So you think your child might have an egg allergy? What do you do?

Michelle Berriedale-Johnson suggests how you go about managing your child's egg allergy. An article and a video.

Introduction
OK – so you have your diagnosis – what do you need to do?
Eggs in the home and outside
Who do I need to tell?
What do I tell my child?
What do I do if my child accidentally eats something containing egg and I think he or she may be having an anaphylactic reaction?
What else can I do to keep myself or my child safe?
Growing out of egg allergy

Introduction

If your child gets any of the following symptoms after eating eggs, especially egg white (which is more allergenic than egg yolk) then you should certainly have them tested for egg allergy:

Symptoms of egg allergy:

• Hives or a rash
• Wheezing
• Sharp abdominal pain
• Vomiting or diarrhoea

Your doctor or allergist will give your child skin prick or blood tests which will confirm the allergy.

If your child is indeed allergic to eggs, do not get too depressed as the majority of children do grow out of an egg allergy. To encourage you—while approximately 2% of all young children are thought to have an egg allergy only 0.1% of adults do—so something must change!

OK – so you have your diagnosis – what do you need to do?

Well the management of egg allergy is very simple—avoid eggs rigorously—and that means both cooked and raw eggs although, as your child gets older, they may well be able to tolerate cooked eggs in cakes or biscuits, for example.

Anaphylactic reactions to eggs are rare but you do need to know what to do just in case it should ever happen.

• You will be prescribed an adrenaline/epinephrine Auto-injector pen (Epipen, Jext, Emerade) but you need to be sure that you know how to use it. (Doctors do not always know themselves!) You should be prescribed two pens; it’s vital to keep them both with you at all times.
• You can download a ‘plan’ from BSACI site here which gives very clear instructions what to do if someone is suffering from anaphylaxis. It has been designed to be used by people with no medical training.
• You can also get ‘trainer pens’ with instructions from all the suppliers. The pens are very simple to use but it is very important that you practice and know what to do. In the unlikely event that someone does have a serious reaction, it will be much easier not to panic and to use the pen properly if you have already practiced with the trainer pen.
• Depending on the age of your child, they should also practice with the pen, even if they do not use it themselves, so that they know what should happen.
• Make sure that you or your child always carry their auto-injector pen at all times.
• Join the Anaphylaxis Campaign in the UK, FARE in the US, and/or a local support group. The Anaphylaxis Campaign has an excellent help-line and both have lots of local support groups.

Eggs in the home and outside

You need to go through your kitchen and your house and get rid of any eggs and any products that include or use eggs.

Depending on the size, age and shape of your family you may decide that some members of the family should continue to eat eggs but, it is very much safer and easier not to have them in the house at all.

Shopping in the UK and Europe is now much easier too as any egg in any packaged food will have not only to have ‘egg’ listed in the ingredients but it will have to be in bold so that it is easy to see.

But… you will need to become an avid label reader!! Remember:

Egg can also be known as

• Albumin
• Conalbumin
• Ovalbumin

And it can appear in unlikely places such as:

• Batter on deep fried foods
• Brioche and other enriched breads
• Egg noodles
• Glazes on desserts
• Ice creams
• Margarines

When you buy food from a café or restaurants, remember to check with your server if the food contains egg or not.

Who do I need to tell?

The family

Tell everyone in the family – and not just your immediate family but grandparents, uncles, aunts and cousins – especially if there are lots of children. You do not want to cause panic but you do need everyone to know that the condition is serious and that they must be vigilant (especially if the child is small) and ensure that the child does not come into contact with any egg-containing foods.

Tell any close friends, and their children, with whom you or your child may spend time.

Child-minders or nurseries

It is very important that you talk to the nursery or child-minder if your child goes to either.  Child-minders may not be prepared to accept the responsibility of seriously allergic child but nurseries should be able manage the situation. A care plan will be of great help but you still need to discuss the child’s needs in detail with them. You also need to know that they know how to use an auto-injector and are prepared to do so if needed – and that they have a proper emergency procedure.

Schools

Make sure that you talk to the school about your child’s allergy and, if there is a school nurse, that you talk to him/her. Again, a pre-existing care plan will be very helpful.

Auto injector pens.

• If your child has a serious allergy then, as in the nursery you need to know that they know how to use an auto-injector, are prepared to do so if needed and that they have a proper emergency procedure.
• You also need to know how the school will deal with your child’s injector pen when he/she is at school. What happens when they play sport or go on an outing? Does the school have a generic pen and who amongst the staff may have been trained, or be prepared, to use it?

Bullying:

• Ask about the school’s policy on bullying as food allergy can be an excuse for bullies to pick on their victims.

Get the school involved:

• Once you have learnt more about egg allergy (see below) encourage the school to involve the other children in the management of your child’s allergy.

