Debra J Palmer1, Thomas R Sullivan2, Michael S Gold3, Susan L Prescott4, Maria Makrides5. 1. School of Paediatrics and Child Health, the University of Western Australia (M561), Perth, Australia; Women's & Children's Health Research Institute, Adelaide, Australia. Electronic address: debbie.palmer@uwa.edu.au. 2. School of Public Health, University of Adelaide, Adelaide, Australia. 3. School of Medicine, University of Adelaide, Women's and Children's Health Network, Adelaide, Australia. 4. School of Paediatrics and Child Health, the University of Western Australia (M561), Perth, Australia; Telethon Kids Institute, University of Western Australia, Perth, Australia. 5. Women's & Children's Health Research Institute, Adelaide, Australia; School of Medicine, University of Adelaide, Women's and Children's Health Network, Adelaide, Australia; Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, Australia.
Abstract
BACKGROUND: The ideal age to introduce egg into the infant diet has been debated for the past 2 decades in the context of rising rates of egg allergy. OBJECTIVE: We sought to determine whether regular consumption of egg protein from age 4 to 6 months reduces the risk of IgE-mediated egg allergy in infants with hereditary risk, but without eczema. METHODS:Infants 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 age 10 months. All infants followed an egg-free diet and cooked egg was introduced to both groups at age 10 months. The primary outcome was IgE-mediated egg allergy defined by a positive pasteurized raw egg challenge and egg sensitization at age 12 months. RESULTS: There 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% CI, 0.48-1.17; P = .20). A higher proportion of participants in the egg group stopped taking the study powder because of a confirmed allergic reaction (25 of 407 [6.1%] compared with 6 of 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 < .0001). CONCLUSIONS: We found no evidence that regular egg intake from age 4 to 6 months substantially alters the risk of egg allergy by age 1 year in infants who are at hereditary risk of allergic disease and had no eczema symptoms at study entry.
RCT Entities:
BACKGROUND: The ideal age to introduce egg into the infant diet has been debated for the past 2 decades in the context of rising rates of egg allergy. OBJECTIVE: We sought to determine whether regular consumption of egg protein from age 4 to 6 months reduces the risk of IgE-mediated egg allergy in infants with hereditary risk, but without eczema. METHODS:Infants 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 age 10 months. All infants followed an egg-free diet and cooked egg was introduced to both groups at age 10 months. The primary outcome was IgE-mediated egg allergy defined by a positive pasteurized raw egg challenge and egg sensitization at age 12 months. RESULTS: There 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% CI, 0.48-1.17; P = .20). A higher proportion of participants in the egg group stopped taking the study powder because of a confirmed allergic reaction (25 of 407 [6.1%] compared with 6 of 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 < .0001). CONCLUSIONS: We found no evidence that regular egg intake from age 4 to 6 months substantially alters the risk of egg allergy by age 1 year in infants who are at hereditary risk of allergic disease and had no eczema symptoms at study entry.