Egg allergies are the second-most common allergy in babies. 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 probably 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 else.
Based on 3 years of work, this is a complete guide to egg allergies. This guide includes everything you ever wanted to know (and some things that will surprise you!) about egg allergies.
Table of Contents:
Egg Allergies in Babies
Egg allergies are different from other food allergies in babies because there are multiple proteins in eggs that babies can be allergic to.
What is an Egg Allergy?
In an egg allergy, your baby’s body mistakes the proteins in the egg for a harmful substance.
An allergy develops when your baby’s body becomes sensitized to egg protein, marking it as harmful and preparing to attack it the next time it sees it. When your baby is sensitized to something, their immune system creates the antibodies necessary to fight it when it enters the body again.
Sensitization to egg, however, does not confirm an allergy. It’s possible for your baby to be sensitized to egg without producing an allergic reaction.
During an allergic reaction, your baby’s body releases histamines to fight off the intruder. This is what we see as hives, coughing, wheezing, etc.
Illustration of an immune antibody releasing the histamines that produce an allergic reaction.
Different Egg Proteins Can Cause Allergies
Eggs contain multiple proteins, and it’s possible for a baby to be allergic to one or both kinds of egg proteins.
The most common egg proteins that babies are allergic to are found in the egg whites, meaning most babies actually have an egg white allergy. The two proteins in egg white that cause allergies are:
- Ovalbumin (OVA) also called Albumin / Albumen
- Ovomucoid (OVM)
Babies can be allergic to one or both of these proteins. People can also, much more rarely, be allergic to other egg white proteins like ovotransferrin, ovomucin, lysozyme, and ovoglobulin.
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.
OVA and OVM are found in most preparations of eggs, such as raw egg, scrambled eggs, and omelettes.
Baking eggs at 350 degrees for 20 minutes eliminates the OVA protein, but leaves the OVM protein in tact. This means that foods that are baked that contain egg, such as cakes and muffins, only contain OVM proteins.
Babies with an OVA allergy can safely eat baked eggs, but babies with an OVM allergy cannot eat any preparation of eggs.
The Causes of Egg Allergies
There are multiple factors that contribute to a baby’s risk of developing food allergies. Most food allergies, eggs included, are caused by a combination of genetics, eczema, and the avoidance of eggs.
The Genetic Component
Babies have an increased risk of developing food allergies if a parent or sibling has a food allergy.
Having a parent with:
- Asthma or eczema doubles the rate of food allergies.
- Seasonal allergies doubles the rate of food allergies.
- A food allergy increases the risk of developing a food allergy almost 6x.
- Two or three allergic conditions (asthma, eczema, food allergies, seasonal allergies) also doubles or triples the rate of food allergies.
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.
When the skin barrier is compromised, teeny bits of egg left on people’s hands, the table, or 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.
Avoidance of Eggs
The LEAP and EAT studies proved that feeding babies allergenic foods like peanuts and eggs early and often actually reduced their risk of developing food allergies. This new research shines a light on how we’ve accidentally been contributing to a higher rate of food allergies.
As we mentioned above, babies can be sensitized to foods like eggs before they even eat them. By avoiding them until 1 year (as per the American Academy of Pediatrics old guidelines), babies’ immune systems finish developing with that harmful marker there.
Preventing Egg Allergies
While egg allergies can seem scary, there’s a lot parents can do to lower their baby’s risk of developing an egg allergy.
Babies aren’t born with egg allergies — they develop them. The best time to reduce your baby’s risk of developing an egg allergy is between 4-12 months old, as their immune system is developing.
The best ways to prevent an egg allergy are to:
- Prevent or control baby eczema.
- Introduce eggs early.
Preventing and Controlling Baby Eczema
Eczema and food allergies are strongly connected. How old a baby is when they develop eczema and how severe their eczema is the biggest indicator of food allergies.
In a study of babies with no, mild, medium, and severe eczema:
- Babies who developed eczema by 3 months old and needed prescription strength medicines had a 50% rate of food allergy.
- Babies who developed eczema closer to 1 year old and needed only emollients had a 5% rate of food allergy.
Eczema leaves babies skin dry and cracked, which allows food particles to enter their system. This allows them to become sensitized to foods like eggs and peanuts before they eat them, increasing their risk for developing food allergies.
But keeping your baby’s eczema under control can help reduce their risk of developing food allergies. Treating eczema is a matter of using the right emollients and steroids (when necessary) to heal the skin.
Feeding Your Baby Eggs Early and Often
The best way to prevent your baby from developing an egg allergy is early introduction.
The American Academy of Pediatrics recommends that babies can and should start eating eggs as soon as they tolerate one or two other solid foods. This usually means that they:
- Are at least four months old.
