Your doctor has suggested that you to introduce cooked and processed egg into your child’s diet This can be worrisome for you, as your child may have had an allergic reaction when they last had an egg containing product. However, the egg ladder is used routinely in allergy practice and likely to help your child outgrow their allergy.

Points to remember

  • 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 hives or skin swellings, but requires guidance from your children’s allergy health professional
  • Ensure your child is well when using these guidelines. 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. If your child is avoiding other food groups, for example wheat or dairy, seek advice from your dietitian on alternative food from milk ladder

Stop the challenge if any of the following develop

  • red, itchy rash (hives)
  • swellings
  • 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.

EGG LADDER: Which foods should you give your child?

STEPFOOD OPTIONS
1Baked Egg in a flour matrix • 1 fairy cake; 1 slice banana bread; 3 meatballs; Slice of *“free from” bread (containing egg) • 1 shop bought Yorkshire pudding/scotch pancake/waffle • 40g egg pasta
2Baked egg in other foods • egg glaze on pastry, 1 x sausage/burger containing egg (vegetarian and meat based); Quorn based products; gravy granules
3Well-cooked whole egg • one medium well cooked egg. Hard boiled
4Lightly cooked egg • 1 medium egg, scrambled/soft boiled/fried/omelette; homemade Yorkshire puddings and pancakes • Egg custards/egg fried rice
5undercooked/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.

EGG LADDER: How much food should you give your child?

StageAmount of foodTime until next stage
1Grain of rice size 400mg)Give the food at LEAST 3 times per week
2Pea size (1,000mg or 1g)
3Teaspoon size (5g)Alternate days/daily dependant on tolerance and symptoms.
4Tablespoon size (15g)
5¼ portionIncrease each stage weekly if possible
6½ standard portion
7Full standard portion
  • If your child reacts to an increase in dose/frequency of egg protein please DO NOTstop completely, go back to the previously tolerated stage until further review by your health professional.

 

  • Wheat free/dairy free options of the egg ladder should be discussed with your dedicated health professional

Where can I find more information?

Hospital Egg Allergy information leaflet and Egg Challenge leaflet, see www.allergynorthwest.nhs.uk