LAUSR

The mistaken belief that you could prevent peanut allergy by withholding peanuts from infants was turned on its head when studies showed the opposite. Now a Japanese group has shown that early introduction of egg is associated with far less egg allergy. Children aged 4–5 months with eczema, and consequent high risk of food allergy, who had never been given egg, were randomised to be given heated egg powder or placebo. The egg was started at age 6 months at a low dose (50 mg daily), increased to 250 mg daily from 9 to 12 months. At age 12 months, the incidence of egg allergy was assessed clinically through oral food challenge. The calculated sample size was 150, but the researchers stopped the study after 100 children had been challenged, because 9% of the eggs exposed but 38% of the placebo children had developed diagnosed egg allergy (risk ratio = 0.22, 95% confidence interval 0.08–0.60, P = 0.001). The only difference in adverse events between groups was that 6 of 60 children in the egg group but none of the placebo group were admitted to hospital; P = 0 022). The novel aspects of this study are the use of heated egg in powder form and the gradual increase in dose.