Egg Allergies & Babies: A Definitive Guide

 

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Last updated October 13, 2019

Table of Contents

Introduction

Egg allergies are the second most common allergy in babies. Almost everyone knows someone who has an egg allergy.

My son developed an egg allergy when he was about 10 months old. He had been having increasing issues with eczema, so our pediatrician asked us to see an allergist. The allergist tested him for food allergies and told us he was not allergic to eggs. So the next weekend we fed him a finely chopped scrambled egg.

When he began breaking out in hives my husband and I did not immediately rush him to the ER. Instead, in one of our darkest moments as parents, we wasted precious time while debating what to do because we had JUST been told he was not allergic to eggs.

After nearly an hour, we finally drove him to the ER to a medical staff that seemed very upset with us.

In the weeks and years since becoming a “food allergy parent” I have spent more hours researching how food allergies develop, what we could have done differently, and what this means for my son as he grows up than anyone other than food allergy scientists

Based on 3 years of work, this is a complete guide on egg allergies. Whether you are dreaming of a baby, expecting your baby, or currently have a bouncing giggling baby in your arms, this guide includes everything you ever wanted to know (and some things that will surprise you!) about egg allergies.

Egg Allergy in Babies

What Does It Look Like If My Baby Has An Egg Allergy?

You may have an image in your mind of what it looks like when someone has an allergic reaction to a food. But an egg allergy in babies can look really different than one in an older child or adult. 

 A study showed that severe symptoms in babies under 12 months are extremely rare. The younger your baby, the less likely it is they'll have a severe reaction.

Infants with allergic reactions to eggs typically only get hives and vomit. It is almost unheard of for babies under 6 months to have a life-threatening (breathing or fainting) response to food.

In fact, the signs of an egg allergy in babies are so “mild” that they can seem very similar to a cold and may take a few minutes to an hour to show.

REMINDER: People can be allergic to anything. Whenever you introduce any food for the first time, do it when you or another caregiver will be around your baby for the next 2 hours. Don’t feed your baby a new food and then hand them off to someone else who wouldn’t know what they ate.
Whenever two body systems are affected (skin hives AND vomiting / diarrhea), immediately call 911. 

The most common symptoms of an allergic reaction to eggs in a baby under 12 months are:

  • Skin hives (95% of reactions): These are red bumps or patches that are itchy. Scratching this itchy skin can lead to eczema.
  • Redness around the mouth or chin.

  • Swelling of the face, including puffiness around the eyes (36%).
  • Runny or stuffy nose. Sometimes with clear discharge, redness, and itchiness of the nose.
  • Vomiting (89% of reactions). Your baby throws up (more than standard spit up) within a couple hours after eating eggs.
  • Diarrhea. Particularly smelly, funny colored, or more than normal poop. 

FAR less common (0-9% of reactions) in babies under the age of 1, but much more likely in toddlers and children are:

  • Swelling of the mouth, including the lips and possibly the tongue
  • Wheezing and coughing
  • Temperature less than 97 degrees or greater than 100.4
  • Swelling in the throat that presents as difficulty swallowing
  • Weak heart pulse
  • Fainting 

If you notice any of the above symptoms, mild or severe, call your doctor immediately. It’s always good to inform your doctor and check in whenever you're worried about your baby.

What Is An Egg Allergy in Babies?

An “egg allergy” is actually a group of several possible allergies to different proteins in the egg. A person can be allergic to one or more egg proteins.

The most common egg proteins that babies are allergic to are found in the egg whites.

  1. Ovoalbumin (OVA) also called Albumin / Albumen
  2. Ovomucoid (OVM)

The egg yolk is made of totally different proteins, which do not seem to cause allergies very often, even though some protein from the white can get into the yolk and vice versa.

Babies can be allergic to OVA only, OVM only, or both OVA and OVM.

OVA protein breaks apart (denatures) when it is cooked at high heat for enough time. When an egg is boiled for 30 mins or baked for 20 mins, the OVA protein breaks apart and can no longer bind with the IgE factors to cause an allergic reaction.

The good news for people with an OVA-only allergy is that they can eat baked egg because the protein they are allergic to is broken down. The bad news is that they cannot eat raw, scrambled, or lightly cooked eggs. Babies with OVA-only allergy have to be careful eating foods if they do not know how it was cooked.

OVM protein, on the other hand, is not affected by heat. So babies with an OVM-only or OVA + OVM allergy cannot eat any egg, no matter how it has been cooked.

