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Runny eggs and toast soldiers for infants?

As we get near to Easter, chocolate eggs are in the spotlight, but the non-chocolate variety shouldn't be forgotten!

Eggs can play a valuable part in a healthy, balanced diet, providing protein and a range of micronutrients, including vitamin D, iodine, selenium and choline.

Are eggs suitable for infants?

Eggs are not recommended before six months due to the risk of allergy.1 However, some emerging research suggests that early introduction may be protective of egg allergy in infants,2 but more evidence is needed before changing the current recommendations.

While well-cooked eggs can be given after the age of six months, the Food Standards Agency (FSA) recommends that raw or lightly cooked eggs (for example, in a soft boiled egg or in sauces like homemade mayonnaise) are not consumed by young children, as well as other vulnerable groups, including pregnant women and the elderly due to the risk of salmonella.

However, it has been some time since this issue has been looked at. The risk of salmonella food poisoning from eggs was last examined in 2001. The FSA has therefore recently requested that the Advisory Committee on the Microbiological Safety of Food (ACMSF) re-assess the risk to the public.3

Their newly published findings suggest a major reduction in risk, particularly for eggs that carry the red British Lion Quality mark (around 85% of UK eggs) for which the risk of salmonella contamination was now considered as 'very low'. The ACMSF accordingly recommends that the FSA's advice is amended, so that eggs with the Lion mark (or an equivalent) can be served raw or lightly cooked to 'at risk' groups.

However, this does not apply to non-UK eggs, UK eggs without the mark and eggs from other birds, nor is this recommendation intended for severely immunocompromised individuals, such as those undergoing transplant surgery.

Providing reassurance

Most commonly, egg allergy presents in infancy, with a prevalence of approximately 2% in children,4 and is often outgrown. Parents and carers may be worried about giving their child eggs during weaning or later on because of concerns about allergy.

However, providing allergy hasn't been diagnosed by a health professional, eggs are great as a nutritious, quick and easy to prepare food, for example mashed hard boiled eggs, scrambled eggs or omelettes are all suitable choices. Let's not forget eggs are one of the few natural food sources of vitamin D; a nutrient of concern in the UK.

However, the time has not yet come to serve young children runny eggs. Although the ACMSF has recommended that the FSA advice should be updated, this is not yet an official government recommendation, and the FSA will only be making a decision further to a consultation period. Until then, parents and carers should be advised to fully cook any eggs that are served to infants or toddlers. 

And of course, if children are enjoying chocolate eggs this Easter, this should be in some moderation with attention to good dental hygiene and lots of physical activity considered as well!

References

1. NHS Choices. Your baby's first solid foods. nhs.uk/conditions/pregnancy-and-baby/pages/solid-foods-weaning.aspx (accessed 26 February 2016).

2. Koplin J et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. Journal of Allergy and Clinical Immunology 2010;126(4):807-13.

3. Food Standards Agency. FSA launches consultation on eggs report. food.gov.uk/committee/acmsf/news-updates/news/2016/14899/fsa-launches-consultation-on-eggs-report (accessed 26 February 2016).

4. Clark AT et al. British Society for Allergy and Clinical Immunology guidelines for the management of egg allergy. Clinical & Experimental Allergy 2010;40(8):1116-1129.