UPDATED infant feeding guidelines recommending earlier introduction of egg into the diet have been associated with a significant reduction in egg allergy prevalence among Australian infants, according to a new population-based study.
Population Data Reveal Changes in Egg Allergy Prevalence
Egg allergy is one of the most common food allergies in infancy. In recent years, allergy prevention guidelines worldwide have shifted from delaying allergenic foods to recommending earlier introduction, based on evidence from randomised controlled trials suggesting this approach can reduce allergy risk. However, population-level evidence demonstrating the impact of these recommendations has been limited.
Researchers compared two population-based cohorts of infants aged 11–15 months recruited during routine 12-month immunisation visits in Melbourne, Australia. The first cohort included 5,276 infants assessed between 2007 and 2011, before guideline changes were introduced, while the second included 1,933 infants assessed between 2018 and 2019, after implementation of recommendations promoting earlier egg introduction.
Early Egg Introduction Lowers Allergy Risk
The study found that the median age of egg introduction decreased from 8 months in the earlier cohort to 6 months following the guideline update. Infants underwent skin prick testing for egg sensitisation, with oral food challenges performed when indicated to confirm allergy.
After adjusting for known allergy risk factors and accounting for missing data through multiple imputation, the prevalence of egg allergy fell from 9.2% before the guideline change to 7.6% afterwards, representing an adjusted absolute reduction of 1.6 percentage points.
The greatest benefit was observed among infants with early-onset eczema, a recognised risk factor for food allergy. In this subgroup, egg allergy prevalence decreased substantially from 34.6% to 21.9%, corresponding to an adjusted absolute reduction of 12.7 percentage points.
The authors note that the findings provide rare population-level evidence that translating clinical trial findings into public health guidance can lead to measurable reductions in food allergy burden. They suggest that effective implementation of evidence-based infant feeding recommendations may contribute to preventing egg allergy at a population scale.
Overall, the study supports current international allergy prevention guidelines and highlights the potential public health impact of introducing egg into infants’ diets earlier in life.
Reference
Koplin JJ et al. Egg allergy prevalence before and after guidelines for earlier egg introduction. JAMA Pediatr. 2026;DOI: 10.1001/jamapediatrics.2026.2080.
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