What about the yolk? Babies with egg allergy have to treat egg yolks the same as egg whites because the proteins from the egg white can be found in tiny amounts in the yolk. Babies with OVA-only allergy can eat baked egg yolk, but babies with OVM only or OVA + OVM allergy can’t eat egg yolk raw, cooked, or baked.

If your baby has an OVA allergy, you can increase their chances of outgrowing the allergy by feeding them baked eggs regularly. See the section on Egg Allergy Cures. 

Why Would My Baby React to An Egg?

Ask a doctor what an egg allergy is, and they will say “an IgE mediated immune response to a protein.”

I-G-who? Meditating what??

When most people eat eggs, their bodies simply break it down as food with no issue.

However, some babies’ immune systems decide the protein in egg is dangerous. This is called sensitization. Once your baby’s body decides something is a threat, it creates IgE antibodies for it. IgE antibodies act like a security alarm so that if your baby’s body sees egg again, it calls up the troops.

Strangely, some babies will be sensitized to egg, meaning that the alarm system is there, but when they eat eggs, the alarm is ignored.

An allergy is when your baby’s body hears that alarm of IgE antibodies and wakes up the fighter cells (mast cells, eosinophils, etc). Those cells respond to the “attack” by releasing histamine and other chemicals.

There chemicals perform tricks like heating up the body, making your baby itch and your baby’s skin swell, building up mucus and making your baby cough or throw-up.

The key point is that in an egg allergy, your baby’s body mistakes the proteins in an egg for a dangerous parasite. Why does it make this mistake?

The short answer is...we don’t know.

The long answer is, we have some theories that are all being studied:

  • The egg protein happens to enter the body at the same time as a parasite and the body thinks the egg IS the parasite. The next time it sees the egg, the body attacks.
  • The egg protein got through the skin before it went to the stomach, and the body tends to call anything that gets through the skin a threat. When your baby then eats egg, the body makes a mistake and attacks. (This is called the Dual Exposure Hypothesis).
  • A protective lining is missing from your baby’s intestines, so egg protein “leaks out" where it shouldn’t and this makes the body think it’s a threat.
  • Your baby’s body is missing friendly bacteria that live in the gut (Microbiome). In most people, these friendly bacteria either tell your baby’s body “I’ve seen this before, stay cool,” or even create the protective mucus lining of the intestines. But without those friendly bacteria, no one is there to tell your baby’s body not to overreact.

The truth is, we still don't have a definitive answer. 

Will My Baby Have An Egg Allergy? What Are the Signs of Risk?

Family History of Egg Allergies

There is at least some genetic or family component to egg allergies. A baby has an increased risk of developing a food allergy if a parent or sibling has a food allergy, though it’s not a huge difference. The overall rate of egg allergy is 3% and in families with a history of egg allergy it might be closer to 6% or even 10%.

No one has found a genetic marker for egg allergies. Family impact may have to do with epigenetics, or certain gut microbiome bacteria that are transferred from mother to child.

Having Eczema, and the Severity of the Eczema

Babies with eczema (also called atopic dermatitis or AD) have a compromised skin barrier. This condition is the single biggest predictor of food allergies, and there is also a known relationship between the severity of the AD and chance of sensitization to food. Babies with AD have skin that feels rough to the touch because it is missing proteins like filaggrin that give skin its soft springy feeling. That is why the LEAP study (the most important study on how to prevent food allergies) used babies with eczema as their definition of a high risk group, and why the current FDA language advises you to talk to your doctor before introducing allergens if your baby has eczema.

Why is a skin condition linked to food allergies? The short answer is that when the skin barrier is compromised, teeny bits of egg left on people’s hands, the table, the ground, break through the skin. Your baby’s body flags this skin-invader as a threat (sensitization). Later, when your baby eats eggs, the body ATTACKS.

Being a Boy

Male babies are 5x more likely to have peanut and tree nut allergies. BUT, they are also more likely to outgrow them. By adulthood, the rate of allergies is about the same between men and women. This difference has also been noted for asthma.

The fact that boys and girls are affected differently means that something in our genetic make-up or endocrine system (hormones) plays a role in food allergies. But scientists have not yet uncovered what that link is.

Living in a City

Research by the SOAAR group found that 9.8% of children living in urban centers have food allergies, compared to 6.2% in rural communities.

Increasing population density was found to be correlated with more food allergies and more asthma. Shellfish allergies are three times as common in city kids, and peanut allergies were twice as common.

Big cities have the highest rates of food allergy and asthma, followed by smaller metropolitan areas, followed by rural areas. These differences were not caused by the differences in race/ethnicity, gender, age, household income, and climate, but rather by how close people lived to each other.

