How to Detect and Manage Egg Allergy in Babies

Eggs can be introduced from 6 months of age, just like practically all other foods.  

There is no evidence to justify delaying the introduction of potentially allergenic foods according to ESPGHAN, as it does not prevent allergy risk.

In fact, recent studies say that introducing eggs (and other allergenic foods) early in the first months of complementary feeding may protect against future allergies. It was previously thought best to delay consumption of foods like dairy, fish, nuts, and eggs to avoid allergies.  

However, the most recent studies indicate that the earlier these products are consumed, the fewer adverse reactions occur. These recommendations apply regardless of the child’s family or personal allergy risk.  

Some symptoms that often occur when a baby has an allergic reaction may be:

Skin symptoms: perioral erythema, hives, swelling of lips and tongue. 

Respiratory symptoms: bronchospasm, cough, feeling of suffocation. 

Digestive symptoms: vomiting, abdominal pain… 

If your baby shows any signs of an allergic reaction, stop feeding immediately and go to the emergency room. Once the allergic episode has passed, visit the baby’s pediatrician or allergist to get a clear diagnosis of the allergy and to receive guidance and advice. 

Practical tips for introducing it in complementary feeding

As a potentially allergenic food, it is recommended to introduce it in a special way. When we talk about egg allergy, we can refer to an allergy to the egg white (most common, as it contains the most allergenic proteins), the whole egg, or only the yolk (less frequent).

On the other hand, some proteins are thermolabile, meaning they change the likelihood of causing allergy symptoms when exposed to high temperatures, and for this reason, well-cooked eggs may be tolerated in some cases while raw eggs cause an allergy.

In fact, there is no consensus among different organizations on the best way to introduce eggs. It is most advisable to consult your pediatrician on whether to do it one way or another; here we show you the most accepted methods based on current scientific evidence:. 

1. Offer it whole, without separating the parts

We can boil the egg and grate it into meals, offer it as a French omelet, or make oatmeal and egg pancakes. 

This way of offering it is justified because it is very difficult to physically separate the yolk from the white without proteins from one part sticking to the other. Therefore, even if we don’t see it with our eyes, it is likely that they have mixed anyway and the allergy will still manifest. 

2. Offer it whole, without separating the parts

We can start by offering the yolk, since, as mentioned before, it is less allergenic. Gradually and in small amounts, we will check tolerance. From that point, we can offer the white and finally the whole egg. And remember to offer it in the morning or at midday, but never at night or before bedtime. 

This method of introduction, endorsed by SEICAP and AEPED, supports that the child is exposed to a milder allergic reaction if they are allergic. In other words, it does not prevent the allergy from appearing, but if the child is genetically predisposed and will have it anyway, at least it will be less severe and we can react quickly. 

It’s best to ask your pediatrician or allergist what method they recommend for your little one based on their medical history, context, and family genetics. 

In what way should we not offer eggs?

Raw or undercooked, for example in preparations like homemade mayonnaise, lightly cooked poached eggs, very runny omelets… This is essential to avoid foodborne illnesses like salmonellosis and also prevents possible allergies. This is because the reaction can be less severe when the food is more cooked, as its proteins are heat-sensitive. 

Also, the protein in undercooked eggs is not absorbed or assimilated the same way. To take full advantage of all the nutrients in this amazing food, it is best that it is cooked. 

How to maintain proper food safety with eggs?

Always store eggs in the refrigerator, avoiding the door as it experiences the most temperature changes. 

The fresher the egg, the better. Choose those that are furthest from their best-before date. 

Check that the egg is not cracked. If it is, discard it. 

Do not wash them; the shell is porous and we can contaminate the inside of the egg. 

Practice extreme hand hygiene and clean the containers you use during recipe preparation. 

Do not break the egg in the same container where you will prepare the egg dish as it can become contaminated. 

Once you have cooked the dish, it is ideal to consume it immediately. 

Fun ideas to offer egg

Oat, egg, and banana pancakes, mix everything well and cook in a pan with olive oil until done. 

French omelet, in strips if they can already pinch. 

Well-made potato omelet. 

Vegetable omelet (sauté zucchini and then add the egg until cooked). 

Cooked whole, in pieces or mashed with its puree, grated, or cooked yolk spread on bread. 

Little burger made of egg, oats, and broccoli. 

And remember…

Since it is animal protein, the daily maximum is important. From 6 to 12 months, they can consume a maximum of one serving of animal protein, that is: 

- 20-30 g of meat, 30-40 g of fish, or 1 S-sized egg. 

This means that if we have offered 30 g of meat to eat, we cannot offer fish or egg again and will have to wait until the next day. We can also divide the portions and give half an egg at lunch and 15 g of fish at dinner (because we split the portions in half to make a whole animal protein portion). Remember that plant protein should be present, so we will evaluate the day's menu based on whether animal protein will be consumed or not. Always around a healthy diet rich in fruits, vegetables, legumes, and cereals. 

Bibliography

American Academy of Pediatrics (AAP), April 2019.  

“There is no evidence that delaying the introduction of allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months prevents atopic disease. There is now evidence that early introduction of peanuts may prevent peanut allergy.”.  

European Academy of Allergy and Clinical Immunology (EAACI), 2020.  

“The most effective age to introduce egg and peanut is from 4-6 months of age.” 

The British Society for Allergy and Clinical Immunology (BSACI), 2018.  

“In babies at higher risk of food allergy, studies have shown that starting egg and peanut earlier - from 4 months of age - can help prevent food allergy to egg and peanut.” 

Canadian Society of Allergy and Clinical Immunology (CSACI), 2020.  

“To prevent peanut and/or egg allergy, peanut and egg should be introduced around 6 months of age.”