Yes, it is safe to introduce egg to this 6-month corrected age infant
You should introduce cooked egg to this infant now, as current guidelines recommend introducing eggs between 4-6 months of age, with around 6 months being the preferred target. 1
Timing and Developmental Readiness
- At 6 months corrected age, this infant is within the optimal window for egg introduction, which the American Academy of Allergy, Asthma, and Immunology recommends as between 4-6 months of age 1
- Before introducing egg, confirm the infant demonstrates good head control, ability to sit with support, and disappearance of the tongue extrusion reflex 1
- The WHO guidelines also support introducing eggs daily or as often as possible starting at this age 2
Risk Assessment Required
Determine if this infant has severe eczema or existing egg allergy, as this changes the introduction approach:
- Low-risk infants (no eczema or mild eczema): Introduce cooked egg at home without specialist evaluation or pre-introduction testing 1
- Moderate-risk infants (mild-to-moderate eczema): Can introduce eggs around 6 months at home without specialist evaluation 1
- High-risk infants (severe eczema requiring topical corticosteroids or calcineurin inhibitors, or existing egg allergy): Should be evaluated by an allergist between 4-6 months before introduction, which may include skin prick testing 1, 3
Form and Method of Introduction
- Start with cooked egg (not egg in baked goods), as this form appears more protective against egg allergy 1
- Research supports that first exposure as cooked egg at 4-6 months reduces egg allergy risk compared to first exposure as egg in baked goods (OR 0.2) 4
- Introduce egg as a single ingredient, not mixed with other new foods 5
Introduction Protocol
- Start with a small amount and gradually increase 1
- Wait at least 4 days after introducing egg before introducing another new food to monitor for allergic reactions 5
- This 4-day observation window allows adequate time to identify both immediate IgE-mediated reactions and delayed reactions 5
Critical Post-Introduction Step
Once egg is successfully introduced without reaction, it must be consumed regularly (at least once weekly) as part of the infant's usual diet to maintain tolerance and prevent sensitization. 1, 5
Evidence Supporting Early Introduction
- Delaying egg introduction beyond 6 months increases egg allergy risk: introduction at 10-12 months carries 1.6 times higher risk, and after 12 months carries 3.4 times higher risk compared to introduction at 4-6 months 4
- Early egg introduction (4-6 months) in high-risk infants reduces sensitization to egg white at 12 months (11% vs 20% in placebo group, OR 0.46) 6
- Introduction of egg white and yolk during infancy is associated with reduced atopic dermatitis by age 2 years (aOR 0.44 and 0.51 respectively) 7
Common Pitfall to Avoid
Do not unnecessarily delay introduction of egg beyond 6 months of age, as current evidence shows early introduction (between 4-6 months) helps prevent egg allergy rather than cause it 5