This research shows that the environment plays a role in a child’s risk of developing food allergies. Some scientists think that kids in urban areas do not eat enough dirt or eat diverse enough foods when they are babies. But, like with gender, we don’t know exactly why.

Ethnicity

One study showed that non-Hispanic black children are three times more likely to have IgE sensitization to certain foods as compared to white children. For example, the prevalence of likely food allergy to shrimp in non-Hispanic black patients was 2.3% compared with 0.3% in non-Hispanic white patients. Another study showed that black children were more likely to be sensitized (have IgE antibodies ready to sound the alarm) to multiple foods when compared with white children.

The racial division could be genetics, or it could have to do with the geographical and diet segregation by race in America.

What Can You Control?

Some of the risk factors discussed above are not controllable. You don’t get to pick if your baby will be a boy or girl! The most important thing you can do is control eczema and introduce diverse foods early. Read more about that in the section on preventing egg allergies.

How Common Are Egg Allergies?

Babies are more likely than adults to suffer from egg allergies, and eggs are the second most common food that cause allergy in children, behind cow’s milk. In the United States, 3% percent of babies are allergic to eggs.

But before you think “what’s going on in America??”, know that egg allergies are way more common in Australia. Raw egg allergy was estimated to affect approximately 8.9% of 1 year old children in Australia (!) however many of these children can tolerate baked egg in their diets.

In contrast, peanut allergies affect 2% of the population.

When Do Egg Allergies Develop?

Almost all childhood food allergies develop before age 1. Of course, if parents avoid a food until their baby is 3 years old, they won’t notice the allergy until much later.

There are a few important points in the two sentences above.

  1. Babies aren’t born with an egg allergy.
  2. Food allergies don’t magically occur, they “develop.” When the body is first exposed to egg, it flags it as a threat, and then reacts to it at a later date.
  3. There can be a big difference between when the egg allergy develops, and when parents notice the egg allergy. A baby exposed to egg on their skin they could develop an allergy at 6 months old, but parents might think their baby got the allergy much later, when they first fed their baby eggs. 

So when do egg allergies actually develop?

Infants have been known to develop an egg allergy as young as one month old, but more commonly, egg allergies develop between 6 months and 1 year. The highest levels of IgE antibodies for egg proteins were found in children around the age of 1, meaning that seems to be the peak age to develop a food allergy.

Why do egg allergies, and all food allergies, seem to develop between 6 and 12 months?

Infant immune systems get stronger and change rapidly in the second 6 months of life. Remember that a food allergy is a mistake the immune system makes. But to make that mistake, the baby has to have a strong, working immune system. Your baby doesn’t have the ability to develop an egg allergy until a bit later. That is why steps to preventing egg allergy should start by 6 months old.

A Last Thought on Timing of Food Allergies

Egg allergies are often “caught” before peanut allergies. It’s not clear if egg allergies actually develop first, or if people notice them first because it's easier to feed your baby very soft, finely chopped scrambled egg instead of peanuts. Either way, an egg allergy at 4 months old is considered a strong risk factor for developing a peanut allergy.

Preventing an Egg Allergy in Babies

Can Egg Allergies Be Prevented?

Yes...sort of. No food allergies are totally preventable today. What we do know is that there are ways to reduce your baby’s risk of developing an egg allergy.

First you need to know that babies aren’t born with egg allergies — they develop them. To have an egg allergy, your baby has to have an immune system. Babies usually don’t develop the ability to have an allergy until between 6 and 12 months old. That is why most egg allergies show up between 6 and 12 months.

That is ALSO why the best time to try to prevent an egg allergy starts before 6 months and continues to at least 12 months.

The only ways we know of today to prevent an egg allergy are:

  1. Prevent or control eczema
  2. Introduce eggs early
  3. Protect your baby’s gut microbiome

Eczema Identification and Treatment

Why are we talking about eczema and egg allergies?

Everyone accepts that eczema and egg allergy are strongly connected. Babies with rough, dry, itchy skin that they scratch open are at high risk for developing food allergy.

In fact, how old a baby is when eczema starts appearing and how bad that eczema is are predictive of the risk of food allergy. (P. E. Martin et al 2014)

The graph above shows the results of a study that looked at babies without eczema and those with mild, medium, or bad eczema and tracked them to see who developed food allergies. Babies who developed eczema very young (age 0-3 months) that required prescription-strength medicines to treat (severe eczema), had a 50% rate of food allergy. Babies who developed eczema later (age 10-12 months) that was pretty mild had only a 5% rate of food allergy.

