Egg allergy is caused by an allergic reaction to egg protein. It is common in children under 5 years and usually noticed in infancy when egg is first introduced into the diet.
Egg allergic children may develop a rash, swelling, vomiting, abdominal pain or diarrhoea after eating egg. Rarely, some children develop a more severe reaction (anaphylaxis) with coughing, or an asthma-type wheeze, or severe drowsiness. Egg allergy may be responsible for worsening of eczema or reflux.
Egg allergy will resolve in most children, usually by school age. Baked egg in foods containing flour (e.g. cake, biscuit) is tolerated first, followed by well-cooked whole egg (e.g. boiled egg, scrambled egg). Raw egg (e.g. mayonnaise, royal icing) is usually tolerated last.
Children who have had more severe reactions, many food allergies or severe eczema may take longer to grow out of their allergy or in some cases it will persist.
The diagnosis of egg allergy is usually based on a history of reacting to egg containing food. In some cases, it may be confirmed by allergy skin tests or blood tests.
It is usually recommended to avoid all foods containing egg initially. However, if your child can eat baked egg, such as in cake, they should continue to eat this.
Children with egg allergy should have access to antihistamine syrup or tablets at home and at nursery/ school to use in case of accidental ingestion or a further reaction. These can be prescribed, but are also available without prescription. Your GP will provide an “Allergy Action Plan”, which explains what to do in case your child has another reaction.
If your child has had a severe allergic reaction (anaphylaxis) to egg, your GP will provide you with an adrenaline auto-injector. Please visit the company’s website to watch the training video and to order a free trainer pen.
Egg may be found in a wide range of foods and may be present unexpectedly. You must read all food labels carefully every time you shop. The word Egg will be listed clearly on the list of ingredient. The proteins in eggs from other birds are very similar to those in hens’ eggs and should be avoided too.
Food manufacturers outside the UK and EU may not follow the same food labelling rules. Egg may be referred to by unusual terms, e.g., egg lecithin E322, albumin, ovalbumin, globulin, ovoglobulin, livetin, ovomucin, vitellin, ovovitellin or albumen.
Here are more examples of foods that contain egg. If “baked egg” foods are already tolerated, these should continue to be eaten regularly (at least twice weekly).
Plain cakes, sponge fingers, brioche, croissants, biscuits & cookies – remember no icing that contains egg
Dried egg pasta and noodles
Egg in shop bought sausages, meatballs, gravy granules and gluten free bread
Egg glaze on pastry
Shop bought precooked frozen Yorkshire puddings or ready-made pancakes and scotch pancakes
Batter made with egg
Bread and butter pudding
Fresh egg pasta
Pancake cooked in frying pan
‘Dippy’ uncooked boiled, fried or poached egg
Ice cream especially fresh and luxury types
Freshly made sorbet
Royal icing (fresh and powdered icing sugar) & soft mallow
Fondant icing inside a Cadbury’s crème egg®
Raw egg in cake mix and other dishes waiting to be cooked (children of all ages love to taste!)
Carbonara sauce, Tartar sauce
Chocolate bars containing egg in their filling eg Milky way, Mars bar
Alternative recipes, which use other foods to replace egg, can be found online and in vegan cookbooks. Alternatively, you can use ‘Egg replacer’ instead of eggs.
You are encouraged to continue breastfeeding your baby. If your own diet contains eggs, a very small amount of egg protein will be present in your breast milk. However, it is usually very well tolerated, even in egg allergic children.
If your baby has severe eczema or reflux, it may be worthwhile removing egg from your own diet for a two-week trial, to see whether your baby's symptoms improve. After two weeks, eggs should be reintroduced into your own diet, even if you have seen an improvement in your baby. Only if your baby’s symptoms clearly worsen again, once egg is re-introduced, is an egg-free diet whilst breastfeeding recommended.
It is important this trial is not undertaken at the same time as medication or creams to manage reflux/eczema are changed or introduced.
You will be advised by your doctor or dietitian when to start reintroducing egg. Most children will be able to reintroduce egg at home following an “egg ladder”, gradually moving from small portions of baked egg (eg cake) to well-cooked whole egg (eg boiled egg). For some patients, who are at risk of more severe reactions, this may need to be supervised in hospital.
Introducing baked egg in this way is important especially in younger children, as it may help them grow out of their egg allergy.
All children with egg allergy should receive their normal childhood immunisations, including the measles, mumps, and rubella vaccination (MMR) as a routine procedure performed by their family doctor/nurse.
Influenza vaccine is safe for all patients with egg allergy and can be given at school, unless they have had an allergic reaction to egg which was severe enough to require intensive care treatment. If this is the case, your child should be referred to an allergy specialist for assessment.
Yellow fever vaccine contains small amounts of egg protein. Children with an egg allergy who need it should be seen by an allergy specialist at a designated yellow fever immunisation centre. Please allow at least six months for this process.
Allergies to other foods are more common in egg-allergic children. Early introduction of allergens (in particular peanut) from 4-6 months of age has been shown to prevent food allergy. It is therefore recommended that babies with an egg allergy are introduced to all allergens as soon as possible. Once tolerated these foods should remain in their diet regularly (e.g. twice weekly). Please refer to the Allergy UK “Weaning your food allergic baby” booklet.
The Department of Health recommends that egg shoudl be introduced into the infant's diet from around six months. The deliberate exclusion of egg may increase the chance of your baby developing an egg allergy. Especially babies who have eczema will benefit from early introduction of egg and peanut from 4-6 months of age to help prevent a food allergy. Please refer to the Allergy UK “Weaning your food allergic baby” booklet.
BSACI Egg Allergy Guideline 2021
Vaccinations: Green Book, Chapter 21 (MMR) and Chapter 19 (Influenza)