Hen egg allergy is one of the commonest forms of food allergy. The majority of significant egg allergy reactions occur in very young children with infantile eczema.

Food allergies are associated with increased risk of anaphylaxis and asthma. Advice on managing food allergies in infants historically focused on avoidance of specific foods during infancy.

The thinking on this, however, has begun to shift, with some research finding that early introduction of foods, under the strict supervision of healthcare professionals, might reduce the incidence of food allergy when compared to avoiding foods. The Prevention of Egg Allergy with Tiny Amount Intake study investigated whether the stepwise introduction of egg combined with aggressive eczema treatment reduced the risk of hen’s egg allergy at 12 months of age.

Participants were between 4 – 5 months of age and had atopic dermatitis. They were randomly allocated to either the egg group or a placebo.

Participants in the egg group consumed a powder consisting of egg and squash orally from six months of age each day for six months. The first three months the powder consisted of 50mg of heated egg powder and 100mg of squash. The final three months the powder consisted of 250mg heated egg powder and squash.

The placebo group received a powder containing squash only, in two doses to mimic the same two-step process as received by the egg group. Participants’ eczema was also treated throughout the study.

Researchers obtained blood samples at patients first visit, at 4 -5 months of age, at 9 months and at 12 months of age. They also conducted oral food challenge (OFC) to test for hen egg allergy. The primary outcome was incidence of hen egg allergy at one year of age in study participants.

The results showed a reduced incidence of egg allergy in those infants who’d received the egg powder compared to those receiving a placebo.  They also found that by and large hen’s eggs could be introduced to these infants with atopic dermatitis using a two-step approach (gradually increase egg powder quantity) without immediate allergic reaction.

Implications

The results of this study suggest that high risk infants with eczema may benefit from early introduction of egg to reduce risk of egg allergies later in infancy.

It’s important to note that this should not be tried at home and should only be performed by a healthcare professional after consultation and approval by a healthcare professional. Talk to your doctor for more information.

Last Reviewed: 13/11/2019

Norman Swan Medical Communications



References

Natsume, O et al. (2016). Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double blind, placebo controlled trial. The Lancet http://dx.doi.org/10/1016/50140-6736(16)31418-0.