What’s wrong with eczema skin?

  1. Eczema skin lacks a protein called filaggrin. Filaggrin is like the mortar that keeps the bricks of the skin together and stops food dust particles for entering the skin, or water from leaving the skin.
  2. Eczema skin loses water faster and more often than normal skin. This Trans-Epidermal Water Loss (TWEL) is measurable and a useful way to measure how bad your baby’s eczema is. Dry skin has a hard time fighting off infections, and keeping dust out.
  3. When the skin has eczema, it’s really itchy. So babies scratch themselves. A really interesting recent study in mice done at Boston Children’s Hospital showed that scratching the skin promotes allergic reactions to foods, including anaphylaxis. Scratching can create cuts in the skin that make it prone to infection, scratching itself seems to call up the cells and chemicals that trigger an allergic reaction.

How Do I Know If My Baby Has Eczema?

If you think you baby might have eczema, you can use a simple scoring tool to describe what issues you are noticing in your baby.

The survey asks:

  • What areas of your baby’s body seem affected?
    • Face
    • Diaper area
    • Inside the elbows
    • Behind the knees
  • Does the issue look like...
    • Oozing and crusting of the skin
    • Severe redness that won’t respond to emollients
  • Does your baby...
    • Seem to lose sleep from itching

Take photos when possible to bring to your pediatrician. Eczema can come and go so pictures will help your doctor see what you're seeing.

How Do I Treat and Control Eczema?

Treating eczema is a matter of using the right emollients and steroids (when necessary) to heal the skin. Daily emollients (thick lotions), especially after a bath, can be a lifesaver for many babies.

In fact, at least two studies have shown that using daily emollients, even if your baby has pretty normal skin, can prevent eczema from ever developing!

If a baby has eczema, the best way to treat it is actually to keep it from acting up, and keep the baby from scratching. A lot of parents use gloves or socks on their baby’s hands at night.

Finding your baby’s triggers can be really tricky since they are changing constantly and they can’t really talk to you. But looking at possible pollens (grass, trees), dander (dogs, cats), clothing materials, soaps / detergents, can all be helpful.

The most important part of controlling eczema is probably making sure that the skin doesn’t get infected. The skin is baby’s natural barrier. An analysis from the team behind the LEAP study showed that babies with eczema who also had an infection were the most likely to develop food allergies and the least likely to outgrow those allergies.

Early Introduction

The single best way to prevent an egg allergy in your baby is early introduction. And it works best when combined with eczema treatment / prevention. Based on ALL the research done, a team of scientists concluded “on the basis of the most recent results...simultaneous intervention by both early boiled egg introduction and eczema treatment is probably indispensable for primary prevention of egg allergy.”

Early introduction of egg in baked form teaches the baby’s immune system to tolerate egg proteins and not make the mistake of reacting to them. This is especially important if family members, including pets, are eating eggs. A lot of pet food has eggs in it!

Basically, early introduction means that:

  1. Baby starts eating egg early - before the immune system develops
  2. Baby eats eggs often - 2-3 times a week
  3. Baby eats enough - 1-2g of egg protein with each serving

We know that early introduction works because about 6 different teams (HEAP, STEP, EAT, BEAT, STAR, PETIT) have attempted to study what happens when you take one group of babies and feed them eggs regularly, as compared to another group of babies who are not eating eggs.

Overall they found that about 50% of egg allergies are preventable, and a large percentage of egg “sensitization” is preventable as well.

Why Use Baked Eggs Vs. Cooked Eggs

One of the most consistent findings from the 6 studies on early introduction of eggs is that a number of babies were already allergic to whole egg powder or egg white powder even when they started the study at 4 months old. However, if babies are fed a baked egg, those reactions don’t happen. When looking at all 6 studies together, babies are 15 times more likely to react to a cooked egg than a baked egg.

That means WAY more babies can safely eat egg, and reduce the chances of developing egg allergy, if they eat baked egg.

The other interesting thing to know is that feeding babies baked egg can still protect them against a cooked egg allergy when they are ready for cooked eggs later in life.

What does “baked” mean? In 2013, a team of researchers set out to answer that question. It means heated at 350F (170C) for 20 mins or boiled at 212C (100C) for 30 mins. 

