Egg allergy - why can some people tolerate baked egg? » Allergy Spot (2024)

Egg allergy can be really confusing sometimes. Some people are allergic to just the egg yolk or (more commonly) just the egg white. And then there are people who are allergic to “whole egg”, but can eat baked eggs in foods like cakes and muffins. Others react to any egg at all, and have both a whole egg and baked egg allergy. So what exactly is baked egg? And why can some people with egg allergy tolerate eggs in baked goods without having a reaction?

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About egg allergies

Egg allergy is a very common food allergy, especially in children. Many young children outgrow their egg allergy before starting school, but some don’t until they are teenagers. Egg allergy can even persist in some adults.¹ (See our post – Food Allergies in Adults: 9 Facts You May Not Know)

Many different types of food contain egg. Someone with an egg allergy usually needs to avoid all forms of egg, including “whole egg”. This includes boiled, fried, poached or scrambled eggs, eggs in frittatas and quiches meringues and other foods where the egg is an obvious ingredient. They also need to avoid hidden egg used as a binder or to thicken other foods. Eggs are used to bind not only sweet foods like cakes, muffins and cookies, but also savoury dishes including hamburgers, meatballs and roast stuffing. Other places eggs are commonly used are dips, sauces and mayonnaise, to glaze bakery foods to make them shiny and even in some drinks.

Some people with an egg allergy are able to tolerate baked egg, also known as “egg in baked goods”, or extensively heat treated egg. However, for egg allergic people, “baked egg” has a very specific meaning.

What exactly does “baked egg” mean when talking about egg allergy?

When allergists talk about “baked egg”, it means egg that is cooked extensively. This means that it needs to be cooked:

• at a high temperature (180C or 350F);
• for at least 30 minutes (some allergists will say 45 minutes); and
• mixed with flour (as in a cake or muffins).

High heat causes some of the egg proteins to break down so that they no longer cause an allergic reaction in people allergic to those proteins. Combining egg with wheat flour is thought to also help to prevent egg proteins being absorbed.

Another important factor is just how much egg is in the food. Egg should not be one of the main ingredients. Some allergists will suggest that it should be listed as at least the third ingredient or later on packaged foods. For home cooking, it is also very important to make sure that the baked item containing egg is cooked all the way through. For example, a cake should not be undercooked or soft in the middle.

So while you may think that pancakes, waffles or biscuits/cookies will be safe for someone who can tolerate baked egg, these foods may not meet the necessary requirements. They need to be cooked at a high enough temperature or for as long as needed to make them safe.

Different people may be able to tolerate different amounts of egg as an ingredient as well. This is why it is so important to only include egg in baked goods as part of your diet under the guidance of your allergy specialist. We have started with 1/12th of an egg per serve (one egg in a cake with 12 slices or one egg between 12 muffins) and will only increase this under allergist guidance.

How do you know if you have a baked egg allergy or not?

Not everyone with an egg allergy can tolerate baked eggs in cakes and muffins. You should always discuss this with your allergy specialist and follow their advice. Don’t assume that baked eggs are safe for you, as they can still cause serious allergic reactions (including anaphylaxis) in some people.

Your allergist may suggest that you or your child undertake an oral food challenge to see if you can safely eat eggs in baked goods.

We have had oral food challenges for baked milk and baked egg, both in a hospital supervised challenge and at home. And we’ve had both successful and unsuccessful attempts.

The latest baked egg challenge was a success, so now we have to include eggs in baked goods like cakes and muffins on a regular basis. This part is really important. Some years ago our child passed an oral food challenge, but then refused to eat that food for a very long time. This effectively meant that we had to start again and repeat the oral food challenge. Not eating the challenged food regularly meant that there was an increased risk of becoming re-sensitised and having an allergic reaction.

So if you can eat eggs in baked goods, make sure that you enjoy them on a regular basis to maintain your tolerance.

Does eating baked egg help children outgrow an egg allergy more quickly?

When our child was first diagnosed with an egg allergy, our allergist mentioned that some studies had suggested that eating baked egg might help children outgrow their egg allergy faster. Some researchers thought that exposure to eggs in baked goods might help induce or hasten egg tolerance.

Another school of thought is that people who can tolerate egg in baked goods have a different type of egg allergy to those who can’t. Those who can eat baked eggs are more likely to outgrow their allergy faster. But eating the baked egg isn’t the reason they do.²

Regardless of whether it helps with outgrowing a general egg allergy, adding baked eggs to your child’s diet is a really positive thing. It opens up so many more food options. Sharing birthday cakes with the family being one of them!

Avoiding confusion about whether a food with egg is safe or not

If you or your child can tolerate egg in baked goods, this can present a whole new challenge in managing an egg allergy.

On one hand, you or your child need to keep eating baked egg to maintain tolerance. On the other, you still need to avoid eating any egg that doesn’t meet the guidelines for baked egg allergy.

Many people will not understand this and find it very confusing. If you tell people that you or your child can have egg in cakes or muffins, they may think that this extends to other cooked foods containing egg. Or not realise that a cake containing 6 eggs might not be safe.

We had an unfortunate incident where a relative assumed that “baked egg” included egg used as a binder in meatballs. The meatballs were baked, but the eggs were not combined with flour in the same way as eggs are used in baking, or cooked long enough. This resulted in an immediate allergic reaction.

To avoid these risks, the Australian Society of Clinical Immunology and Allergy recommends that:

• If your child has an egg allergy, they should only be allowed to eat foods containing baked egg when they are supervised by a parent or carer; and
• parents/carers should not expect childcare or early education staff to give children foods with baked egg while they are in their care.¹

In other words, keep the baked treats to enjoy at home under supervision of someone who understands which foods are safe and which are not.

Other risks to watch out for with baked eggs

You always need to make sure that any baked goods with egg meet the guidelines for cooking time and temperature. Make sure your baked items are cooked evenly all the way through.

When you are baking with eggs at home, you still need to be aware of the risk of cross contact with other foods, utensils and surfaces.

If you buy ready made baked items, be careful about decorations. Egg is sometimes used in icing, decorations or fillings in cakes, rather than as an ingredient in the cake itself. This can sometimes be hard to tell from ingredient labels if not separately listed.

Baking without eggs

For those people who can’t tolerate baked egg, there are so many options for enjoying safe cakes, muffins and other baked goods.

We often look to vegan baking recipes for inspiration. Although be aware if you have other allergies that these can often contain seeds and nuts.

Otherwise, it is usually very simple to adapt your usual recipes by substituting the egg with an egg replacer. Some great options for baking include:

• aquafaba (liquid from canned quick peas);
• apple puree;
• ground flax or chia seeds mixed with warm water (1 Tb to 3 Tb water) to create a gel like liquid; amd
• commercial egg replacers, like Orgran No Egg made up according to the instructions.

Other recipes use a combination of oil, water and baking powder.

For some delicious egg free recipes including delicious cakes and biscuits, make sure you have a look through our recipe page.

References and more information

For more information about managing egg allergies and baked egg allergy, see:

• ¹ASCIA Factsheet – ASICA Dietary Avoidance – egg
• ²Dang et al., “Debates in allergy medicine: baked egg and milk do not accelerate tolerance to egg and milk” World Allergy Organization Journal (2016) 9:2
• Food Allergy & Anaphylaxis Connection Team website, Food allergy and anaphylaxis – Egg.

*Disclaimer: Allergy Spot does not provide medical advice. You should always consult a suitably qualified medical practitioner in respect of your own medical conditions, symptoms or concerns. See our Website Terms for more details.