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Nine-Step ‘Ladder’ May Allow Kids with Mild Reactions to Eat Egg

Updated guidelines from the British Society for Allergy and Clinical Immunology (BSACI) now detail a nine-rung ‘ladder’ approach for the stepwise home-based reintroduction of foods that contain eggs.

The BSACI said that attempts to reintroduce egg into a child’s diet can start from 12 months old, or six months from the last reaction. Past reactions must have been mild to moderate, and the child must not have asthma, according to guidelines. For children who have had severe reactions to egg in the past, or who have asthma need to be guided by a specialist allergy service.

Dr Susan C. Leech, DCH, a consultant in paediatric allergy with the Department of Child Health at Kings College Hospital London, and first author of the guidelines said that home reintroduction should begin slowly with small amounts of baked egg, starting with just a pea-sized piece of cake.

Parents can be reassured that it’s a relatively safe thing to do as long as it’s done with caution,” added Leech.

The expanded guidelines include a new nine-step programme which builds on a three-stage classification of egg-containing foods the BSACI introduced in 2010.

On the bottom four rungs, children can work their way through small but increasing amounts of cupcakes, biscuits cookies and other foods that contain baked eggs.

The next three rungs include hard-boiled eggs, quiche and other well-cooked egg products.

At the eighth rung, children can have small mouthfuls of runny scrambled eggs, mayonnaise, and other less-cooked or raw egg-containing products. At the top rung, children can have increasing amounts of those products as well as licks of cake batter.

The guidelines were published in September in Clinical and Experimental Allergy – onlinelibrary.wiley.com/doi/10.1111/cea.14009.

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