Egg Allergy in Children

Egg Allergy in Children

Egg allergy is one of the most common food allergies in young children, affecting approximately 1–2% of infants and toddlers. The good news is that most children outgrow egg allergy by school age, though some children remain allergic into adolescence and adulthood.

Dr Mugilan Anandarajan provides specialist assessment and management of egg allergy for children aged 0–16 at Kingsbridge Private Hospital and Ulster Independent Clinic in Belfast.

Symptoms of Egg Allergy

Egg allergy symptoms typically occur within minutes to two hours of eating egg or egg-containing foods:

• Hives (urticaria) and skin redness
• Swelling of the lips, face or tongue (angioedema)
• Vomiting and abdominal pain
• Runny nose and watery eyes
• Eczema flares (particularly in infants)
• In severe cases: difficulty breathing, wheeze, anaphylaxis

Some children with egg allergy tolerate well-cooked egg (e.g. in baked goods) but react to lightly cooked or raw egg. This is known as baked egg tolerance and has important implications for management.

Diagnosis and Testing

Diagnosis involves a detailed clinical history and allergy testing. Dr Anandarajan will recommend the most appropriate testing approach for your child, which may include:

• Skin prick testing with egg white and egg yolk extracts
• Specific IgE blood testing including component testing (Gal d 1, Gal d 2, Gal d 3)
• Supervised baked egg challenge to assess tolerance to cooked egg
• Supervised oral food challenge to assess outgrowing of egg allergy

The Egg Ladder

The egg ladder is a structured approach to reintroducing egg into the diet of children who have egg allergy. It starts with well-cooked egg in baked goods (which are less allergenic) and gradually progresses to lightly cooked and then raw egg. The egg ladder is used under medical guidance and is tailored to each child's allergy profile.

Dr Anandarajan will advise whether your child is suitable for the egg ladder and provide a personalised plan for safe egg reintroduction.

Vaccination Advice for Children with Egg Allergy

Some vaccines — including the influenza (flu) vaccine and MMR vaccine — are produced using egg-based technology. Children with egg allergy can usually receive these vaccines safely, but specific guidance depends on the severity of the egg allergy:

• MMR vaccine: Safe to give in children with egg allergy, including those with a history of anaphylaxis to egg. The MMR vaccine contains very small amounts of egg protein and is not contraindicated in egg allergy.
• Influenza vaccine: Most children with egg allergy can receive the flu vaccine in a standard setting. Children with a history of severe anaphylaxis to egg should be vaccinated in a hospital setting under specialist supervision.
• Yellow fever vaccine: Contains significant amounts of egg protein and should be discussed with a specialist before administration in children with egg allergy.

Dr Anandarajan will provide personalised vaccination advice based on your child's allergy history.

Management of Egg Allergy

• Egg avoidance advice and food labelling guidance
• Written emergency action plan
• Adrenaline auto-injector prescription where indicated
• Egg ladder guidance for appropriate children
• Vaccination advice
• Referral to paediatric dietician if required
• Regular review to reassess allergy status

For further information, also visit belfastallergyclinic.com and belfastchildrensclinic.com.