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Does early egg introduction prevent egg allergy in children?
  1. Viktorija Kaminskaite1,
  2. Sian Ludman2
  1. 1 University of Exeter Medical School, Exeter, UK
  2. 2 Paediatrics, Royal Devon and Exeter Hospital, Exeter, Devon, UK
  1. Correspondence to Miss Viktorija Kaminskaite, University of Exeter Medical School, Exeter, UK; vk252{at}exeter.ac.uk

https://doi.org/10.1136/archdischild-2021-321968

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    Clinical bottom lines

    • Dietary introduction of cooked hen’s egg can reduce the risk of egg allergy in infants. (Grade B)

    • The degree to which egg has been processed for early introduction seems to affect clinical outcomes with raw egg powders causing more complications due to increased allergenicity. (Grade C)

    • Pre-testing with either SPT or specific serum markers (e.g., sIgE) in high-risk infants can inform the clinician whether clinical supervision of early egg introduction may be useful. (Grade C)

    Scenario

    A 4-year-old infant comes into allergy clinic with her parents who say that after eating eggs and egg-containing foods she develops a ‘nettle sting’ rash around the mouth. This usually happens within an hour of eating. After an oral food challenge, an egg allergy is diagnosed. At a follow-up appointment, the parents ask you whether this could have somehow have been prevented. You look into whether early dietary introduction of egg would have played a role.

    Structured clinical question

    In children (population), does early introduction of egg (intervention) compared with later introduction (comparison) prevent the development of egg allergy (outcome)?

    Search

    All searches were all performed on 17 February 2021.

    Secondary sources

    Cochrane Library searched: ‘egg allergy prevention’ and ‘early introduction’; 26 results, none relevant. National Institute for Health and Care Excellence evidence searched: ‘egg allergy prevention’; 204 results, none relevant.

    Primary sources

    PubMed searched (“infant*“[Title/Abstract] OR “child*“[Title/Abstract] OR “paediatric”[Title/Abstract]) …

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    Footnotes

    • Twitter @Viktorija__K

    • Contributors VK and SL together decided to pursue this specific topic idea. VK was responsible for the researching, writing and editing. SL contributed her expertise to the write-up and was involved in the editing process.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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