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Diagnosis & Specialist Care of Allergy - Since 1982
If your child has been diagnosed with egg allergy, the 'egg ladder' is a term you may have come across — and it's one worth understanding properly. For many children with egg allergy, a structured, step-by-step reintroduction of egg into the diet is not only possible but actively encouraged, since carefully managed reintroduction may actually help promote tolerance over time.
This page explains what the egg ladder involves. It is intended as general information only — the egg ladder should always be undertaken under appropriate medical or dietetic guidance, and it is not suitable for all children.
Egg Allergy - Some Facts
Egg allergy affects approximately 2% of children — making it one of the most common childhood food allergies in the UK.
The good news is that it often resolves with age, and evidence consistently shows that regularly eating baked egg (where it is well tolerated) can help the process of outgrowing the allergy.
This principle is the foundation of the egg ladder approach, which is backed by guidance from the British Society for Allergy and Clinical Immunology (BSACI).
What is the Egg Ladder?
The egg ladder is a step-by-step framework for gradually reintroducing egg into the diet of a child who has previously had an allergic reaction to egg.
It works on the same principle as the milk ladder: egg proteins change in structure when heated, and extensively baked egg is far less likely to trigger a reaction than raw or lightly cooked egg. The ladder therefore starts with well-baked egg products and works progressively towards less-cooked forms.
The current BSACI egg ladder has nine steps, colour-coded to reflect three broad stages — baked egg products, well-cooked egg, and lightly cooked or raw egg preparations.
Who is the Egg Ladder For?
According to BSACI guidance, home reintroduction using the egg ladder may be appropriate for children:
• From around 12 months of age, or six months after their last reaction (whichever is later)
• Whose previous reactions have been mild to moderate
• Who do not have asthma, or whose asthma is well controlled
Children who have had severe reactions to egg, or who have asthma, should have reintroduction guided by a specialist allergy service rather than attempting it at home. In these cases, the egg ladder should not be started without a proper specialist assessment first.
The Nine Steps, In Outline
Steps 1–4: Baked egg — small and gradually increasing amounts of egg baked into products such as fairy cakes and biscuits, where the egg protein is most thoroughly broken down.
Steps 5–7: Well-cooked egg — including hard-boiled egg and egg in products such as quiche, where the protein is less broken down than in baked goods.
Step 8: Lightly cooked egg — such as scrambled egg or mayonnaise, where the egg protein is closer to its natural form.
Step 9: Raw or minimally cooked egg — including increasing amounts of products such as cake batter.
The exact foods, portions and timings at each step should be agreed with your dietitian or specialist team, as individual circumstances vary.
What To Watch For
If your child shows any sign of a reaction at any step — such as a rash, hives, swelling, vomiting or digestive upset — stop at that step and seek guidance before continuing. Do not move to the next step until the previous one has been well tolerated.
If your child shows signs of a severe reaction at any point — facial or lip swelling, breathing difficulty, or sudden deterioration — this requires emergency medical attention. Call 999 or go to A&E immediately.
How We Can Help
Dr Tammy Rothenberg and Dr Emily Derrick have extensive experience in the diagnosis and management of egg allergy in children, and can advise whether the egg ladder is appropriate for your child and at which step to begin.
Our specialist Paediatric Allergy Dietitian, Misbah Primett, can provide a personalised, step-by-step plan and ongoing support throughout the process. to guide families through the milk ladder process with a clear, personalised, step-by-step plan — taking into account your child's specific history, symptom pattern and confidence level.
If you'd like a specialist assessment before starting the egg ladder, or want expert support throughout the reintroduction process, we're here to help — six days a week, with a real person always at the other end of the phone, email or WhatsApp.
📞 0207 637 9711
WhatsApp
✉ enquiries@londonallergyclinic.com
Mon–Sat, 9am–7pm
