A Parent's Guide to Egg Allergy
Egg allergy is one of the most common food allergies in young children. And since egg is one of the hardest foods to avoid, egg allergies have a significant impact on quality of life. Here’s what parents need to know about egg allergy, including tips for egg allergy management and prevention.
The new 2020 USDA Dietary Guidelines recommend feeding peanut and egg starting at 4 months to prevent food allergies for every baby, read more here.
Egg allergy is one of the three most common food allergies in young children (along with peanut and milk). It’s also one of the food allergies with the largest impact on quality of life. After all, egg is one of the hardest foods to avoid. Here’s what parents need to know about egg allergy, including tips for egg allergy management and prevention.
What is an egg allergy?
Normally, our immune systems defend and protect us from foreign invaders, like certain viruses and bacteria.
But if your child has an egg allergy, their immune system mistakenly treats the proteins in eggs as foreign invaders. So, it over-defends the body against eggs. Their immune system makes special allergy antibodies, called IgE antibodies, that are designed to fight off the egg proteins. These antibodies trigger a reaction each time your child consumes eggs.
An allergic reaction could range from mild to severe, and could be life-threatening.
Most people with egg allergies have an allergy to the protein in egg whites. But if your child has any egg allergy, they must avoid all parts of the egg---both the white and the yolk. This is because it's impossible to completely separate the egg yolk protein from the egg white protein.
Egg Allergy Testing
Egg allergies can be diagnosed through:
- A skin prick test (where your child's forearm is pricked with a needle containing egg protein, and monitored to see if an allergic reaction develops around the area where the skin is pricked)
- A blood test (where your child's blood is checked for IgE antibodies that respond to egg proteins)
- An oral food challenge (where your child eats small amounts of egg under allergist supervision, to see if they develop an allergic reaction. This is the most accurate way to diagnose an egg allergy.)
Symptoms of an Egg Allergy
Some of the common symptoms of an egg allergy reaction include:
- Skin: Hives, swelling, red rash, itchy skin, worsening eczema
- Gastrointestinal: Stomach pain, vomiting, diarrhea, gas, nausea
- Respiratory: Sneezing, runny nose, nasal congestion, coughing, chest tightness, throat tightness, difficulty breathing, wheezing
- Mouth: Swelling of the lips, swelling of the tongue, itching in or around the mouth
- Eyes: Red, watery, or itchy eyes
- Cardiovascular: Fast heartbeat, low blood pressure, dizziness, fainting
When an egg allergy reaction involves severe symptoms in more than one organ system, this is known as anaphylaxis. Anaphylaxis can be life-threatening. Swelling of the face, tongue or throat, wheezing, breathing difficulty, and significant cardiovascular symptoms may be signs of an anaphylactic reaction. Call 911, and give epinephrine (use an Epi-Pen) immediately, if your child shows signs of anaphylaxis.
Learn more about egg allergy in this video from Food Allergy Research & Education (FARE):
Egg Allergy Trends
Egg allergy is one of the top three allergens affecting young children, along with peanut and cow’s milk. It affects around 2% of all children, around 16% of children 5 years of age and under with food allergies, and around 14% of children 14 years of age and under with food allergies.
Can an egg allergy be outgrown?
Many children may eventually outgrow their egg allergy, or become tolerant to eggs. But some children will not outgrow their egg allergy until their teenage years, and some people have lifelong egg allergies.
Some children will not outgrow their egg allergy until their teenage years, and some people have lifelong egg allergies.
Reports differ on estimates of the percentages of children who outgrow their egg allergy.
A 2007 study found that 4% of children outgrow their egg allergy by age 4, 26% outgrow it by age 8; 48% outgrow it by age 12, and 68% outgrow it by age 16.
According to Dr. Ruchi Gupta's 2011 study, around 55% of kids with a history of egg allergy outgrow their allergy by age 7. Dr. Gupta reported that egg allergy is one of the allergies most likely to be outgrown. But if a child has had a severe reaction to egg in the past, they're less likely to outgrow their allergy.
Egg Allergy Management
If your child has an egg allergy, they'll need to avoid all foods with eggs in them, because even a small amount of egg could cause them to develop an allergic reaction.
Even a small amount of egg could cause them to develop an allergic reaction.
Since egg is one of the 8 major allergens in the United States, food manufacturers must clearly identify if a food contains eggs on the label. They're required to do so under federal law.
Unfortunately, avoiding eggs can still get complicated, because so many foods contain hidden egg ingredients. Egg often appears in unexpected places. So, you'll need to read food labels carefully.
