When to Introduce Eggs to Babies
Eggs should be introduced to infants between 4-6 months of age, with around 6 months being the preferred target, but not before 4 months. 1, 2
Timing Guidelines by Risk Category
Standard Risk Infants (No Eczema or Food Allergies)
- Introduce eggs around 6 months of age when developmentally ready (good head control, ability to sit with support), but not before 4 months 1, 2, 3
- Eggs can be introduced at the same time as other complementary foods—there is no need to delay allergenic foods 1, 2
- Introduction at home without specialist evaluation is appropriate 2
High-Risk Infants (Severe Eczema or Existing Egg Allergy)
- For infants with severe eczema, egg allergy, or both: introduce eggs between 4-6 months AFTER evaluation by an allergist 1, 2
- This evaluation may include skin prick testing or specific IgE measurement before introduction 1, 2
- Despite testing, approximately 8-9% of high-risk infants may still react to egg even with negative screening tests 4, 5
Mild-to-Moderate Eczema
- Introduce eggs around 6 months at home without specialist evaluation 2
- No pre-introduction testing is required for this group 2
Form of Egg Introduction
Start with cooked (well-cooked) egg rather than egg in baked goods, as this appears more protective against egg allergy 1, 6
- Introduction of cooked egg at 4-6 months reduces egg allergy risk compared to first exposure as egg in baked goods (80% risk reduction) 6
- Raw or undercooked egg should be avoided in infants 4
Critical Evidence Supporting Early Introduction
The recommendation for early egg introduction represents a complete reversal from previous guidelines that advocated delaying allergenic foods:
- Early egg introduction (4-6 months) reduces egg allergy risk by approximately 44-80% compared to delayed introduction 4, 6
- Delaying egg introduction beyond 6 months significantly increases egg allergy risk—introduction after 12 months carries 3.4 times higher risk compared to 4-6 months 6
- Even in high-risk infants with eczema, early regular egg exposure reduces egg allergy incidence and induces protective IgG4 antibodies 5
Important Caveats and Pitfalls
Do NOT Delay Beyond 6 Months
- Delaying egg introduction beyond 6 months does NOT prevent egg allergy and actually increases risk 1, 6
- Many infants already have egg sensitization by 4 months of age (36% in high-risk populations), even before any known egg exposure 5
Maternal Diet During Breastfeeding
- Maternal egg consumption during early breastfeeding (first 5 days) does NOT affect infant egg allergy risk at 12 months 7
- Routine maternal egg avoidance during pregnancy or breastfeeding is NOT recommended for allergy prevention 1
Continued Regular Intake
- Once eggs are successfully introduced, they should be consumed regularly (at least weekly) as part of the infant's usual diet 1
- Discontinuing egg intake after initial introduction may increase risk of sensitization and allergy 1
Developmental Readiness Markers
Before introducing any solid foods including eggs, ensure the infant demonstrates: 2, 3
- Good head control
- Ability to sit with support
- Disappearance of tongue extrusion reflex
Normal vs. Concerning Reactions
Expected Normal Responses
- Initial hesitation or refusal (may need 8-10 exposures for acceptance) 2
- Facial expressions showing surprise or confusion 2
- Small gagging episodes as oral motor skills develop 2
- Mild stool changes in consistency or color 2
Warning Signs Requiring Medical Attention
- Persistent or projectile vomiting 1-4 hours after eating 2
- Severe diarrhea with blood or mucus 2
- Skin rashes, hives, or facial swelling 2
- Respiratory symptoms (wheezing, persistent coughing, difficulty breathing) 2
- Lethargy or significant behavioral changes 2