There is a brilliant free school video pack created by Allergy Adventures which will teach not only the children but the teachers about the management of food allergy in a really fun and exciting way – all tied into curriculum subjects.

Karen Waggott, whose son Jamie has a severe nut allergy, has put together an excellent management plan for schools. For the background to the plan click here; for a summary of the plan, click here; for the full plan click here.

For another mum, Nathalie’s way to manage she son’s school, see here.
For more suggestions on how to manage allergy at school see here.

Other care-givers
If you ever leave your child in the care of another organisation (e.g. a piano teacher, a Scout pack or Sunday School), it’s also vital that they know your child’s allergy needs, and that they know what to do in the event of an emergency.

What do I tell my child?

This will depend very much on the age of the child.

If very young:

If they have an IgE mediated allergy:
They need to know that if they eat something and then ‘feel funny’ – tickly throat or lips, short of breath – they must tell an adult immediately.

Whatever kind of allergy/intolerance they have:
They need to know that they must not eat any eggs or anything with eggs in it so, unless they know the person offering them food very well (parents or close family members), they should always ask if the food contains any egg before they eat it.

Once they go to school:

If they have an IgE mediated allergy:

• They need to know that if they eat something and then ‘feel funny’ – tickly throat or lips, short of breath – they must tell an adult immediately.
• They need to know that they must always carry their Epipen/adrenaline auto-injector or know who has got it and where to find it. (Some schools may prefer it to be kept in a safe place rather than the child keeping it on them as it could get lost or damaged.)
• They need to know that they should never swap foods with their friends or eat anything that their friends offer them.
• They should learn to recognise the word ‘egg’ even if they cannot read so that they can check foods themselves wherever they are before they eat it.
• If they are not sure about a food they should always ask an adult to check it for them.
• If they are worried about a food they should never eat it.
• They need to know that they never need to be ashamed of their allergy. Lots of other children have problems with foods – coeliac children cannot eat any bread or cakes, for example, and diabetic children need to inject themselves. So while having a food allergy or intolerance  is serious and they must be careful, it in no way stops them having a fun and exciting life.
• So they should tell their friends about their allergy. Friends are really good at looking after ‘their friends’ and protecting them from harm – and it is good to encourage them from a young age to be responsible.

What do I do if my child accidentally eats something containing egg and I think he or she may be having an anaphylactic reaction?

• Watch very carefully and at the least sign of a reaction (feeling sick, tingly mouth, difficulty in breathing, wheezing or anything else out of the ordinary) call 999 and tell them that you think someone is suffering from an anaphylactic (pronounced “ana-fill-ack-tick”) reaction.
• Be very clear when you give instructions to the emergency services how to find you. Getting lost wastes crucial time. Always provide them with a postcode or zip code to key into their SATNAV and have someone ready at the door to take them to where the person is.
• If you have an Adrenaline auto-injector (Epinen, Emerade etc) then use it, being careful to read the instructions carefully.  (The pens are very easy to use but it really pays off to have ‘trained’ with a trainer pen as using it is then so much less scary.) Even if the reaction is not a bad one, you will not do any harm in using the pen; it is perfectly safe to inject adrenaline/epinephrine even if you do not need it.
• Even if you have used the pen and you/your child feels better, always go with the ambulance as sometimes you can get a delayed reaction.

What else can I do to keep myself or my child safe?

• If you or your child have a serious allergy and are asthmatic, make sure that your asthma is well controlled. Asthma and serious allergy are closely linked and it is thought that many of the deaths apparently from asthma might in fact have been allergic reactions. Keeping your asthma well under control greatly reduces the risks.
• If you don’t already know how, learn to cook and teach your child to cook! The safest—and the healthiest—way for an allergic or intolerant person to eat is to cook for themselves!
• We have over 800 recipes in our ‘freefrom’ recipes section, all of which are free from cow’s milk and gluten adn many of which are free from eggs.
• We also have huge directories of ‘free from’ foods  available in the UK – and you can check out our FreeFrom Food Awards site for award-winning egg-free products.
• Learn more about egg allergy. On the FoodsMatter site we have many articles and research reports about egg and other food allergies.

Follow the links below to find:

• Articles and research reports specifically on egg allergy
• Articles and research reports on anaphylaxis
• Articles and research reports on the management of food allergy in children and young people
• Articles and research reports on the management of food allergy in general
• Articles and research reports on the possible causes of food allergy

Growing out of egg allergy

Because most children do grow out of their egg allergy it is worth having them checked on a fairly regular basis—maybe once a year. The chances are that they will start to tolerate cooked egg first but that will already open up a big range of foods—such as cakes!!

Hopefully they will continue to progress so that by the time they are in their teens they will be able to tolerate egg in most forms.

Those with serious allergies should also check in to the Anaphylaxis Campaign site in the UK, the FARE site in the US or Allergy & Anaphylaxis Australia in Australia or New Zealand.

More articles on egg allergy