Egg Allergy

Egg allergy is one of the most common allergies in children, but most children will eventually outgrow their allergy. It is estimated that by age 6, up to 71% of children will outgrow their egg allergy (1). This does mean that almost 30% of people will remain allergic to eggs for their entire lives.

Of the children with an egg allergy, up to 70% will tolerate egg baked into food (2). When you heat the egg, you can break up the protein enough so that the body doesn’t recognize it as a threat. Consuming eggs in baked foods consistently over time may lead to resolution of an egg allergy over time (3). Since egg is one of the top sources of choline, many parents choose to keep baked egg in the diet if they are able to.

How to Introduce Eggs

As with other allergens, introduce egg as the only new food that day. If you are looking for a more comprehensive guide to introducing allergens, then check out my Allergy Introduction Handbook. Note that some of these foods do contain other allergens (noted with an *).

• Omelet
• Egg quesadilla*
• Fried rice
• Egg banana pancakes
• Banana oat muffins*

Diagnosis

The gold standard for the diagnosis of a food allergy is an oral challenge. While scary, it’s actually an easy test to perform: if the child eats the allergen, do they consistently produce a reaction? If so, they are allergic. Then, to confirm a diagnosis, a doctor may use a blood test or skin prick test. A medical professional should always make the diagnosis as a self-diagnosis can lead to unnecessary restriction.

How to Avoid Egg

It may not be as simple as just not eating egg. Egg can come into contact with other foods during processing. There can be cross-contact in the kitchen if the cook touches egg or egg products and then cooks another dish.

The whites of the egg contain the proteins that most commonly cause reactions, however you will need to avoid the whites and the yolk, because it is impossible to completely separate the egg white from the yolk. Cross-contact will be a concern.

If you are allergic to chicken eggs, your doctor may also have you avoid other animal eggs. Eggs from other birds such as ducks, geese, turkey, or quail may cause a reaction, because the proteins are similar.

It’s very important to always check food labels. Companies need to list egg clearly on the ingredients list in plain language or under the label in a statement that reads “Contains egg.”

Places to Check

Always ask about ingredients in foods that you did not make yourself. When eating at a restaurant, there is always a risk of cross-contact, so it is important to make it very clear that there is an allergy.

Egg on Labels

Any of these terms may indicate that an egg product is present (4):

• albumin
• apovitellin
• avidin globulin
• egg (dried, powdered, solids, white, yolk)
• eggnog
• lysozome
• mayonnaise
• meringue
• ovalbumin
• ovomucoid
• ovomucin
• ovovitellin
• surimi
• vitellin

Other Places to Check

While not always present, egg can be found in baked goods (although some people can tolerate eggs in baked goods), breakfast goods, breads, cake decorations, chips, crackers, egg substitutes, Hollaindaise, ice cream, custard, sorbet, lecithin, marzipan, marshmallows, nougat, pasta, pretzels, salad dressings, souffle, specialty drinks, and tortillas.

Egg Alternatives

There are many alternatives for eggs. You can mix 1 tbsp chia seeds and 3 tbsp water to replace 1 egg in baking. 3 tbsp aquafaba or canned chickpea liquid can substitute for 1 egg as well. You can also substitute applesauce or mashed potatoes. If your child tolerates eggs in baked goods, you can use egg. Exposure may help lead to a resolution of their allergy.

Egg Allergy Symptoms

Although reactions can range from mild to severe, it is usually recommended for all kids with egg allergies to have an epi-pen with them at all times. Epinephrine is used to treat anaphylaxis, a severe reaction to allergies.

This is not intended as medical advice. If you have any concerns about your child, reach out to your physician. If your child is having multiple symptoms or severe symptoms, call 911.

	Mild	Severe
Skin	mild rash, some hives	widespread rash, hives all over the body
Face	itchy mouth, runny nose, sneezing	lip swelling, tongue swelling
Gastrointestinal	nausea	vomiting, diarrhea
Airway	none	coughing, wheezing, trouble breathing

Egg Allergy Ladder

Food ladders, such as an egg ladder, are widely used in Europe for the reintroduction of allergens in children with food allergies (5). Before starting a food ladder, it is very important to discuss with your allergist. Any introduction of an allergenic food should be done under medical supervision.

An example of an egg allergy ladder would be to start with baked goods with egg ingredients. As stated before, up to 70% of children already tolerate these foods. Then you can work towards foods like pancakes or waffles where the egg is cooked into the food, but it is not egg all by itself. Next you would go to a well cooked egg like hard boiled or very well scrambled. Lastly, you could try an egg with runny yolk such as a sunny side up egg.

You give the food daily and start with a very small amount. Over the course of several days or weeks, you increase the amount to a portion that is age appropriate for your child. Once your child is tolerating that portion for at least a month, you can move onto the next stage. If your child has a reaction at a particular stage, you would go back to the previous stage for at least a month.