If your baby develops a rash, swelling, vomiting or seems unwell after eating egg, it can be really worrying.
Egg allergy is one of the most common food allergies in babies and young children, and it often becomes apparent when egg is introduced for the first time. In the UK, around 2% of children develop egg allergy.
The good news is that many children do grow out of egg allergy, often during childhood.
The important thing is understanding what type of reaction your baby has had, whether testing is needed, which forms of egg they need to avoid and whether reintroduction should happen at home or under specialist guidance.
In this guide, I’ll explain the common symptoms of egg allergy in babies, how it is diagnosed and what usually happens next.
What are the symptoms of egg allergy in babies?
Egg allergy can cause either immediate or delayed symptoms.
Immediate reactions are usually IgE-mediated and typically happen within minutes of eating egg, although symptoms can sometimes develop within a couple of hours.
Symptoms can include:
- Hives or an itchy rash
- Redness around the mouth
- Swelling of the lips or face
- Vomiting
- Coughing or wheezing
- Breathing difficulty
- Becoming pale, floppy or very unwell
If your baby experienced severe symptoms that you are concerned about, it is important to contact 999/911 immediately or take them to A&E
Delayed reactions can happen several hours later and may be harder to recognise.
These can include:
- Vomiting
- Diarrhoea
- Tummy symptoms
- Worsening eczema
- Feeding difficulties
Not every rash or episode of vomiting after eating egg means your baby has an egg allergy. The timing, amount eaten, how the egg was cooked and whether the same symptoms happen again are all important.
Why does the way egg is cooked matter?
This is one of the things that often surprises parents.
Some children with egg allergy can tolerate egg when it is thoroughly baked into foods such as cakes or biscuits but react to less-cooked egg such as scrambled egg, omelette or mayonnaise.
Heating changes the structure of some egg proteins, which can make them less likely to trigger a reaction.
That does not mean baked egg is automatically safe for every child with egg allergy.
Some children need to avoid all forms of egg, while others may already tolerate baked egg
This is why I would not recommend trying baked egg at home simply because you have read that other children can tolerate it.
The form of egg your child can eat should be based on their individual reaction history and advice from their healthcare professional.
What is the difference between IgE and non-IgE egg allergy?
IgE-mediated egg allergy causes symptoms quickly – minutes up to 2 hours after eating egg based foods.
These can include hives, swelling, vomiting, coughing, wheezing or, more rarely, anaphylaxis.
Non-IgE-mediated reactions are delayed and can happen 2-72 hours later. They are more likely to involve symptoms such as vomiting, diarrhoea or eczema flares.
There are also less common forms of egg allergy, including FPIES, which can cause significant vomiting one to four hours after egg is eaten.
If you’re unsure what IgE means or how allergy testing works, there is more information on allergy testing via my blog below
How is egg allergy diagnosed?
Diagnosis starts with the history.
A healthcare professional will usually want to know:
- What your baby ate
- How much they ate
- How the egg was cooked
- How quickly symptoms started
- What symptoms occurred
- Whether the same thing has happened more than once
- Whether your baby has eczema or another food allergy
For many children, a clear history is enough to make the diagnosis.
Skin prick testing or blood testing for egg-specific IgE may be useful if the reaction was moderate or severe, or if the diagnosis is uncertain.
A positive allergy test on its own does not always mean your child will react when they eat egg.
Tests need to be interpreted alongside the clinical history.
That is why broad food allergy panels or home IgG food sensitivity tests are not a reliable way to diagnose egg allergy.
Does my baby need to avoid all egg?
Not necessarily.
The amount and form of egg your child needs to avoid depends on their reaction history and what they already tolerate.
Some children are advised to avoid all egg initially, while others may safely continue foods containing baked egg.
If your baby has reacted to egg, do not experiment with different forms at home unless you have been advised that it is safe to do so.
Can babies with egg allergy eat baked egg?
Some can.
Many children with egg allergy can tolerate well-baked egg, such as egg baked into cake with flour.
But this is not something I would recommend testing at home without individual advice.
Children who have had mild reactions may sometimes be advised to reintroduce baked egg at home.
Children who have had more severe reactions, breathing symptoms, anaphylaxis or asthma may need specialist assessment or a supervised food challenge.
This is where an Egg Ladder may be used for some children.
What is the Egg Ladder?
The Egg Ladder is a stepwise way of reintroducing egg in increasingly less cooked forms.
It usually starts with egg that has been thoroughly baked into a food such as cake and gradually progresses towards more lightly cooked egg.
It is not suitable for every child.
Some NHS Egg Ladder guidance is specifically designed for children with non-IgE-mediated allergy, and home reintroduction should only be used when a healthcare professional has advised that it is appropriate.