In Lane 1 - raw egg white, you see the sharp bands of color for each of OVA and OVM. It gets faint but there is still OVA protein in Lane 2 (fried egg) and Lane 3 (Boiled for 10 mins). The OVA is gone in Lane 4 (boiled for 30 min) and Lane 5 (baked for 20 min at 170℃). You also see that the OVM is there no matter what you do. They did the next step of also seeing how each one reacts in blood with IgE factors and the results were consistent.

How Do You Feed Eggs to Babies?

Simply add two scoops of Lil Mixins Infant Egg Powder to any baby food. It’s pre-baked and ground fine so it’ll blend into anything and doesn’t create a risk of choking.

If you want to prepare eggs on your own, know that feeding your baby eggs gets easier the older they get. At 4 months old, they can only eat very thin purees. By 6 months, an applesauce is okay. By 10 months, they can eat scrambled eggs, bits of muffins/ baked goods, and by one year old they are ready for most textures.

Pro-tip: Especially for little babies, make a lot of food at once, and then freeze it in an ice cube tray. Lil Mixins can be added to baby food and then frozen and thawed when your baby is ready for a meal.

Preparing Eggs for 4-8 Months Old

Step 1: Boil or Bake the Egg
Remember, how the egg is cooked really matters. Multiple studies showed that feeding babies raw or lightly cooked eggs can cause reactions.
  • Boiling - Bring water to a boil, and boil egg for 30 mins
  • Baking - Mix egg with a starch (i.e. rice flour) bake for 20 min at 350F
Step 2: Fine Mash or Puree
One of the most helpful items you can have in your house when your baby is ready for solids is a blender. It can be the same blender you use for your smoothies, though we like having a smaller one that can serve as a baby food holder as well. Babylist has a good round up of baby food makers. Our favorite is the “baby bullet”, or simply any immersion blender so that you can use it for years.
Depending on if you boiled the egg or baked it, add enough water or breastmilk to the egg to soften it and then puree it. If you are mashing the egg, use a fork or potato masher. You can also use a knife to finely chop the egg and then add the liquid.
Step 3: Mix the egg into a Fruit, Veggie, or Cereal
Turns out, boiled pureed egg doesn’t taste great. But the neutral taste works well with almost anything.
Some great ideas for foods that mix with eggs are broccoli, apples, peaches, berries, and oatmeal.

Preparing Eggs for 8-12 Months Old

If your baby is older (8 to 12 months) they can handle eggs chopped or mashed. The food no longer needs to be pureed. Of course, each baby is different and you will know what textures your baby is ready for.

Preparing Eggs After the First Birthday

After about a year old, baby should have good enough pincer movement to eat boiled or scrambled eggs. (Note: babies & children should never eat raw eggs because of the risk of salmonella poisoning.)

How Long Does It Take To Prevent An Egg Allergy?

Even though the best way to prevent an egg allergy is called Early Introduction, it is just as important that babies are fed eggs regularly as it is to start early. Babies’ immune systems are developing typically between 6 and 12 months old.

Imagine your baby’s developing immune system like a painting finished over several months. The "early" part of early introduction means that you start training tolerance of eggs ideally before the painting is really taking shape.

For each baby, that painting is going to fill in at different speeds and different times. That is why regular exposure to eggs, about 3 times a week, kept going through one year, makes sure that when your baby hits key parts of development, they are being trained to tolerate eggs.

My Baby Has An Egg Allergy

What Will Future Egg Allergy Reactions Look Like in My Baby?

Every reaction is its own. The last time someone reacted to an egg does not predict how they will react the next time. A person with an egg allergy, or any food allergy, has to be vigilant all day every day to avoid a potentially life-threatening episode.

Have An Exposure Plan

The organization FARE, Food Allergy Resource & Education is one of the best out there. They have a number of resources that are great, but their action plan is a go-to for many parents of children with food allergies.

Exposure plans are pretty similar overall. Here are the major rules.

  1. At the earliest signs of a reaction, use an anti-histamine like Benadryl or Zyrtec if the child can swallow.
  2. If two body systems are involved in the reaction (like skin AND stomach), use epinephrine and go to the ER.
  3. If any critical body systems are involved in the reaction (trouble breathing, fast heart rate, drop in blood pressure) use epinephrine and go to the ER.

Reactions can show up minutes to hours after the exposure, so it is important to stay with your baby. If it is late at night and you feel you won’t be able to stay awake, go to the ER.

Whenever epinephrine is used, a child must get additional care. It doesn’t necessarily mean your baby will get more medication. However because symptoms can worsen and improve over several hours after an exposure, it is important to be under the care of trained healthcare providers until your baby is in the clear.

