Egg Allergy

Egg allergy is common in babies and toddlers - occurring in 1 -2 % of pre-school children.

This page answers the following questions:

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What are the symptoms of egg allergy in infants and toddlers?

The symptoms include:

  • skin reactions with urticaria (also known as hives) - this is the most common reaction. Read more
  • tummy upset and vomiting - even if the egg makes contact with the skin and is not ingested
  • anaphylaxis which is a serious allergic reaction with breathing difficulty and shock - this is much less common than with other foods such as peanut, other nuts and milk. Read more

The allergic reactions may be:

  • immediate - which occur within a few minutes to an hour of ingesting the egg. These are IgE mediated reactions, so caused by a particular antibody (called IgE) in the body. Read more
  • delayed - which may occur up to 24 hours after ingesting the egg. These are usually non-IgE mediated reactions, so they are caused by an immune response but it doesn't involve IgE

Some children only have a reaction when egg touches the skin and not when they eat it, while some children only have problems with raw egg and can manage cooked egg. This is because cooking changes the shape of the protein and can make it less likely to set up a reaction. Stomach acid can also alter the shape of the protein.

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How do you test for egg allergy?

As mentioned on the main food allergy page, the best test is what happens when your child eats the egg.

There are some tests that may be useful for IgE mediated reactions and these include:

  • skin prick tests - read more
  • blood tests such CAP RAST, EAST

Unfortunately there are no reliable tests for non-IgE egg allergy. This is why the history of what happened is so important.

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Can a baby have an allergic reaction to egg the first time she has it?

Yes, the first time a baby has egg or even the first time there is skin contact with egg, she can get an allergic reaction. The most usual sign of allergy in this case is a rash with redness and itch which is known as urticaria or hives.

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Why does my toddler get hives when egg touches her face but doesn't seem to react when she eats it?

Some of the proteins that cause the allergic reaction are altered by stomach acids so that they no longer set up the allergic reaction once the protein reaches the stomach.

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Why can my toddler tolerate egg in cookies but not a soft-boiled egg?

The egg protein that sets up the allergic reaction can be altered by heating, so egg that is heated well, like in cookies, has altered protein that is unable to set up the allergic reaction. It is always worth while trying cooked egg (eg. cookies) even if more raw egg (like soft boiled eggs) gives a reaction as long as your child has not had an anaphylactic reaction to egg in the past.

If your child has had an anaphylactic reaction, re-introduction of the food should only be done with medical supervision.

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Can my egg allergic child have chicken?

Yes, there is no need to avoid chicken even if your child is allergic to egg.

Usually, egg allergic children can tolerate eggs from species other than chickens, so they can tolerate quails' and ducks' eggs.

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Why does my child's eczema get worse after eating eggs?

Most children with eczema do not get worsening eczema when they eat eggs.

However, some children (particularly babies with severe eczema) do have a delayed reaction to egg where the eczema gets worse. In these cases, removing egg from the diet does improve the eczema. This is likely to be a non-IgE mediated reaction.

Over time, it is likely that your child will tolerate egg without it worsening the eczema so it is worthwhile trying egg again every six months or so.

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Should I avoid egg if I am breast-feeding my baby with eczema?

It is not clear whether removing egg from your diet if you are breast-feeding will improve the eczema, but if your baby has severe eczema, you could try for 2 - 4 weeks and see if it makes a difference for her.

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What foods should be avoided if my child is allergic to egg?

If your child is allergic to egg, she should avoid foods containing the following:

  • egg
  • eggnog
  • albumin (albumen)
  • mayonnaisse
  • meringue
  • surimi
  • pasta (if made with egg)
  • lysozyme

As mentioned already, some children can tolerate cooked egg but not raw egg or they can tolerate egg yolk but not egg white.

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Will my child need Epinephrine (Adrenaline)?

Children who have had an anaphylactic reaction to egg will require epinephrine (adrenaline) which can be given in an auto-injector (such as EpiPen or AnaPen). If your child has just had a skin reaction or swelling of the lips with egg, but has not had any problems with breathing or shock, she will not generally need Epinephrine (Adrenaline).

Generally, if the initial reaction to egg is mild then it is unlikely there will be a future serious reaction such as anaphylaxis.

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Which part of the egg causes more allergy?

Children can be allergic to the proteins in the white and the yolk (yellow) of the egg. However, allergy to the white (albumin) of the egg is more common. If you are introducing egg to your infant or toddler, generally start with the yolk (yellow).

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Can my child have the MMR vaccine if she is allergic to egg?

Yes. In the past, there was some controversy over MMR (measles, mumps, rubella) vaccine and egg allergy. However, it is now agreed that being allergic to egg is not a reason to miss the MMR vaccination.

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Are there any vaccines that need to be avoided in egg allergic children?

Yes. The influenza vaccine may cause a reaction in children with egg allergy and so it must only be given with caution. If your child has had an anaphylactic reaction to egg, influenza vaccine would be generally avoided all together. If it is absolutely necessary to give influenza vaccine to an egg allergic child, there are guidelines on how it should be given.

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Will my child grow out of her egg allergy?

Most children do grow out of egg allergy.

Most will do so by school-age and some children take a little longer. Only a small number of children will have life-long egg allergy.

Once your child has shown she can tolerate eggs, it is important that there is continued exposure to egg to ensure she remains able to eat it without problems, so it's important that there is a regular "dose" of egg.

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Will avoiding egg during pregnancy reduce the risk of egg allergy in my child?

No, there is no evidence that you can prevent egg allergy in your child by avoiding egg during pregnancy. During pregnancy, it is important to have a healthy well-balanced diet.

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Will delaying introduction of egg beyond 12 months of age reduce the risk of egg allergy in my child?

There is no evidence to support the delaying of allergenic foods, like egg, beyond 12 months. Some studies even suggest that delay beyond 12 months increases the chance of allergy.

Best evidence at the moment is that egg can be introduced at the usual time, so start giving egg yolk around 7 - 8 months.

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References

  • Kemp A. Egg Allergy. Pediatr allergy Immunol 2007; 18: 696-702
  • Allen CW et al. Egg allergy:Are all childhood food allergies the same? J Paed Child Health 2007 (43) 214-218

To go to the top of the Egg Allergy page, click here

To go to the main Food Allergy page, click here

To go to the main Allergy page, click here

To go to the Skin Prick testing page, click here

To go to the Eczema page, click here

To return to the Home page, click here


Last reviewed 11 April 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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