Before we started baby-led weaning with Camryn, I did all the research. I read books and blogs and joined baby-led weaning Facebook groups. I’m a questioner and I wanted to know all I could. I was terrified of the idea of gagging and choking (and would continue to feel this way the first few months).
Everything is very overwhelming at first. Obviously, it’s intimidating to know which foods to start with. And what about allergy foods – when do you do those? Shouldn’t you just wait so your baby doesn’t have a reaction? - Sarah Schlichter, MPH, RDN, LDN
The Top 8 Allergens
Eggs are one of the top 8 allergens, along with cow’s milk, peanuts, tree nuts, wheat, soy, fish, and shellfish. The egg white is typically the allergenic part of the egg and contains several proteins that can range from mildly to highly allergenic. Children with immune systems that aren’t fully developed may not be able to handle certain proteins in the egg white, which may cause certain allergic reaction symptoms.
There is a great deal of confusion about when to introduce eggs, and other allergen foods, to babies, for fear of causing adverse food reactions. However, the latest research encourages the early introduction of allergen foods.
Allergen Introduction Research and Recommendations from the American Academy of Pediatrics
Most babies are developmentally ready for solids between 4 and 6 months old, but before then, they should exclusively receive breastmilk or formula.
Introducing allergen foods to babies can be a scary process, especially if you have a family history of allergies. Older recommendations from the American Academy of Pediatrics (AAP) suggested that eggs should not be introduced until after age two in high-risk families. This was based on evidence from two studies that were based on consensus rather than direct evidence.
After reviewing more evidence, the American Academy of Pediatrics now recommends introducing eggs and allergen foods earlier, between 4 and 6 months, to lower the risk of food allergies. The AAP “found no convincing evidence that delaying the introduction of allergens beyond 4 to 6 months has any significant protective effect on the development of atopic disease” (1). A guideline released in 2010 by the National Institute of Allergy and Infectious Diseases supported the academy’s position. The American Academy of Allergy, Asthma, and Immunology also acknowledges that studies are emerging that may support early introduction as being protective against food allergy (2). Additionally, the AAP supports not limiting or restricting allergen foods during pregnancy and lactation (3).
A 2010 study of 2,600 infants found that babies who were introduced to eggs between 4 and 6 months were less likely to develop an egg allergy, compared to those who waited until after their first birthdays. Findings remained constant among children without risk factors and children with a family history of allergies (4). Older studies have also found similar results. A 2004 study found that among children who were followed from birth to age of 5 ½, there was no evidence for a protective effect upon wheezing, atopy or eczema from the late introduction of allergens. Conversely, a late introduction of eggs was associated with a non-significant increased risk of preschool wheezing (5).
Are There Any Exceptions to Introduction?
One exception to no longer delaying the introduction to allergenic foods is for infants with older siblings who have a peanut allergy, as there is almost a sevenfold increased risk in the younger sibling. Infants with moderate to severe atopic dermatitis (eczema) should also exercise caution. In these cases, infants should be evaluated by their pediatrician and a certified allergist before allergenic foods are introduced (2).
How You Can Start to Incorporate Eggs
Parents may feel most comfortable starting with introducing the cooked egg yolk, though introducing the whole egg is safe. An easy way to incorporate cooked eggs is to mash or puree them with breastmilk or formula, avocado, bananas or sweet potatoes. For older babies, consider serving it with toast, mixing it in with oatmeal, making egg muffins or baby-friendly french toast.
Eggland’s Best eggs provide several essential nutrients for babies. One Eggland’s Best Egg has just 60 calories, yet packs in more than double the brain-boosting omega-3 fatty acids than ordinary eggs and have key micronutrients like Vitamin A, Vitamin D, Vitamin E, folate and choline. Eggs also provide iron, which is a nutrient of significance in the first year of life during periods of rapid growth.
Eggs are also recommended throughout the lifespan and for a variety of specific diets. They offer crucial nutrients for children, pregnant women, and older adults.
Resources
- Thygarajan, Ananth and Burks, A. Wesley. “American Academy of Pediatrics recommendations on the Effects of Early Nutritional Interventions on the Development of Atopic Disease.” Current Opinion in Pediatrics. Dec. 2008. Accessed from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659557/.
- Fleisher, David M et al. “Primary Prevention of Allergic Diseases Through Nutritional Interventions.” J Allergy Clin Immunol.Jan 2013. Accessed from https://www.ncbi.nlm.nih.gov/pubmed/24229819
- Sicherer, Scott and Burks, A. Wesley. “Maternal and infant diets for the prevention of allergic diseases: Understanding menu changes in 2008.” J Allergy Clin Immunol. June 2008. Accessed from https://www.jacionline.org/article/S0091-6749%2808%2900955-X/pdf
- Koplin, JJ et al. “Can early introduction of egg prevent egg allergy in infants? A population-based study.” J Allergy Clin Immunol. Oct 2010. Accessed from https://www.ncbi.nlm.nih.gov/pubmed/20920771.
- Zutavern, A, et al. “The introduction of solids in relation to asthma and eczema.” Arch Dis Child. April 2004. Accessed from https://www.ncbi.nlm.nih.gov/pubmed/15033835