Carry An “EpiPen” (Epinephrine Auto Injector)

It is critical for a baby with a food allergy to always have an EpiPen nearby. Allergic reactions can happen at unexpected times.

It's impossible to avoid people eating or snacking in public. And rarely do people wash their hands after eating; most will simply wipe their hands on a napkin, which does not remove the chance of egg protein transfer.

Imagine a child who eats scrambled eggs, wipes their mouth, and then promptly puts a toy in their mouth. Depending on how sensitive your baby is to eggs, that toy can now lead to an allergic reaction if your baby with an egg allergy also puts the toy in their mouth.

This is an extreme case, but it has happened. You baby’s sensitivity to eggs can change as the baby gets older, when your baby is tired, or if your baby’s stress levels are high, or if they have a cold.

Carrying an EpiPen at all times is baby’s most important line of defense.

EpiPens can be sensitive to heat and cold. Never leave an EpiPen in the car on a hot day, out in the sun, or out in the cold. There are many EpiPen carrying cases and holders available that can help control temperature, or make them easier to place in a bag or attach to your body. EpiPens are easy to slip into a diaper bag.

EpiPens expire so you have to buy new ones every year. While several studies have shown that the medicine inside is still effective well past the expiry date, your baby’s allergist will write a new prescription each year.

What You Need to Tell Friends / Family / Teachers

If your child has a food allergy, it is important to tell everyone who takes care of your baby and everyone who might offer them food both what not to do, and what to look out for.

Everyone

 Make sure that every adult caring for your child knows how to use your child’s epinephrine auto-injector. Each prescription comes with a trainer which you can leave with others and show them exactly how to use the EpiPen.

  • Talk through all the foods that have egg in them. It’s a long list, and can help people understand the seriousness of paying attention.

Family Members  

  • Give each person an emergency plan, and talk through it with them. This can actually put everyone at ease. (It might also scare them, but that’s probably a good thing).
  • Bring food or give caregivers specific lists of brands you are comfortable with. It definitely adds a lot of work and stress to the parents of babies with egg allergies, but many people aren’t sure what foods do and do not have eggs in them. The best option is often to bring your own food to gatherings so that there is no confusion. If someone else is shopping for your baby, telling them which brands you trust can help, but it is also easy to get the wrong flavor within a brand — be specific.
  • Take your time and only trust others with your baby once you feel comfortable doing so. It can be helpful to care for your baby together with a family member as a trial period.

Schools

 For some parents, sending their baby to a school or daycare with an egg allergy can seem scary. But for many parents, there’s also no way around it.

  • Remember that each school wants to keep your child safe. A meeting to discuss your baby’s egg allergy and what she needs is helpful for both you and the school.
  • Most schools are required to create a 504 plan with parents. The goal of 504 plans is for children to be in the same classrooms with all other children, but with the services, changes, or help they need.

What Foods Have Eggs In Them?

Let’s face it — eggs are kind of magical. Eggs bind ingredients in meatballs, leaven soufflés, thicken custards, emulsify mayo, and glaze pastry for a perfect finish. Eggs are used to clarify soups and coffee, and retard crystallization in boiled candies and frostings. Eggs add color, flavor, and moisture to many baked goods. In short, eggs are everywhere.

This is a disaster for people with egg allergies.

While peanut allergies sometimes get all the attention, people with food allergies will often tell you that an egg allergy is far more terrifying. We surveyed nearly 200 Food Allergy Moms whose children have an egg allergy. Almost every single person had an accidental exposure to eggs because they didn’t realize all the ways in which eggs are used and all the foods in which eggs are used.

Here are some surprising foods that contain eggs:

  • Ice cream
  • Deli meat
  • Honey mustard
  • Coffee
  • Pasta
  • Pizza
  • Pies
  • Sweet Tarts
  • York Peppermint Patties
  • Icing or frosting
  • Ketchup at Wendys
  • Foam in espresso drinks
  • Marshmallow fluff
  • Sprinkles
  • Laffy Taffy (some flavors)
  • Soups
  • Spices and spice mixes
  • Salad dressings
  • Cheeses
  • Meatballs
  • Burgers
  • Battered & fried foods
  • Bagels with egg wash
  • Sunscreens
  • Beauty products
  • Shampoo and conditioners
  • Body washes
  • Pet food
  • Potting soil (can have egg shells)
  • Snickers / Milky Way

There are probably a few things on that list you are shocked could have eggs in them. And any of those could be lethal to a person with an egg allergy. 

Do I Have To Be Worried About Vaccines?

