The egg ladder is used routinely in allergy practice and likely to help your child outgrow their allergy faster.
- DO NOT attempt reintroduction of egg products at home if your child has previous suffered from breathing problems or floppiness after eating egg or egg containing products
- this egg ladder can be used for children who have previously suffered from delayed skin or gastrointestinal reactions, as well as in children who have had hives or skin swellings
- ensure your child is well when introducing egg. If your child has been wheezy recently or has taken antihistamines in the last 5 days wait until they are better. DO NOT increase food portions or introduce new foods when your child is unwell
- start at the step you have been advised by your doctor or dietitian. Your child may already be tolerating some foods of the ladder, so you can then progress from there
- if your child reacts to an increase in amount/frequency of egg protein please DO NOT stop completely, but go back to the previously tolerated stage until further review by your health professional
- wheat free/milk free options of the egg ladder are available and should be discussed with your dedicated health professional
- red, itchy rash (hives)
- vomiting / tummy pain / loose stools
- noisy breathing, wheeze / persistent cough
- dizziness / feeling faint / floppiness
Give antihistamine if a rash or swelling develops. Symptoms should resolve within half an hour.
In the unlikely event of breathing problems or faintness, take your child to the nearest Emergency Department. Do not challenge them again, but contact the allergy team for further advice.
|1||Baked Egg in a flour matrix • 1 fairy cake; 1 slice banana bread; 3 meatballs; Slice of gluten-free bread (containing egg) • 1 shop bought Yorkshire pudding/scotch pancake/waffle • 40g dried egg pasta/noodles|
|2||Baked egg in other foods • egg glaze on pastry, 1 x sausage/burger containing egg (vegetarian and meat based); Quorn based products (vegetarian); 40g fresh egg pasta|
|3||Well-cooked whole egg • one medium well cooked egg (hard boiled), well-cooked homemade pancake/Yorkshire pudding|
|4||Lightly cooked egg • 1 medium egg, scrambled/soft boiled/fried/omelette; • Egg custards/egg fried rice|
|5||undercooked/raw egg • Royal/fondant icing; raw egg in cake mix; fresh mayonnaise; meringues; some ice creams/sorbets|
In composing this table manufacturing ingredients and cooking processes were checked and correct at the time of printing.
Give the food at LEAST 3 times a week. Increase the amount weekly if possible.
|Stage||Amount of food|
|1||Grain of rice size 400mg)|
|2||Pea size (1,000mg or 1g)|
|3||Teaspoon size (5g)|
|4||Tablespoon size (15g)|
|6||½ standard portion|
|7||Full standard portion|
- Give an antihistamine if a rash or swelling develops and follow your allergy management plan (if you have one). Symptoms should resolve within half an hour.
- In the unlikely event of breathing problems or faintness, ring 999 to call for an ambulance stating anaphylaxis (ana-fi-laxis). Inform your allergy health professional.
- Do not challenge them again and contact your GP or the allergy team for further advice.
Hospital Egg Allergy information leaflet and Egg Challenge leaflet, see www.allergynorthwest.nhs.uk