You'll also need to avoid cross-contamination, or the accidental mixing of a food with egg into a food without egg. You'll need to watch out for foods that were processed on the same equipment as foods that contain eggs (these foods will say "may contain eggs" on their labels.)
(Some children with egg allergies are able to tolerate baked eggs, but not eggs in other forms. Your child will need to complete a baked egg challenge with an allergist, though, for you to know if they can tolerate baked egg.)
Hidden foods that contain egg
Common foods that may contain hidden egg include:
- Cake mix
- Baked goods
- Certain breads (brushed with egg wash)
- Battered foods (egg may be used to make the batter stick)
- Pretzels (often dipped in an egg wash glaze)
- Pizza dough
- Ice cream
- Salad dressings
Even most "egg substitutes" aren't safe for people with egg allergy, as they still contain egg proteins (they're made of egg whites without the yolk). Like always, be sure to read the label!
Hidden ingredients that contain egg
In addition to avoiding foods with ingredients that have "egg" in their names (dried egg, powdered egg, egg white, egg yolk), your child will also need to avoid these ingredients, as they're egg-based.
- Silici albuminate
- Any ingredient that starts with "ovo" (as "ovo" is Latin for "egg")
Making sure your child gets enough protein
Since eggs are a common source of protein, you'll need to make sure your egg-allergic child gets enough protein from other sources, such as meats, beans, peas, and milk. If you're concerned that your child isn't getting enough protein, a registered dietitian or nutritionist can help.
The Impact of Egg Allergy (Quality of Life)
Since eggs are so hard to avoid, egg allergy is one of the allergies that has the greatest impact on a child's quality of life. For example, eggs are a common ingredient in ice cream, so many ice cream treats are off-limits to children with egg allergies. Pasta also contains eggs, so spaghetti and macaroni and cheese are off-limits as well. And if a sandwich contains mayonnaise, it's also unsafe for a child with egg allergy.
Things get even more complicated at restaurants, and anywhere your child could eat outside the home, because of concerns about cross-contamination.
Worse, some children with egg allergies (those who can't tolerate baked egg) won't be able to enjoy cake at their friends' birthday parties, or other baked goods that contain egg on special occasions. In addition, some pizza crusts have eggs in them, so that keeps children with baked egg allergies from enjoying pizza with friends and family.
With all of these foods (and more) containing egg, egg allergies can cause children to feel left out. Some children are excluded or bullied because of their egg allergy.
Some children are excluded or bullied because of their egg allergy.
Egg Allergies and the Flu Vaccine
Most influenza vaccines (flu vaccines) also contain a small amount of egg protein. So, people with egg allergies need to stay alert when receiving the flu vaccine.
Even with the eggs most flu vaccines contain, the CDC currently recommends that most children with egg allergies receive the standard flu vaccine for their age. This is because the amount of egg in the vaccine usually isn't enough to cause a severe reaction.
However, if your child has had a moderate to severe allergic reaction to egg before, with any symptom other than hives, you'll need to take special precautions. They should get the flu vaccine in an inpatient or outpatient setting, with a health care provider who knows how to spot and manage a severe allergic reaction. Make sure the health care provider is aware that your child is allergic to egg.
If your child has had an allergic reaction to egg before, and they're over 4 years of age, they can also receive a flu vaccine that doesn't contain any egg. This vaccine is called Flucelvax Quadrivalent.
Egg Allergy Prevention
There is no cure for egg allergies, but thanks to landmark studies, we now know that there is a way to help prevent egg allergies before they start. The landmark PETIT study's results show that introducing babies to egg starting between 4-6 months of age, and continuing to introduce them to egg multiple times per week for at least six months, can significantly reduce their egg allergy risk. This is because, around 4 months of age, babies enter a critical immune window where introducing egg helps them build up a tolerance to it. Waiting to introduce a baby to egg, though, increases their risk of developing an egg allergy.
The landmark PETIT study, and other clinical studies on allergy prevention, prompted the USDA to recommend early feeding of egg in their new Dietary Guidelines for Americans report. The USDA recommends introducing babies to egg as early as 4 months of age, and before they turn one year old, for the best chance of egg allergy prevention.
Ready, Set, Food! makes it easy to follow the PETIT study protocols and international medical guidelines, and safely introduce egg to babies early and often. It’s the only early allergen introduction system that follows the exact egg dosage recommended by PETIT. Plus, it also introduces peanut and milk, the two other most common childhood food allergens, in evidence-based amounts. Learn why Ready, Set, Food! is recommended by 1,000+ pediatricians.
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.