Many medicines and vaccines have ingredients derived from egg. People with an egg allergy should confirm that their doctor and pharmacists are aware of their egg allergy, especially before receiving any new medicines. Some medicines use propofol, intralipid, or lysozyme, all of which can cause a reaction.

Flu vaccines are derived from the fluid of chicken embryos. Flu vaccines typically contain residual egg white protein (OVA), though the OVA levels varies between manufacturers and batches. Allergic reactions, including anaphylaxis, have been reported in people with an egg allergy after receiving a flu vaccine, though it was extremely rare.

The yellow fever vaccine is prepared in egg embryos, and allergic reactions to this vaccine have been reported. The measles, mumps and rubella (MMR) vaccine is also made using a culture of chick embryo, but three large studies have demonstrated that it is safe for people with an egg allergy.

Most infants with an egg allergy must have their first vaccines at an allergists office. Following a successful administration of a vaccine, children may then receive future vaccines at their pediatrician.

Do Egg Allergies Go Away On Their Own?

The good news about egg allergies is that, like milk allergies, there is a decent chance a child will outgrow them.

The old research showed that it could be outgrown 80% of the time. That seems to be changing.

Later studies have shown that only about 55% outgrow the allergy by age 7. Furthermore, a study done in 2014 showed that the ability to outgrow an egg allergy increased with age: at 3 years, 20% outgrew it, by age 5, 30% outgrew it, and by age 7, 55% outgrew it.

More importantly, the likelihood of outgrowing an egg allergy was related to two things.

  1. The strength of the body’s reaction to egg, also called an IgE level, when the allergy surfaced.
  2. Whether the baby had moderate to severe eczema as an infant.

Infants who had higher IgE levels were less likely to outgrow the allergy and infants with moderate to severe eczema were also much less likely to outgrow the allergy. 

Similar to egg allergies, milk allergies also seem to be most common around one year of age, and then about half of children outgrow them by the age of 6. Peanut allergy is different in that it seems more children become allergic between the ages of 1 and 6, although a significant portion of that “increase” is simply children who were never fed peanut before age 3.

Everyone wants to know if there is something they can do to increase their child’s chances of outgrowing an egg allergy. So far, no clear interventions have been identified. However, if a child can tolerate baked egg, regularly eating baked egg has been shown to increase the chance of eventually tolerating cooked or raw egg. Same goes for milk, where, if tolerated, eating baked milk can help the chances of outgrowing a milk allergy.

There’s hope for the future. A lot of research is being done into oral immune therapy — giving people increasing amounts of foods until they can tolerate them. And some studies are showing moderate success. Heavy investment in this area continues and we are hopeful that it will be solved in the next 20 years.

Best Resources For Egg-free Recipes

It can feel incredibly daunting to live a life free of eggs.

For some, it means completely re-imagining breakfast as a meal centered around eggs to another chance to eat fruits, vegetables, and whole grains. And you still get to have bacon!

Others are overwhelmed by how they are going to bake and make foods that holidays and family gatherings are focused around. (Is it even a birthday without birthday cake??)

Rest easy knowing that great minds have picked apart almost every recipe you can think of and found a way to make it without eggs. Our top favorite cookbooks for cooking and baking without eggs are

  1. Bakin’ Without Eggs
  2. The Allergy-Free Family Cookbook
  3. The Allergy-Free Baby & Toddler Cookbook
  4. Frugal Vegan
  5. Eating Eggless
  6. The Allergy-Free Pantry
  7. The Egg-Free Cookbook

There are also a number of recipes on the top cooking websites. And certain cuisines, like Indian food, rarely include eggs.

After a while, you might even forget that you used to cook with eggs!

Treating or “Curing” an Egg Allergy

There are NO perfect ways today to cure an egg allergy. Anyone promising you a cure through acupuncture, alternative medicine, probiotics, etc is not being honest with you.

There is no interventional therapy for egg allergy currently approved by the FDA, nor by the European Medicines Agency (EMA). Management of an egg allergy is about strict avoidance, even of tiny or trace amounts. In the US, laws require food manufacturers to label packaging in plain language, listing egg if it’s an ingredient. But these laws do not necessarily extend to “prepared foods” and foods at farmers markets, etc.

Your baby is much more likely to outgrow an egg allergy naturally if he or she:

  1. Has mild or no eczema
  2. Has had less severe reactions to egg
  3. Has low IgE levels
  4. Can tolerate baked eggs
  5. Has no other food allergies

What if this doesn’t describe your baby? And even if it does, read on to learn more.

