Randomized controlled trial of early regular egg intake to prevent egg allergy

Publication date: Available online 20 August 2016
Source:Journal of Allergy and Clinical Immunology
Author(s): Debra J. Palmer, Thomas R. Sullivan, Michael S. Gold, Susan L. Prescott, Maria Makrides
BackgroundThe ideal age to introduce egg into the infant diet has been debated for the past two decades in the context of rising rates of egg allergy.ObjectiveTo determine if regular consumption of egg protein from 4-6 months of age reduces the risk of IgE-mediated egg allergy in infants with hereditary risk, but without eczema.MethodsInfants aged 4 to 6 months were randomly allocated to receive daily pasteurized raw whole egg powder (n=407) or a color-matched rice powder (n=413) to 10 months of age. All infants followed an egg-free diet and cooked egg was introduced to both groups at 10 months. The primary outcome was IgE-mediated egg allergy defined by a positive pasteurized raw egg challenge and egg sensitization at 12 months of age.ResultsThere was no difference between groups in the percentage of infants with IgE-mediated egg allergy (egg 7.0% vs. control 10.3%; adjusted relative risk 0.75; 95% confidence interval 0.48 to 1.17; P=0.20). A higher proportion of participants in the egg group stopped taking the study powder due to a confirmed allergic reaction (25/407, 6.1% compared to 6/413, 1.5%). Egg-specific IgG4 levels were substantially higher in the egg group at 12 months (median 1.22 mgA/L vs. control 0.07 mgA/L; P<0.0001).ConclusionWe found no evidence that regular egg intake from 4-6 months of age substantially alters the risk of egg allergy by 1 year of age, in infants who are at hereditary risk of allergic disease and had no eczema symptoms at study entry.

Teaser

For infants without eczema symptoms, regular egg intake from 4-6 months of age does not substantially alter the risk of egg allergy by 1 year of age.


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