Introducing egg to infants with eczema: a randomized controlled trial
Published Online: June 28, 2013
Egg allergy is one of the most common food allergies affecting young children. As food allergies can result in a significant burden to families and the health care system, researchers are trying to prevent the development of food allergies. One approach to prevent egg allergies may be to introduce egg into the diet of infants in small regular amounts earlier (from 4 months of age), which is thought to help the infant’s immune system to develop tolerance to egg.
A randomized controlled trial from Palmer et al, published in The Journal of Allergy and Clinical Immunology (JACI) studied infants with eczema as they tend to have a much higher chance of developing a food allergy. Each infant in this trial was randomly assigned to one of two groups. One group of infants (n=49 infants) were introduced to egg powder from 4 months of age and the other group of infants (n=37 infants) were introduced to rice powder from 4 months of age. The families were asked to give their infant 1 teaspoon of powder mixed with solid foods each day until their infant was 8 months of age. Cooked egg was introduced to both groups of infants at 8 months of age. At 12 months of age, the infants had a medically observed pasteurized raw egg challenge to determine which infants had developed an egg allergy.
The authors found that 31% of the infants in the egg group had an allergic reaction to the egg powder within the first few days of eating the powder. Based on these results, it would be recommended that caution be taken when infants with eczema are first introduced to egg in their diets, as many have already developed sensitivity to egg by 4 months of age, possibly while in utero or via breast milk or via environmental exposure. Overall, 33% of infants in the group that were given the egg powder developed an egg allergy by 12 months of age compared to 51% of the infants given the rice powder. The results from this trial show that by introducing small, regular amounts of egg from as early as 4 months of age, the incidence of developing an egg allergy is reduced. Whilst research in the area of food allergy prevention is continuing, this randomized controlled trial shows promise in helping families to find the best age to introduce egg into the diet for infants with eczema.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.