delayed past the first year of life, as this delay is associated with an increased risk of developing an egg allergy. For high-risk infants (e.g., those with severe eczema or an existing food allergy), early introduction between four and six months of age is particularly important and should be discussed with a healthcare provider.
When introducing egg, it must be fully cooked to reduce the risk of foodborne illness. It should be presented in an age-appropriate, non-choking form, such as a well-cooked, mashed portion mixed into a puree. The egg should be offered in small amounts initially, followed by regular inclusion in the diet if tolerated. Parents should always consult their pediatrician before beginning the introduction of any highly allergenic food.