Egg allergy is one of the commonest allergies in children, affecting 1 in 50 children in the UK. The allergy is caused by proteins present in both the egg white and yolk. Up to two thirds of children will grow out of their egg allergy by 10 years old.
Symptoms usually occur immediately after eating food containing egg. They often consist of a rash (hives or “nettle” rash), swelling of the lips or around the eyes, and itching. Some children develop an itchy throat, others feel sick, vomit or have diarrhoea.
Severe reactions (anaphylaxis) are much less common but include difficulty breathing (with wheeze or swelling of the mouth or throat), feeling faint or dizzy.
Delayed reactions may lead to flares of a child’s eczema.
Most children only have mild reactions. Severe reactions are uncommon but need urgent medical attention.
Egg proteins are affected by heat. Cooking changes the protein in eggs and makes it less likely to cause allergic reactions. For example although a child may get an itchy rash or swelling if they touch raw egg in cake mix, they can often tolerate the mix once it has been baked into cakes or biscuits.
The diagnosis of egg allergy is usually based on a history of a typical reaction. Allergy tests such as skin prick tests and blood tests provide evidence of reactivity to raw egg and may be positive in patients who tolerate cooked egg. Thus, where (1) the history is unclear, (2) one wants to know if the child can tolerate cooked egg, or (3) if the child has outgrown their egg allergy an oral challenge is required.
Avoid eating eggs in a form that cause reactions. If baked egg is tolerated in biscuits and cakes these foods should not be taken out of their diet. Continuing to eat egg in a form that is tolerated may help your child grow out of their allergy.
For those with severe reactions, all egg and egg containing foods listed below might need to be avoided. It is important to read all food labels and packaging.
egg white egg yolk egg solids/powder globulin
ovalbumin livetin ovoglobulin ovomucin
ovovitellin egg albumin egg lecithin (E322)
Lecithin is made from either egg or soya. If an ingredient does not specify the type of lecithin used check with the manufacturer.
Mumps, Measles and Rubella (MMR) vaccine can be given to children with egg allergy. No special precautions are required. The vaccine can be given at your GP surgery. ‘flu vaccine can be given in the GPs surgery to anyone who has “out grown” their egg allergy and can eat small amounts of egg even if they had serious reaction in the past. Those who still cannot eat any egg may be referred to the local paediatric allergy service.
A written management plan will be given in clinic. Allergy medication should be available at all times.
If egg is accidentally eaten, get the child to spit it out if possible and give an antihistamine.
Severe symptoms are:
- Difficulty breathing (wheezing, noisy breathing, blue colour)
- Swelling in the throat (noisy breathing, drooling)
- Feeling faint or dizzy, looking very pale (lie the child down with their legs raised).
If any of these severe symptoms occur get help straight away and dial 999 stating “anaphylaxis” (ana-fil-ak-sis).
It is important to inform the nursery/school and any after school clubs. Any other carers such as grandparents, relatives and school friends’ parents will need to know.
Many children will be able to eat well cooked egg in biscuits and cakes. Your allergy team may suggest trying less well cooked egg again using written guidelines. If your child has had a reaction associated with breathing problems or faintness this may be done in hospital.