All parents want to keep their babies safe. And one of the first challenges they encounter is preventing food allergies when their baby starts eating solids foods. The good news is there are steps parents can take to try and prevent egg allergies from developing.
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.
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 is around 6 months and continues to at least 12 months.
The only ways we know of today to prevent an egg allergy are:
Prevent or control eczema.
Introduce eggs early.
Protect your baby’s gut microbiome.
Preventing and Controlling Eczema
Everyone accepts that eczema and egg allergies are strongly connected. Babies with rough, dry, itchy skin that they scratch open are at high risk for developing a food allergy.
In fact, how old a baby is when eczema starts appearing and how bad that eczema is 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?
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 from entering the skin, or water from leaving the skin.
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.
When the skin has eczema, it’s really itchy. So babies scratch themselves. An 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, while scratching itself seems to call up the cells and chemicals that trigger an allergic reaction.
How Do I Treat and Control Baby 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 your baby has eczema, the best way to treat it is 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 making sure that the skin doesn’t get infected. The skin is your 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.
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 your 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. Surprise: a lot of pet food has eggs in it!
Early introduction means that:
Baby starts eating egg early - before the immune system develops.
Baby eats eggs often - 2-3 times a week.
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.