TOMORROW we are going into hospital for a ‘baked egg challenge’. This means that Sidney will be fed a pre-baked, egg-containing muffin in incremental doses to see if he reacts.
Apparently 80 per cent of egg allergic children can tolerate baked (i.e. “extensively heated”) egg.
Other than attempting a taste challenge such as this, there are no other reliable tests to determine tolerance.
Eeek.
This is the first time I must confess to feeling properly nervous about a food challenge.
What do I know of Sidney’s egg allergy so far? Well, that he reacted at just five months old when somehow a trace amount of egg that my husband and I had been eating got on to his skin. Within minutes he was bright pink, covered from head to toe in hives and screaming his teeny head off.
I know that his latest skin prick test results were pretty big – maybe a 12mm wheal, if I remember rightly. Not little, anyway. And while SPTs (skin prick tests) cannot determine the severity of an allergy they can determine the likelihood of an allergy. So even though Sidney has never actually eaten any egg, ever (other than via breastfeeding), we can be pretty sure he is definitely allergic.
Baked egg, of course, is the unknown quantity.
Why else am I nervous?
We used to dub Sidney the 5 per cent kid because his doc had said that, despite a positive SPT to wheat at six months old, he was “95 per cent unlikely” to be allergic but that we should wait until he hit a year before trying it. He was allergic to wheat. Plus, he is one of the five per cent of peanut allergic kids with allergy to other legumes.
So I won’t be too surprised if he sits in that 20 per cent of kids who can’t tolerate baked egg, as unscientific as my theorising may be. It’s a question of ‘hope for the best, expect the worst’.
I’ve also been agitating about the best way of approaching this new challenge with Sidney himself.
We’ve conducted food challenges at home, but with food that he has had low to zero skin prick tests for and which his doctor felt were safe to try. There have been some nuts included in this (hazelnuts, walnuts and almonds) and I’ve got over the confusing aspect for him by not actually ever referring to them as nuts. So we have homemade ‘hazel’ butter now, for instance, because I would rather maintain the simplicity of ‘all nuts bad’ than give his poor little head too much to ponder on. He’s only three.
The last time we had a hospital challenge, to sesame, he was barely 18 months old and we could have daubed poo on his face for all he knew. Now, he understands that we are feeding him something to test whether he can safely eat it. So, I had a few issues…
Scenario 1: Tell him we are trying a muffin with egg in it
The possible outcomes are:
1. He is nervous and refuses, the mantra “no eggs” having been drilled into him since before he could walk
2. He fails the test and has a reaction. OK, he’ll then know exactly why eggs are bad, but will he trust us with any future food trials again?
3. He passes the test. Now he can have very specific amounts of baked egg but ‘eggy’ egg (e.g. scrambled, fried, etc) remain no-nos. Can a three-year-old really assess the complexity of this scenario? Should a three-year-old have to assess the complexity of such a scenario? Might the still-present danger of eggs be lost on him after this?
Scenario 2: Don’t tell him this is an egg challenge, just say we are trying a “new cakey thing”
The possible outcomes are:
1. He reacts, and is then nervous about any future challenges we try
2. He passes the test, is none the wiser (for now) but we can introduce baked egg secretly and hope that this early tolerance develops into an outgrown allergy by the time he hits teendom
We’ve gone for scenario 2. As far as I’m concerned, at three he’s too young to have to grapple with the intricacies of his allergies. The simpler we can make it for him, the better, and the safer.
The muffins are sitting in our freezer in the basement, safely sealed in a box. I asked Mum to bake them for me to a specific recipe provided by the hospital (around four medium eggs shared between 12 muffins), because I didn’t want to be fannying around with eggs in the house.
They look nice, huh? Who would think that something so innocuous could be so fraught with risk.
Wish us luck…
yesnobananas 
We most certainly do wish you luck………
Good luck – let us know how he does xx
Fingers crossed for you. You sum up how it feels to be a parent in this situation so very well. Thank you for your blog!
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Why are they testing so young and so soon after positive testing! My daughter was one of the lucky ones and can now eat baked egg, but she was re tested for it at 17 yrs after having been seriously allergic since 10 months. She failed an earlier test at about 6 yrs and we nearly lost her in the process.
Hello Sue – I’m so sorry to hear about what you went through with your daughter. It must have been so very traumatic; I can’t imagine how awful it must have been. But of course wonderful that she can finally eat baked egg after all these years.
As it has been explained to us, 80 per cent of egg allergic children can tolerate baked egg (a set amount of egg, baked to a very specific heat for a very specific period of time in a very specific recipe!) and it is worth testing as it can revolutionise their diets, especially if they are already tackling multiple allergies.
I imagine also that any child who has had a previous anaphylactic shock to egg may not be put forward at such a young age, although I’m not certain of the criteria. We were told that the most common reactions are those that Sidney had, along with vomiting. However, the risks do mean that it is done in extremely carefully controlled hospital conditions – starting with a tiny dose built up very slowly over several hours, all the while with the child undergoing blood pressure, oxygen and other checks. We felt nervous, of course, but also confident that our doctor wouldn’t have suggested the challenge if he hadn’t assessed that the potential benefits outweighed the risks to our son.
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