What is an egg allergy?

An egg allergy is a reaction by your child's immune system to eggs. Our immune systems normally respond to bacteria or viruses that attack the body. A food allergy occurs when the body's immune system mistakenly believes that a harmless substance (a food) is harmful. In order to protect the body, the immune system creates substances called antibodies to that food. The next time you eat that particular food, your immune system releases huge amounts of chemicals, such as histamines, to protect the body. Eggs are among the 8 foods that are responsible for most food allergies in children. The other foods include milk, soy, peanuts, tree nuts (such as walnuts and cashews), wheat, fish, and shellfish. The good news is that most kids outgrow an egg allergy by age 5.

What are the symptoms of an allergic reaction to egg?

If you suspect your child is allergic to eggs or any other food, it is important to get a diagnosis from your healthcare provider or allergist. Symptoms can be mild, or severe:

• skin reactions such as hives, eczema, or swelling
• diarrhea, nausea, vomiting, stomach pain, or itching around the mouth
• running nose, wheezing or trouble breathing
• rapid heartbeat.

Although very rare, it is possible to have an anaphylactic reaction. This is a serious reaction that is sudden, severe, and can involve the whole body. It can cause swelling of the mouth and throat, dangerously lower blood pressure, and trouble breathing. This type of reaction is a medical emergency. It is treated with epinephrine (a medicine that is given by injection). Usually parents or caregivers of children that have severe allergic reactions carry their own shot kits in case of emergency.

An allergic reaction to a food usually starts within minutes but may be delayed 2 to 4 hours. It usually lasts less than 1 day. The more severe the allergy, the smaller the amount of food it takes to cause a reaction.

How will this affect my child's diet?

New studies show that slowly adding small amounts of eggs to the diet may help children get over the allergy sooner. However, for now, the only treatment for egg allergy is to completely avoid eggs and foods that contain egg products.

If you are breast-feeding, eliminate the food your child is allergic to from your diet. Food allergens can be absorbed from your diet and enter into your breast milk. Eggs are found in hundreds of processed foods, many of which your child probably eats everyday. You will need to change the way you order, shop for, and prepare foods. Be sure to check the ingredients on food package labels and ask about the ingredients in food prepared in restaurants when you eat out.

The first step is to learn to read labels and become familiar with ingredients that contain egg products. Always ask about ingredients if you are not sure. Study the lists below to learn more about foods and ingredients to watch out for.

Foods that almost always contain egg

• Breads, cakes, cookies, pastries, pastas, and cereals.
• Shiny breads, such as bagels and pretzels (egg yokes or whites are used to brush the tops to make them shine). Shiny baked goods should always be avoided.
• Orange Julius beverage.

Foods that often contain egg (check the label or ask):

• Salad dressing, candies, chocolates with cream filling, and beverages such as root beer and specialty coffees.
• Fried restaurant items (the same fryer might be used to cook egg-battered foods and other foods, such as French fries.)
• Food products that include the word binder, coagulant, or emulsifier on the label. Egg is often used as a binding agent.

Ingredients that indicate the presence of egg include (especially look for names beginning with Ovo or Ova)

• Albumin (egg protein)
• Binder
• Coagulant
• Egg (dried, powdered, white, yolk, solids)
• Egg substitutes (typically made with egg white)
• Emulsifier
• Flavorings (natural or artificial)
• Globulin
• Lecithin E322 (although lecithin is a natural component of egg, when used in processed foods, it is typically derived from soy. Many of these products may be acceptable for your child, so call the manufacturer to make sure of the source.)
• Livetin
• Lysozyme
• Mayonnaise
• Meringue
• Ovalbumin (sometimes indicated as Ov)
• Ovoglobulin
• Ovomucin
• Ovomucoid
• Ovotransferrin
• Ovovitella
• Ovovitellin
• Silici albuminate
• Simplesse (fat replacer)
• Vitellin

Foods that may contain eggs (only use these if you can call manufacturer to clarify the makeup of all ingredients)

• Nougat
• Noodles
• Macaroni
• Marshmallows
• Marzipan

Reading labels to avoid allergens has become a lot easier. Foods that contain milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, or soy products must list the food in plain language on the ingredient list. For example, albumin (egg). These possible allergens must be listed even if they are part of a flavoring, coloring, or spice blend. There are still some things to watch out for when reading food labels:

• Read the label every time. The manufacturer may change ingredients.
• Watch out for the words "may contain". Milk, peanuts, or other allergens may not be ingredients, but the food may be made in a factory that also produces these foods. If you see the words "may contain", there may be very little of the allergen, or there may be a large amount.
• Words on the package such as "peanut free" or "milk free" do NOT mean that the food is completely without these allergens. You still need to read the label carefully to make sure that it does not contain ingredients derived from allergens.

It is very important for you to know less common names and scientific names for food ingredients.

How can I provide my child with a healthy diet that tastes good?

Your child can still have a nutritionally complete diet. The primary nutrients found in eggs are protein and B vitamins. Your child can get plenty of protein from other sources such as dairy products, meat, poultry, pork, fish, beans, soy foods, legumes, nuts, and seeds. However, when grain products such as cereal are eliminated, there may be a risk of not getting enough B vitamins. Try to offer egg-free whole grain products. You can make these from scratch or buy an egg-free type. Other sources of B vitamins include dark leafy vegetables, bananas, asparagus, oranges, peanuts, and brewers yeast. It is a good idea to have your child's diet checked by a pediatric dietitian.

How do I modify recipes?

You can modify most recipes that call for 3 eggs or less.

Each egg in the recipe can be replaced by one of the following substitutions:

• 1 tsp of yeast dissolved in 1/4 cup warm water
• 1 and 1/2 tablespoon water, 1 and 1/2 tablespoon of oil, and 1 teaspoon baking powder.
• 1 packet gelatin mixed with 2 tablespoons warm water (mix just before adding to recipe).

It is also helpful to get cookbooks for people with food allergies, such as the NEW-Food Allergy and Anaphylaxis Network (FAAN) Cookbook - Cooking Allergy-Free Everyday. Visit the Web site at http://foodallergy.org or call 800-929-4040 to order this cookbook and others. There are also Web sites that sell specialty foods modified for allergies (such as http://www.allergygrocer.com.)

How can I keep my child safe at school?

• Teach your child not to eat foods unless they are safe. Even young children can grasp this concept, especially once they have gotten sick after eating a particular food.
• Prepare your child's lunch at home.
• Talk with teachers and the school administrator regarding your child's needs. Ask teachers to keep an eye out and explain the situation to other children if needed.
• Have the teacher call you if there is a special event or party planned so that you can bring a few modified treats that your child enjoys and can share with other kids.
• Make a card that lists foods and ingredients that should be avoided and give one to the teacher. The card can also be helpful to older children in making decisions when out with friends.
• The flu shot should not be given to anyone with severe egg allergy. Although allergic reactions are rare, the virus for the flu shot is grown in eggs. Ask your doctor or allergist if it is safe for your child to have a flu shot. The nasal spray flu vaccine should not be given to children with egg allergy. The MMR (measles, mumps, and rubella) vaccines are no longer considered unsafe for those with egg allergy.