If your child has had a severe immediate reaction, breathing symptoms or anaphylaxis, do not start an Egg Ladder at home unless your allergy team has specifically advised you to.
What happens if my child reacts during egg reintroduction?
If your child develops symptoms while reintroducing egg, stop the new form of egg.
If they have an allergy action plan, follow it.
For mild or delayed symptoms, contact your GP, allergy team or dietitian for advice before progressing further.
If your child develops symptoms of a severe allergic reaction, such as breathing difficulty, swelling of the tongue or throat, or becomes floppy or very unwell, seek emergency medical help.
NHS guidance for home egg introduction advises stopping reintroduction if a reaction occurs and getting further advice before moving on.
Will my child grow out of egg allergy?
Most children do.
Egg allergy commonly starts in infancy, and many children become more tolerant as they get older.
Often, children begin to tolerate well-baked egg first.
They may then progress to more cooked forms of egg before eventually tolerating lightly cooked egg.
Some children take longer, particularly if they have had more severe reactions.
A smaller number of children continue to have egg allergy into later childhood or adulthood.
Can egg allergy make eczema worse?
It can.
Babies with eczema are more likely to have food allergy, including egg allergy.
Egg can sometimes contribute to eczema flares in younger children, but eczema is common and has many possible triggers.
An eczema flare on its own does not prove egg allergy.
If you are repeatedly seeing eczema worsen after egg exposure, particularly alongside other symptoms, it is worth discussing the pattern with your GP, health visitor or dietitian rather than removing lots of foods without assessment.
What foods contain egg?
Egg can appear in more foods than parents expect.
These can include:
- Cakes and biscuits
- Pastries
- Pancakes and waffles
- Pasta
- Mayonnaise
- Breaded or battered foods
- Some meat products
- Desserts
- Chocolate or confectionery
- Some breads and bakery products
Egg is one of the 14 allergens that must be clearly identified on UK food labels when it is used as an ingredient.
If your child has an egg allergy, you will need to know which forms of egg they need to avoid rather than assuming every child needs the same level of restriction.
What about vaccinations if my child has an egg allergy?
This is another common worry.
Most children with egg allergy can also receive the routine flu vaccine.
There are some exceptions for people who have had an extremely severe egg reaction requiring intensive care, so if that applies to your child, speak to your allergy specialist before vaccination.
For travel vaccines such as yellow fever, specialist advice is recommended if there is an egg allergy.
Should I remove egg from my diet if I am breastfeeding?
Usually, no.
Tiny amounts of egg protein can pass into breast milk, but most breastfed babies with egg allergy do not react through breast milk.
If your baby is breastfeeding comfortably without symptoms related to your own egg intake, there is usually no reason for you to remove egg from your diet.
In rare situations where reactions through breast milk are suspected, a temporary maternal elimination diet may be recommended, but this should be done with professional support.
When should I get individual advice?
It is worth getting individual support if:
- Your baby has had an immediate reaction to egg
- There has been swelling, wheezing or breathing difficulty
- Your baby has reacted more than once
- You are unsure whether the reaction was egg allergy
- Your child has multiple food allergies
- You are unsure whether baked egg is safe
- You do not know whether an Egg Ladder is appropriate
- Your child’s diet has become very restricted
- Growth or feeding is becoming a concern
The aim is not simply to remove egg.
It is to work out what your child actually needs to avoid, keep their diet as varied as possible and reintroduce foods safely when the time is right.
If you are unsure what your baby’s reaction means or what to do next, I can help you look at their symptoms, allergy history and current diet and work out the safest next step.
When should I seek urgent medical help?
Seek urgent medical help if your baby develops:
- Difficulty breathing
- Swelling of the tongue or throat
- Significant facial swelling
- Persistent coughing or wheezing with other allergic symptoms
- Becomes pale, floppy or very unwell
- Signs of anaphylaxis
If you think your baby is having a severe allergic reaction or anaphylaxis, call 999/911.
Hannah Whittaker RD is a specialist paediatric allergy dietitian with over 20 years’ experience in nutrition and 10 years as a Registered Dietitian. She specialises in food allergy in babies and children, including cow’s milk, egg, soya, wheat, peanut and tree nut allergy, food reintroduction and nutritional adequacy.
Hannah has worked in NHS paediatrics and now supports families with practical, evidence-based nutrition advice. She is also an experienced media spokesperson and has contributed to publications including The Sunday Times, The Independent and Huffington Post.
Credentials
Registered Dietitian
First Class Degree in Nutrition
Postgraduate qualification in Dietetics
Experience
Over 20 years’ experience in nutrition
10 years as a Registered Dietitian
NHS paediatric dietetics experience
Media spokesperson in the UK and internationally
Writer, committee member and researcher supporting the British Dietetic Association