The Latest Science On Egg Allergy Treatment

Eating Baked Egg If Possible

If a child can tolerate baked egg, regularly eating baked egg has been shown to increase the chance of eventually tolerating cooked or raw egg. Regularly eating baked egg was 14 times more likely to lead to outgrowing the whole egg allergy than avoiding eggs. Higher serum EW-specific IgE level is associated with persistent baked and regular egg reactivity, while initial baked egg reactivity is not.

Oral Immunotherapy (OIT)

There are different types of oral immunotherapy, and there is no standard treatment yet. Oral immunotherapy means regularly eating small amounts of egg through the mouth (as opposed to an injection) with the goal of desensitizing a person to egg and eventually allowing them to fully tolerate egg. Typically, the amount of egg eaten each day starts incredibly small and increases until it is about ½ of an egg each day.

When “desensitized” a person will not react to egg if they are exposed to it by accident. BUT if they stop eating their daily dose of egg, the previous allergy will return.

The real goal is “tolerance” to egg. In this state, the body continues to ignore egg protein permanently whether or not the person eats eggs every day.

So what does oral immune therapy look like?

  1. OIT starts with an in-office date to figure out the starting dose. This is done by beginning with a tiny amount like 1 milligram of egg protein, and doubling it every 30 minutes until you reach either 50mg or whatever the person can tolerate. That is the starting dose.
  2. Then a person eats the starting dose for some number of days, say 2 weeks, at home.
  3. Periodically (ie every two weeks) the dose is increased at home by a small amount, for example, 5-10 milligrams.
  4. The goal is to get all the way up to 2 grams (2,000 milligrams) over a period of 10 - 20 months.

A recent review of 10 studies on oral immune therapy was a mixed bag. The treatment definitely has promise: in the group of children who underwent the treatment, a MUCH larger percent were able to eventually tolerate egg than in the groups of children who did no treatment.

BUT:

  1. A far higher percentage of people are desensitized to egg rather than tolerate it (meaning the reaction comes back once they stop being exposed, rather than being “cured”). That means they are less likely to have an accidental exposure, but they need to eat their dose amount every day forever.
  2. A large number of people stop therapy because eating egg in increasing amounts, and sticking to the protocol, is logistically difficult and causes a lot of anxiety.
  3. A large number of people have an allergic reaction to eggs on their journey. An increased dose one day will be too much for their bodies and they end up needed treatment. On the flip side, strict avoidance means no reactions.

The net is that for those people who are so anxious about their egg allergy that they are restricting their lives, a treatment, even one that isn’t dialed in yet and has some risks, might give them a sense of control over their future. For those with less anxiety and fear about their egg allergy, this level of effort may cause more pain than needed. They may be better off waiting for the science to improve.

Future Work On Egg Allergy Treatment

Allergic reactions to eggs, as has been stated many times before, are a mistake the immune system is making. The chain reaction that was intended to fight off parasites is the one that is being triggered in an egg allergy. Right now, there isn’t a lot of clarity on why the body mistakenly sees egg protein as a parasite, or how to stop that from happening.

Instead, where a lot of work is being done is on stopping the chain reaction that causes the acute immune reaction (allergic reaction) to happen, basically making it impossible for the body to go into crisis mode. 

When the body sees a parasite, or what it thinks is a parasite, T cells transform into TH2 (T helper 2) cells. TH2 talks to B Cells which release the IgE antibodies specific to that parasite. This is called sensitization.

The next time your body sees this parasite, the TH2 release interleukins, and the IgE antibodies turn on eosinophils, easophils, and mast cells. These last three cells are the ones that actually cause what you know of as an allergic reaction (squeezing of the airways, hives, vomiting, etc).

Stay with us because it’s going to pay off.

Steroids work on the eosinophil cells. When the eosinophil is stopped, the allergic reaction stops. That is why when you are having an allergic reaction, you get steroids. But steroids have a lot of effects on other parts of your body that are really harmful. So overuse of steroids is a bad thing.

Instead, new drugs are trying to stop earlier parts of the chain reaction and take the body back to a normal state

Xolair (Omalizumab) works by targeting IgE antibodies. It is given by injection in the doctor’s office, because some people have a reaction to it where they get anaphylaxis.

Another drug, dupilumab, messes with the interleukins (IL-4 and IL-13) that are both produced by, and stimulate the master regulator cells. This drug is given by injection into the skin every two weeks at home. These drugs have been studied and approved to treat a number of allergic diseases, and are being studied for younger kids and treatment of more kinds of food allergies.