Egg Allergies in Children: Symptoms, Diagnosis,
and Treatment

Egg allergies are one of the most common allergies among infants and young children. For children with egg allergies, the egg is simply inedible.

Egg allergies are very hard to diagnose, because it is an ingredient in so many things that young children eat. Ultimately, it is the parent's responsibility to monitor what the child eats and to consult a doctor if they have any concerns about possible allergic reactions.

WHAT IS AN EGG ALLERGY?

Food allergies, according to the website Kidshealth.org, occur when a person's immune system mistakenly believes that something he or she ate is harmful to the body. In an attempt to protect the body, the immune system produces antibodies, called immunoglobulin E to that food. The antibodies then cause mast cells (allergy cells in the body) to release chemicals, one of which is histamine, into the bloodstream. The histamine acts on a person's eyes, nose, throat, lungs, skin, or gastrointestinal tract and causes the symptoms of the allergic reaction. Future exposure to that same allergen (things like eggs, nuts or pollen that you can be allergic to, are known as allergens) will trigger this antibody response again. This means that every time that person eats that particular food, he or she will have an allergic reaction.

An egg allergy usually begins when children are very young, but most children outgrow the allergy by the time that they are five. Most children with an egg allergy are allergic to the proteins in egg whites, but some cannot tolerate proteins in the yolk. Egg white powder, used in cooking and in baked goods, can also be dangerous to those who have a severe egg allergy.

SIGNS AND SYMPTOMS

Symptoms begin to show within a few minutes after eating eggs, but in some cases, it can take a few hours. Most reactions last less than a day and the body systems could be affected in one or more of the following three ways:

• Red, itchy, bumpy rashes develop.
• The child could develop severe tummy cramps, diarrhea, nausea and vomiting.
• The child could have a runny nose and some sneezing or asthma with coughing and wheezing could develop.

Some people could experience a more severe allergic reaction, called anaphylaxis. Anaphylaxis causes swelling of the mouth, throat, and airways, which results in an inability to breathe. In addition to this, anaphylaxis causes a dangerous drop in blood pressure; low blood pressure can make a person feel dizzy or pass out.

Some people are so sensitive to eggs that even egg fumes or egg on their skin can cause anaphylaxis. In these instances, eggs should be completely banned from the house.

DIAGNOSING AN EGG ALLERGY

The best way to test for food allergies is through a process of elimination. If, through this process, it is decided that the child is allergic to eggs, avoidance of any foods made with eggs is crucial. If a child has the same reaction every time he or she eats eggs, diagnosis is rather simple and straightforward. However, most egg-allergic people react to egg proteins within other foods; this makes the diagnosis more complicated.

An accurate diagnosis can only be made by an experienced doctor or allergy specialist. If the doctor suspects an egg allergy, he will probably do a skin sensitivity test. In this test, a diluted extract of egg is placed on the forearm or on the back and the skin is scratched or pricked with a needle. If swelling or redness occurs it is considered an allergic reaction.

Doctors also use an elimination diet, during which the eggs and egg products are completely removed from the child's diet for 1 to 2 weeks.

If the symptoms go away, an egg allergy can be presumed, especially if the symptoms reappear upon reintroduction of eggs into the diet. An elimination diet must be strictly monitored and followed if the egg allergy is to be identified.

If the results of these tests are still unclear, a food challenge may be needed for final diagnosis. For this test, the child might be given gradually increasing amounts of eggs to eat while being watched by the doctor for symptoms. This type of test should only be performed in a clinic or hospital where access to immediate medical care and medications is available. It should be avoided completely if your child has experienced an anaphylactic reaction to eggs in the past.

TREATING AN EGG ALLERGY

There is no easy way out, states the website Kidhealth.org. The only way to treat an egg allergy is to eliminate eggs, and foods made with eggs from the child's diet. This could prove challenging because so many foods are made with eggs and egg derivatives. If your child has an egg allergy, you will need to read ingredient lists carefully. Everything your child eats must pass the no-eggs test.

There is no medication available to prevent an allergic reaction to eggs. If a child does ingest egg products and has an allergic reaction, antihistamines could relieve gastrointestinal symptoms, hives, sneezing, or a runny nose.

Anaphylactic reactions can be fatal even if they begin mildly. Parents and caregivers must know how to protect children from eating foods that contain eggs, as well as what to do if the child does eat something that can cause an allergic reaction.

In case of an emergency, doctors recommend that children 12 or 13 and older (depending on the maturity of the child) with a severe egg allergy or their parents keep a shot of epinephrine with them in an easy-to-carry container that looks like a pen. This device is also called an EpiPen. EpiPen administers epinephrine, or adrenaline, with one injection into the thigh, to ease the allergic reaction.

Children are often advised to wear a medical alert bracelet. It is also a good idea to carry an over-the-counter antihistamine, which can help alleviate allergy symptoms in some people. Antihistamines should be used in addition to the EpiPen and not as a replacement for it.

Kids who have had to take an epinephrine shot should immediately be taken to a medical facility or hospital emergency room, where additional treatment can be given if needed. Up to one third of anaphylactic reactions can have a second wave of symptoms several hours following the initial attack, so the child might need to be observed in a clinic or hospital for 4 to 8 hours following the reaction.

CARING FOR YOUR CHILD

Flu and measles/mumps/rubella (MMR) vaccines are grown in cultures from egg cells and may contain a small amount of egg protein. Significant evidence by the American Academy of Pediatrics (AAP) and Centers for Disease Control (CDC) indicates that the MMR vaccine is safe for children who are in fact allergic to eggs.

When it comes to feeding your child, the solutions are not as clear-cut. It should come as no surprise that baked goods, baking mixes; cereals, cookies, custards, and ice cream are all made with eggs. Candies, hot dogs, meatballs, fast foods, and salad dressings can include egg derivatives as well.

Food makers are required to clearly state on the food label, in or adjacent to the ingredients list, whether the food contains egg or egg products. Look for, and avoid, the following egg products on labels:

• Dried egg,
• Egg white,
• Egg white solids,
• Egg yolk,
• Egg solids,
• Powdered egg,
• Egg substitutes,
• Whole egg.

Many products and food ingredients that contain egg products, but whose names do not always include the word egg, such as albumin and hidden ingredients, begin with the prefix "ovo."