Study eggs on earlier introduction of food allergens

Egg allergy rates in Australian children have fallen by 17% over the past 10 years, with a new study indicating a likely link to an update of national dietary guidelines.
 
Research led by the University of Queensland and Murdoch Children’s Research Institute (MCRI), published this week in JAMA Pediatrics, has shown ‘measurable reductions’ in the prevalence of egg allergy in children in Australia since 2016.
 
In that year, the Australasian Society of Clinical Immunology and Allergy (ASCIA) updated its guidelines to recommend that the most common food allergens in children – including egg, cows’ milk, peanut, tree nuts, wheat, soy and shellfish – be introduced into a child’s diet in the first year of life.  
 
Prior to the update, most recommendations to parents were to delay giving eggs and other food allergens to children until 1–3 years of age, particularly ‘if there was a strong family history’, said the MCRI’s Associate Professor Rachel Peters. 
 
‘Current advice from [ASCIA], based on the latest available evidence, is to introduce well-cooked egg and smooth peanut butter soon after a baby starts eating solid foods, usually around six months of age,’ she said.
 
However, an RACGP expert says it is important for GPs to know this can happen even sooner, if a baby is developmentally ready for solids.
 
Dr Nick Cooling, Chair of RACGP Specific Interests Allergy, told newsGP that according to an ASCIA update in February 2026, eggs are now recommended to be introduced ‘certainly not before four months of age, but when the child is ready to start eating solids, around the age of five or six months’.
 
‘That is actually another even more extreme recommendation, and GPs need to know this,’ he said.
 
‘They’re saying if your child starts eating solids in the next week or two, you need to bring peanut and egg into this diet, and you need to do it weekly, at least.
 
‘That’s such a huge difference from what most GPs were saying 10 years ago, and certainly very different from 15 or 20 years ago, and so we really need them on board to understand.’
 
Australia has one of the highest allergy rates in the world, and egg is among the nation’s most common childhood food allergens. It affects around 9% of infants up to one year of age, but drops to an incidence rate of 1.2% by the age of six years.
 
In the newly published study, researchers analysed data from 7200 infants aged 11–15 months across two population samples, recruited using identical methods when attending 12-month immunisation visits in Melbourne.
 
One group was from 2007–11, before the 2016 guideline update, and one after, from 2018–19.
 
After the update, the prevalence of egg allergy in infants decreased from 9.2% to 7.6%. 
 
In babies with eczema, the drop in egg allergy was even greater, falling from 35% to 22%.
 
Dr Cooling said the study is ‘rigorous’, as it uses hard data from infants undergoing skin prick tests, rather than parents reporting allergies.
 
‘Those [infants] that had positive results went on to have food challenges, so there’s very reliable endpoints; they were absolutely able to say for sure whether this infant had an egg allergy or not,’ he said.
 
Lead author, Associate Professor Jennifer Koplin of the University of Queensland, said the researchers believe it is the first study to show a reduction in egg allergy after the introduction of new infant feeding guidelines. 
 
However, she said more research into food allergies is still needed, as egg allergy remains common despite the updated guidelines.
 
‘Some babies can still develop food allergy despite following the guidelines, and further research is underway and needed to find other prevention strategies,’ Associate Professor Koplin said.
 
‘But we hope these findings provide reassurance to parents to continue following the current recommendations.’  
 
Dr Cooling believes the same findings on egg could apply to other food allergens in what are known as ‘the big eight’: cow’s milk, peanut, tree nuts, soy, wheat, fish and shellfish.
 
‘This is a great start, but I think we look at the other allergens as well to see if the same trend applies, but there’d be no reason why it wouldn’t,’ he said.
 
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