Egg Allergy Factsheet

Your Guide to Thrive: Egg allergy

From omelettes to biscuits and pancakes, hen eggs are one of our most versatile ingredients. But excluding them from your daily diet is actually far more doable than you might think – there are a host of great substitutes on offer, not to mention fabulous egg-free recipes.

And while living with an egg allergy can seem overwhelming at first, it may be comforting to know that you’re not alone. Egg is one of the most common food allergens for children. That means there’s a mine of information and advice, readily available at your fingertips. Read on, for our guide to thriving with an egg allergy.

Did you know?

An egg allergy is caused by the proteins in the egg.

Children with an egg allergy are commonly allergic to other food too.

Studies suggest around 70% of children outgrow an egg allergy by the time they reach adulthood [1].

What causes an egg allergy?

It is the proteins in an egg that trigger an allergic reaction. You find these in both the white and yolk, but an allergy to the whites is more common. When someone who is allergic to eggs comes into contact with these proteins, their immune system mistakenly thinks they are a threat and releases chemicals to defend against attack. It’s these chemicals that cause the allergic symptoms.

It’s useful to know that it isn’t just eating eggs that can cause a reaction. If you’re very sensitive to eggs, touching raw egg or eggshell can trigger symptoms too.

What are the symptoms?

Egg allergy symptoms vary from person to person, and they can range from mild to severe. The timing of the reaction can vary too dependent on the type of allergy – symptoms will most commonly be seen within two hours of exposure, but people with delayed allergy might experience symptoms that develop over a few hours or even days.

You can read more about allergy symptoms here.

How is an egg allergy diagnosed?

If you think you or your child could have an egg allergy, speak to your GP or health visitor and explain any symptoms. The more detail you can give them, the better. It can be useful to write these down or even take photos of the reaction to show your health care professional.

They might advise an allergy test at a specialist clinic, which can be done using a skin prick test or blood test. You may also be asked to keep a food diary, detailing what you or your child eats and any symptoms. Depending on you or your child’s symptoms your health professional may advise you to remove eggs from the diet completely.  Some children are able to eat eggs that have been baked into foods and you may be encouraged to include these foods within the diet.  Your health professional can explain more.

Please note, if you or your child has an egg allergy it is important not to trial baked egg without health professional advice and support.

What is the treatment?

For the majority of people with an egg allergy, an antihistamine might be recommended to treat allergic reactions to egg. However, for those people with more severe egg allergy or those with certain co-morbidities (e.g. severe asthma), an auto adrenaline injector may be prescribed.

Over time, you or your child may be referred for a food challenge in hospital, to gauge whether there’s any sign of developing a tolerance to egg.

Team Tip

Vegan recipes and foods can provide great egg-free options!

How does an egg allergy affect what you eat?

Allergies impact everyone differently and treatment varies according to each individual’s diagnosis and symptoms, but you will be advised to avoid some or all food containing egg. This includes eggs from other birds like ducks, geese and quail, as well as hens, because they contain similar proteins.

That said, some people only develop allergic symptoms when they’re exposed to raw or partly cooked egg, such as a poached egg, mayonnaise or a dessert like tiramisu. That might mean you or your child is able to tolerate well-cooked egg when it’s an ingredient in something like a cake.

In fact, research does suggest that up to 70% of children with an egg allergy can tolerate well-cooked/baked egg in a muffin or waffle.[2]

However, always stick to what your GP or allergy specialist recommends!

Be egg-aware

Eggs are an incredibly common ingredient, and it’s worth remembering that they’ll be hidden in some unexpected places. In addition to more obvious foods like quiche, pancakes, mayonnaise and cakes, you’ll find them in things like royal icing, some ice creams and confectionery, plus they can also be used as a ‘wash’ on pastries and bread. And that’s just the tip of the iceberg.

When you’re buying manufactured products, always check the label to be sure it doesn’t contain egg. Do this even if you’ve bought the item before because recipes can change. In the UK, ingredients lists are required to make it clear if they contain any common allergens – you’ll often find they do this by highlighting the allergen or writing it in bold. Take extra care when you’re abroad though, or if you’re eating food that comes from outside the UK or EU, because the same laws may not apply.

If you’re eating out, don’t feel embarrassed about asking whether a dish contains egg, or whether there is any threat of cross-contamination. Restaurants, cafes and takeaways are legally obliged to give either written or oral information on allergenic ingredients.

Did you know?

Cooking egg changes some of the egg proteins and for some people with egg allergy, this means it can be better tolerated. If a child starts to outgrow his or her allergy, food containing a small quantity of baked egg is often the first that can be introduced safely (but only on the advice of your doctor). Examples of this could include well-cooked cakes, muffins, pastries or bread. In contrast, raw or lightly cooked egg tends to take longer to be tolerated, if at all. You’d find lightly cooked egg in food like home-cooked pancakes or scrambled eggs, and raw egg in dishes like fresh mayonnaise or some chocolate mousses.

