Introducing Egg Earlier May Help Prevent Egg Allergy

For many years, parents were told to wait before giving babies foods such as egg. Research over the past several years has changed that advice. We now have good evidence that introducing egg once a baby is ready for solid foods may actually lower the chance of developing an egg allergy.

A new Australian study compared two groups of infants, more than 7,000 in total, before and after feeding recommendations changed. The typical age of egg introduction moved from about 8 months to 6 months. During the same period, egg allergy at one year of age decreased from 9.2% to 7.6%, which is about a 17% relative decline.

The difference was even greater among babies with early eczema, who are at much higher risk for food allergies. In this group, egg allergy decreased from about 35% to 22%.

These findings are especially helpful because they show what happened in the general population after feeding recommendations changed. While this type of study cannot prove that earlier egg introduction alone caused the decline, the results are consistent with clinical trials supporting earlier introduction.

In clinical trials involving more than 4,800 infants, earlier egg introduction was linked to about a 40% lower relative risk of egg allergy. The larger benefit may partly reflect that many of the infants in the trial were at higher allergy risk and received more feeding support.

What should parents do?

Once your baby is developmentally ready for solid foods, usually around 6 months and not before 4 months:

• Do not intentionally delay egg.
• Introduce well-cooked egg, rather than raw or undercooked egg, in a texture your baby can safely eat.
• If egg is tolerated, continue offering it regularly rather than giving it once and then waiting a long time before offering it again.
• If your baby has significant eczema or has already reacted to another food, talk with your pediatrician about the safest way to introduce egg and other common allergens.
  What if my baby reacts to egg?
• If your baby develops symptoms that could be an allergic reaction after eating egg, stop giving it and talk with your pediatrician or allergist before trying it again.

A positive skin or blood allergy test does not always tell the whole story. An allergist can help determine whether your baby truly has an egg allergy and whether certain forms of cooked egg may still be safe. Unnecessary testing can sometimes lead to unnecessary food avoidance.

Treatment for egg allergy is also changing. Some children may be able to gradually introduce different forms of cooked egg under the guidance of an allergist. Another option is oral immunotherapy, or OIT, in which very small amounts of egg are gradually increased over time to help raise the amount a child can tolerate.

Research on egg OIT in very young children is encouraging, but it is not yet routine treatment for every infant with egg allergy. Many children naturally outgrow egg allergy, and more research is needed to understand which babies benefit most from early treatment and whether that protection lasts after treatment stops.

The bottom line

For most babies, the message is simple: start solid foods when your baby is ready, introduce well-cooked egg early, and keep it in the diet if it is tolerated.

If your baby does react, it does not automatically mean years of complete egg avoidance. An allergist can help confirm whether a true egg allergy is present and discuss whether cooked egg introduction, continued observation or newer treatments may be appropriate.