Helping a child manage an egg allergy means being aware of what
the child eats and reading food labels carefully. It's work,
but it's important.
About Egg Allergy
Eggs in themselves aren't bad, but when someone
is allergic to them, the body thinks they are. When a person
is allergic to eggs, the body's immune system overreacts to
proteins in the egg. So every time something made with eggs enters
the digestive system, the body thinks that these proteins are
harmful invaders.
The immune system responds by creating specific antibodies to
that food, which are designed to fight off the "invader."
These antibodies - called immunoglobulin E (IgE) - trigger the
release of certain chemicals into the body, one of which is
histamine.
So when a child with an egg allergy eats a food that contains
eggs, the immune system unleashes an army of chemicals to protect
the body. The release of these chemicals can affect the respiratory
system, gastrointestinal tract, skin, and the cardiovascular system
- causing allergy symptoms like wheezing, nausea, headache,
stomachache, and itchy hives.
Most people who are allergic react to the proteins in egg
whites, but some can't tolerate proteins in the yolk. Egg
allergy usually first appears when kids are very young, and most
kids outgrow it by the time they're 5 years old.
Egg allergy is like most food allergy reactions: It usually
happens within minutes to hours after eating eggs. Most reactions
last less than a day and may affect these three body systems:
- the skin: in the form of red, bumpy rashes (hives), eczema,
or redness and swelling around the mouth
- the gastrointestinal tract: in the form of belly cramps,
diarrhea, nausea, or vomiting
- the respiratory tract: symptoms can range from a runny nose,
itchy, watery eyes, and sneezing to the triggering of asthma with
coughing and wheezing
Most kids with egg allergy have some of the reactions listed
above, but a few may have a very strong reaction called
anaphylaxis
. This severe allergic reaction causes swelling of the mouth,
throat, and airways leading to the lungs, resulting in breathing
difficulty. In addition, there is a dangerous drop in blood
pressure, which can make a child dizzy or pass out, and may
quickly lead to shock.
For kids who are especially sensitive to eggs, even egg fumes or
getting egg on the skin can cause an anaphylactic reaction, so eggs
should be kept out of the house completely.
Diagnosing an Egg Allergy
If your doctor suspects your child might have an egg
allergy, he or she will probably refer you to an allergist or
allergy specialist for further testing. The allergy specialist will
ask things like how often your child has the reaction, the
time it takes between eating a particular food and the start of the
symptoms, and whether any other family members have allergies or
conditions like eczema and asthma.
The allergy specialist may perform a skin test. This test
involves placing liquid extracts of egg protein on a child's
forearm or back, pricking the skin a tiny bit, and waiting to see
if a reddish, raised spot forms, indicating an allergic
reaction.
Your child may need to stop taking anti-allergy medications
(such as over-the-counter antihistamines) 2 to 3 days before the
skin test because they can interfere with the results. Most cold
medications as well as some antidepressants may also affect skin
testing. Check with the allergist's office if you're unsure
about what medications need to be stopped and for how long.
Some doctors may also take a blood sample and send it to a lab
where it will be mixed with some of the suspected allergen and
checked for IgE antibodies.
In some cases, however, positive results of skin and blood tests
aren't enough to prove that symptoms are definitely being
caused by eggs. So doctors may use what's called a food
challenge to help diagnose the allergy.
With a food challenge, the person is told to not eat eggs or
anything made with egg proteins for a certain period of time -
usually a few weeks. After that, the person will eat foods that
contain eggs only under close supervision from a doctor. If
symptoms come back after eating egg products, it's likely the
person has an egg allergy.
Treatment
Treating egg allergy might seem simple - just make sure your
child doesn't eat eggs. But so many foods are made with
eggs and egg products that it can be really hard to know what's
OK and not OK to eat. Consider working with a registered dietitian
to develop an eating plan that provides all the nutrients your
child needs while avoiding things made with eggs.
If your child has a severe egg allergy - or any kind of serious
allergy - your doctor may want you to carry a shot of epinephrine
with you in case of an emergency. Epinephrine comes in an
easy-to-carry container about the size of a large marker. It's
easy to use - the doctor will show you how to give a shot to your
child should you ever need to.
If your child accidentally eats something with egg in it
and starts having serious allergic symptoms, like swelling inside
the mouth, chest pain, or difficulty breathing, give the shot right
away to counteract the reaction while you wait for medical help.
Always call for emergency help (911) if your child has needed to
use epinephrine. Besides keeping epinephrine in your home,
briefcase or purse, also be sure it's at relatives' homes
and your child's day care or school.
Also carry an over-the-counter antihistamine as this can help
alleviate allergy symptoms in some kids. Antihistamines should be
used in addition to the epinephrine and not as a replacement for
the shot.
If your child has had to have an epinephrine shot because of an
allergic reaction, go immediately to a medical facility or hospital
emergency room so they can provide additional treatment if needed.
Up to one third of anaphylactic reactions can have a second wave of
symptoms several hours following the initial attack. So your
child might need to be observed in a clinic or hospital for 4
to 8 hours following the reaction.
Living With an Egg Allergy
The best way to be sure a food is egg free is to read the label.
Manufacturers of foods sold in the United States must list on their
labels whether a food contains any of the most common allergens. So
look for statements like these somewhere on the label:
"contains egg ingredients," "made using egg
ingredients," or "made in a facility that also processes
eggs."
This label requirement makes things a little easier than reading
the ingredients list - instead of needing to know that the
ingredient "ovoglobulin" comes from egg protein, you
should be able to tell at a glance which foods to avoid. Still, to
make sure the foods your child eats are egg free, you'll
need to be on the lookout for any ingredients that might come from
eggs. That means asking questions when eating out at restaurants or
others' homes and carefully reading food labels.
Try to find out how foods are cooked and what's in them. In
some cases, you may want to bring your child's own food
with you. When you're shopping, look for egg-free alternatives
to foods that usually contain eggs, such as pasta.
When preparing food, use one of these egg alternatives in
recipes. Each of these replaces one egg (these substitutes may not
work as well in recipes that call for more than three eggs):
- 1 teaspoon baking powder + 1 tablespoon liquid + 1 tablespoon
vinegar
- 1 teaspoon yeast dissolved in 1/4 cup warm water
- 11/2 tablespoons water + 11/2 tablespoons oil + 1 teaspoon
baking powder
- 1 packet gelatin + 2 tablespoons warm water (don't mix
until ready to use)
- 1 tablespoon pureed fruit such as apricots or bananas
When cooking at home, always carefully scrub the utensils
you're using in case they have been used on egg products.
Although the number of people in the United States with food
allergies is low (just over 1% of the total population),
there's a growing awareness about food allergies. This means
that everyone - from the waitstaff at a restaurant to food
manufacturers - is more understanding and willing to accommodate a
child's food needs.
Reviewed by:
D. Pauline Williams, MPA, RD, CD
Date reviewed: April 2006
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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