Egg allergy and vaccinations

The NHS recommends that children are fully immunised against serious illnesses and it might be reassuring to know that children with an egg allergy can have the MMR vaccine (measles, mumps and rubella). It is grown on chick embryos, not eggs, so is widely considered to be safe [3]. This is even the case for children who have had an anaphylactic reaction to egg but, as always, do check with your GP or specialist first.

What about the flu vaccine?

The majority of children with an egg allergy can also have the nasal flu vaccine, which is sprayed up the nose and commonly offered as part of the childhood immunisation programme. While the vaccine is grown on egg, it contains a minimal amount of the proteins that can trigger an allergic response. However, extra care does need to be taken for those with a severe egg allergy, as well as egg-allergic children who have serious asthma. This doesn’t rule out the vaccine, but it may need to be given in hospital.

Most injectable flu vaccines also contain tiny quantities of egg protein, but they are considered to be very low risk too. As always though, seek expert advice if you or your egg-allergic child has had a severe allergic reaction to egg, or has serious asthma. As with the nasal vaccine, this one may need to be given in hospital too. Flu vaccines change from year to year, and sometimes there are options that contain no egg protein.

The yellow fever vaccine

Unlike the MMR or flu immunisation, this is a foreign travel vaccine that’s only needed by those visiting an area where yellow fever is found. It is developed on egg and isn’t generally advised for anyone who can’t tolerate any egg. However, if you think it is necessary (for example if you’re visiting a high-risk area, or you have been asked to provide a vaccination certificate) do consult your GP or allergy specialist.

Q&A: Living with an egg allergy

Q: Can I breastfeed a baby who’s allergic to eggs?

A: When you breastfeed, small amounts of egg proteins will be in your milk. If your baby is showing allergic symptoms, then it might be useful to stop eating eggs for a fortnight. Monitor whether his or her symptoms improve and, if they don’t, try reintroducing eggs back into your own diet.

Always seek advice and guidance from your GP, health visitor or allergy specialist before changing your diet with breastfeeding a baby with a suspected/confirmed allergy.

Q: How do I cook without eggs?

A: Thanks partly to the upsurge in veganism, you’ll find a wealth of egg-free products in the supermarkets, including mayonnaise and pancake mixes.

While eggs are a useful binding agent in foods like cakes and meatballs, you’ll find plenty of alternatives in your cupboard. Mashed sweet potato and even the gluey liquid from a can of chickpeas can work wonders in a cake. The latter, known as aquafaba, even whisks into an incredible egg-free meringue. You can also buy powdered egg replacers in most major supermarkets too.

Check out recipes on egg substitutions, and remember we have loads of great egg-free meal and baking ideas here.  You can also have a look at the Vegan Society too.

Q: Will my child grow out of an egg allergy?

A: Good news! Many children have begun to outgrow an egg allergy by the time they reach five. However, some children do remain allergic to eggs into adulthood.

Q: What is the egg ladder?

A:  If your child is showing signs of growing out of their egg allergy they may be asked to come and do a hospital challenge to baked egg.  This means giving small amount of well-cooked/baked egg in something like a scone or cake to your child under medical supervision.  If this is tolerated it may be suggested that you try the egg ladder.  This is where you try different forms of egg in stages, moving from very well cooked to less cooked to see if they can ultimately tolerate all forms of egg.

It is important not to try the egg ladder at home unless you have been advised to do so by a health professional.

Be ingredient-savvy!

These ingredients can derive from egg, although they may not all cause an allergic reaction:

Albumin, globulin, ovoglobulin, ovomucin, vitellin, livetin, ovovitellin, lysozyme, lecithin (E322).

Written by: The Allergy Team, 15th March 2021

Reviewed by:
Rachel De Boer, Specialist Paediatric Allergy Dietitian

References

[1] Hasan SA, Wells RD, Davis CM (2013). “Egg hypersensitivity in review”. Allergy Asthma Proc. 34 (1): 26–32.
doi :10.2500/aap.2013.34.3621. PMID 23406934.
[2] BSACI guidelines

Other references

NHS-PAE019_immunising_egg_allergic_children.pdf
NHS-Egg-Allergy.pdf
Anaphylaxis/Egg Allergy:The Facts.pdf
NHS-Egg-Allergy-in-children.pdf
www.allergyuk.org/information-and-advice/conditions-and-symptoms/36-types-of-food-allergy#download_access
NHS: How do I introduce egg into my child’s diet? The ‘egg ladder’.pdf

Disclaimer: All information provided by The Allergy Team Ltd is general information only.
Please contact your GP or other qualified healthcare professionals for specific advice.