- Can hold their head up steady for a long time.
- Are showing interest in food.
- Have tolerated one easy food like pureed fruit.
Six different studies (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.
How to Feed Your Baby Eggs
As we mentioned above, babies can be allergic to the OVA and/or OVM proteins in eggs. In order to safely introduce your baby to peanuts, the American Academy of Pediatrics recommends starting with baked eggs.
In the studies above, feeding babies baked eggs was 15 times safer than regular cooked eggs. That means that by starting with baked egg, WAY more babies can safely eat eggs, and reduce their chances of developing an egg allergy.
What Does “Baked” Eggs Mean?
For an egg to be baked safely for your baby to eat, it must be baked at a temperature of 350 degrees Fahrenheit for 20 minutes or boiled at 212 degrees Fahrenheit for 30 minutes.
It’s hard to feed your baby eggs if they start solids at 4 months, since they can only tolerate smooth and thin purees. Lil Mixins Baked Egg Powder Mixin is designed for parents to get an early start on early introduction. Our baked egg powder mixes in to anything else you’re feeding your baby.
So you can spend extra time preparing and feeding your baby baked eggs in addition to their other food 3 times a week. Or you can add Lil Mixins Baked Egg Powder Mixin to any baby food 3 times a week.
Signs and Symptoms of an Egg Allergy
Egg allergy symptoms in babies are similar to other food allergy symptoms.
Allergic reactions to eggs most often look like:
- 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.
Redness around the mouth as part of an allergic reaction
Swelling under the eye as part of an allergic reaction
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 101.
- Swelling in the throat that presents as difficulty swallowing.
- Weak heart pulse.
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.
Living With an Egg Allergy
If your baby does develop an egg allergy, every reaction is its own. But managing an egg allergy has never been easier for parents.
The best way to avoid accidental egg exposure is to avoid eggs altogether. But avoiding eggs can be tricky.
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:
York Peppermint Patties
Icing or frosting
Ketchup at Wendys
Foam in espresso drinks
Laffy Taffy (some flavors)
Spices and spice mixes
Battered & fried foods
Bagels with egg wash
Shampoo and conditioners
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.
A Note About Vaccines
Did you know some vaccines have ingredients that are derived from eggs? Parents and people with egg allergies should confirm that their doctors and pharmacists are aware of any egg allergies.
Medicines that use propofol, intralipid, or lysozyme can cause reactions. Flu vaccines and the yellow fever vaccine have been reported, in rare cases, to cause reactions. However, the measles, mumps, and rubella (MMR) vaccine has been demonstrated as safe for people with an egg allergy.
Have an Exposure Plan
It’s imperative for any food allergy parent to have an exposure plan for their baby.
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:
At the earliest signs of a reaction, use an antihistamine like Benadryl or Zyrtec if the child can swallow.
If two body systems are involved in the reaction (like skin AND stomach), use epinephrine and go to the ER.
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.
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.
Always Carry an EpiPen
It is critical for a baby with a food allergy to always have an EpiPen nearby. Allergic reactions can happen at unexpected times.
Carrying an EpiPen at all times is your 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.
Preventing Accidental Exposure
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.
Make sure everyone has a list of the foods that contain eggs in them. Bring food or give caregivers specific lists of brands you are comfortable with. The best option is often to bring your own food to gatherings so that there is no confusion.
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.
When it comes to sending your child to school, remember schools want to keep your child safe. 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.
Outgrowing and Curing Egg Allergies
There is a good chance your baby might outgrow their egg allergy.
The likelihood of outgrowing an egg allergy is related to two things:
The strength of the body’s reaction to egg, also called an IgE level, when the allergy surfaced.
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.
Besides being lucky enough to outgrow an egg allergy, a lot of research is being done into oral immune therapy for egg allergies.
Oral immune therapy works to try and desensitize a person to what they are allergic to. For eggs, this means eating an incredibly small amount of egg and gradually increasing it to try to build a tolerance. When oral immune therapy is successful, it means someone could be exposed to egg accidentally and not suffer a life-threatening reaction.
But oral immune therapy poses a number of cons for people with allergies.
The current success of oral immune therapy depends on people taking their dose of egg every day. And a large number of people stop therapy because eating more of something they are allergic to causes anxiety.
In more severe cases, a large number of people experience allergic reactions while participating in oral immune therapy. For some, this poses too large a risk.
The science on curing food allergies is still progressing, and it’s possible new science will emerge with a better solution.
A Final Note on Babies and Egg Allergies
With all the information above, you’re educated and prepared to start introducing eggs to your baby when the time comes.
Early introduction of eggs is the single best way to prevent an egg allergy. But if an allergy does develop, rest assured you’ve got the resources to tackle it head on.