Egg allergy is one of the commonest allergies, affecting 1 in 50 children in the UK. It is caused by proteins present in both the egg white and yolk.
80% of children who are allergic to scrambled or boiled egg will tolerate baked egg in biscuits and cakes. In this case, your child should continue to eat the baked egg to maintain and improve their tolerance.
Symptoms usually occur immediately after eating the 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. These need urgent medical attention.
Delayed reactions may lead to flares of a child’s eczema, tummy pain, vomiting or diarrhoea.
Most children only have mild reactions. Severe reactions are uncommon but need urgent medical attention.
Diagnosis is usually based on a history of a typical reaction. Allergy tests such as skin prick tests and blood tests provide evidence of reactions to raw egg. They can be positive in patients who are fine with cooked egg. Where the history is unclear or we want to know if the child has outgrown their egg allergy an oral challenge is required.
Cooking and baking makes egg less likely to cause an allergic reaction. Although a child may get hives or swelling if they touch raw egg in cake mix, they usually tolerate the mix once it has been baked into cakes or biscuits. If the biscuits and cakes are tolerated, these foods should not be taken out of their diet, as it helps your child grow out of their egg allergy more quickly.
In children who have had severe reactions, all egg-containing foods listed below might need to be avoided:
egg white egg yolk egg solids/powder globulin
ovalbumin livetin ovoglobulin ovomucin
Ovovitellin egg albumin egg lecithin (E322)
Lecithin can be made from egg, soya or sunflower. If the type of lecithin used is not specified, check with the manufacturer. It is important to read all food labels and packaging.
Mumps, Measles and Rubella (MMR) vaccine can be given to all children with egg allergy at the GP surgery. No special precautions are required.
Eight hundred UK children with egg allergy, a third of whom had previous suffered anaphylactic reactions to egg, were given the ‘flu vaccine in the “Sniffle study”. None suffered a serious allergic reaction. ‘flu vaccine can be safely given at the GP surgery to anyone with an egg allergy. The exception is children who have had a previous anaphylactic reaction requiring intensive care, in which case they should seek advice from their allergy doctor.
Your child should be provided with advice about what to do if they have another reaction. The plan is usually written down – Allergy Management Plan.
Mild reactions – hives, swelling or vomiting, but no breathing problems or faintness. If possible, get the child to spit out the food. Give an antihistamine.
Severe reaction – 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). Get help straight away and dial 999 stating “anaphylaxis” (ana-fil-ak-sis). If you have an adrenaline pen – use it.
If your child has suffered breathing problems or faintness, egg may first be tried in a hospital challenge.
It is important to inform the nursery/school and any after school clubs. Any other carers will also need to know.
Half of children will grow out of their allergy to egg by 5 years old, particularly if they are able to consume baked egg products.