Introducing Eggs to Babies
The humble egg has been subjected to quite a wide variety of opinions when it comes to introducing it to your baby. It is also classified as a 'high allergenic food', being one of the top eight food allergens.
Nutritionally, the egg is packed full of important nutrients. It is a complete protein (containing all eight essential amino acids) plus it contains both saturated fat (approximately 1g) as well as unsaturated fat, including your omegas. Eggs have a significant number of vitamins and minerals including selenium, folate, iron, calcium Vitamins A, E, D, B5, B12 and more!
When you look at how much goodness eggs can provide to our babies, it is a food we do want to introduce especially in the sensitive period the first year offers for developing food preferences. However, I know it can be quite daunting when there is such conflicting information and worry considering eggs are a top allergen.
So below I answer some of the top questions and de-bunk the major myths on introducing eggs to babies.
Important Note: If there is a reaction to introducing egg please ensure you seek medical attention immediately. If you are concerned about the risk of allergy in the family, needing support following a reaction and/or any other individualised questions we would recommend a one:one consultation.
1. When to introduce eggs?
As with all allergenic foods it was previously recommended to be very careful of introducing eggs. When my first son was starting solids (now eight years ago). It was recommended to start with an egg yolk at seven months and then egg white around eight months. Inline with new, essential evidence on allergenic foods to indicate that early introduction can reduce the incidence of allergy (Tan et al., 2017) it is now strongly recommended by The Australasian Society of Clinical Immunology and Allergy, to introduce eggs very quickly around six-seven months of age. Due to its nutritional power I recommend to introduce egg within the first month of starting solids.
2. What is the best way to introduce eggs?
You do want to try egg on its own for the first time (i.e. not with any other foods) just to see if there is a reaction. You can now give the whole egg together - so no need to do the egg yolk and white separately which will make things a lot easier. In my experience once tried for the first time, scrambled eggs are very easy for babies to have. All my boys love their eggs this way!
3. How much eggs can babies have?
The following is a statement from the Nutrition Foundation: "It was previously thought that eggs were related to high cholesterol. Studies conducted in healthy people show no effect of daily egg intake on blood cholesterol. In addition the latest scientific evidence shows no association between increased intake of dietary cholesterol and increased risk of heart disease or stroke." This is a very simple (trusted) summary of current evidence here. In terms of exact amount, there is no 'rule' as such. You still want to get in a good balance of vegetables and other wholefoods across the day, keeping in mind you are developing your babies preferences and variety is important for a broad range of nutrients.
4. Can you give runny egg to a baby?
It is currently not recommended to give a baby raw egg and that best practice is for a well-cooked egg.
5. Is there a risk of Salmonella?
Salmonella is a type of food poisoning caused by the Salmonella bacterium. I have read some blogs, which suggest that babies can contract Salmonella and therefore to avoid introducing eggs in the first year. In New Zealand we have very stringent code of practice in place for the industry for best before dates on eggs and there has not been a single reported case of Salmonella from eggs for over 10 years. Some of the research cited in these blogs is very outdated, does not align with new allergic guidelines (released in mid-2016 last year) and based in the United States. The Allergy New Zealand website is a very trusted source of information on allergic foods, so worth checking out in this regard as well.
6. How common is egg allergy?
Egg allergy is the second most common food allergy in infants and young children after cows' milk allergy (Caubet and Wang, 2011). It usually presents after the first exposure to egg protein.
7. What are signs of a reaction?
An autoimmune response will be evident within two hours, normally very quickly. Reactions can range from a flare in eczema, to hives or swelling around the mouth or more widespread, gastrointestinal reactions with tummy pain and vomiting, to severe reactions (anaphylaxis). Most children with egg allergy have mild symptoms, but some children have severe, life-threatening reactions to even the tiniest amount of egg. Some egg-allergic children can eat well-cooked egg, but not raw or lightly cooked egg. Others are allergic even to egg that has been well cooked (Allergy New Zealand).
8. Can children grow out of it?
Yes! In fact the majority of those infants diagnosed will out grow it by the time they reach their late teens. There is now evidence to show that slow re-introduction (rather than strict avoidance) especially through baked egg can help to build tolerance (Leonard, 2012). This must be done with individualised support and given the two-year window of gut materation, I would not recommend waiting to seek some help with this as this two year period is critical in the development of the auto-immune system. Both myself and my allergy expert (Kelly Sutherland) can assist with this (booking system here).
9. What about other types of eggs?
If you are allergic to eggs, you will need to avoid eggs from other poultry, such as duck, goose and quail. You also need to avoid both the egg white and the egg yolk. For those not allergic other types of eggs will provide slightly different nutrients, especially vitamins and minerals and therefore are good to try with your babies.
10. What if my baby does not like the texture?
This is quite common, so please do not despair if it does happen. It does not mean your baby will never eat eggs, just that they need a few more opportunities (it can take up to 21 attempts) and possibly a different texture to try. Do not be afraid to try a variety of styles from scrambled, to fried (in a healthy oil). You can also check out my Egg and Spinach Cups for a different idea.
In my best selling starting solids book, The Nourished Baby, I have a whole section on allergenic foods, how and when to introduce them - including a complete week-by-week plan to help take a lot of the thinking (and worry) out for you! In addition my Baby and Toddler Cookbook has both a number of helpful ideas to include eggs for babies and toddlers as well as some egg-free alternatives if your little one does have an egg allergy - like the tofu scramble pictured below (top right).
Happy Egg Eating,
xx Dr Julie Bhosale
Helpful References and Reading:
Allergy New Zealand: http://www.allergy.org.nz/
Cusick, S.E., & Geogieff, M. K. (2016).. the role of nutrition in brain development: The golden opportunity of the first 1000 days. Journal of Pediatrics, 175, 16-21.
Leonard, S. (2012). Dietary baked egg accelerates resolution of egg allergy in children. Journal of Allergy and Clinical Immunology, 130, (2), 473-480.e1.
Gray, J. (2016). Eggs - can we finally stop worrying about them? Nutrition Bulletin, 41(2), 130-134
Nutrition Foundation of New Zealand https://www.nutritionfoundation.org.nz
Savage J., et al. (2007). The natural history of egg allergy. Journal of Allergy Clinical Immunology,120, (6), 1413-1417.
Tan et al., (2017). A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy. Journal of Allergy and Clinical Immunology, 139, (5), 1621-1628.e8