Oral Food Challenge for Raw Egg: Passed

Raw egg food challenge 2725x3164

After discovering my son’s milk allergy when he was about 9 months old, we found ourselves identifying more potential allergens he needed to avoid, including eggs, peanuts, tree nuts and sesame. Even though he had never eaten these foods, blood and skin prick tests indicated a positive result—the possibility an allergic reaction could occur. His allergist in the United States recommended avoiding these foods until further testing could be done with a new allergist after our move to Switzerland in 2012. Today, I’m happy to report that my son passed his most recent oral food challenge, which means he only has one allergen now: milk—the original inspiration for this blog.


Eating Raw Eggs at the Hospital

On Halloween, my 3-year old son had his fifth food challenge at a Swiss hospital. Scheduling a food challenge on a holiday—although not widely celebrated in Switzerland—probably wasn’t the best idea. It can be hard to get an appointment though, and I was feeling optimistic. After passing a baked egg food challenge in April 2013, my son’s pediatric allergist decided it was time to try a food challenge with raw egg.

The rationale for using raw egg—as opposed to lightly cooked egg that’s been boiled or scrambled—was that if he “passed” the test, he could safely eat eggs in any form. Spaghetti carbonara? Chocolate mousse? Swiss meringues? A food challenge with a negative result for raw egg would give a clear sign that any of these egg-based dishes would be okay for him, as long as they’re made without milk.

Based on our son’s last food challenge for baked milk, when he refused to eat his third dose, I knew we needed a different approach. My thoughtful cousin suggested giving him “prizes” after each of the five doses, so I picked up some little Matchbox cars. I don’t normally bribe my kids (to this extent, anyway!), but for this particular test with raw egg, it seemed especially necessary.

Even though the final dose was mixed with applesauce, the look of that large bowl of runny, yellow egg made me grimace for a moment when my back was turned. The nurse suggested using the oral syringe for this last dose (see the photo above), so it could bypass his taste buds and arrive more quickly to his throat. As he was halfway through that final dose, I reminded him that the last prize was the biggest of all, and it was his favorite color (red). The prizes certainly did the trick, and thankfully he finished the test.


Evaluating the Symptoms: A Contact Reaction

Altogether, my son consumed over 35 grams of raw egg during the test. After the fifth and final dose, he developed a little redness and a few raised hives around his mouth where the raw egg came in contact with his skin, but he did not experience a systemic reaction. As usual, the allergist and nurse were monitoring his heart rate and blood pressure throughout the test, and he had no other symptoms. When the egg on his face was washed away with water, the redness and hives disappeared almost immediately.

Since it was a non-severe and late-phase reaction, and because my son has mild atopic dermatitis (excema), his allergist determined he only experienced a contact reaction to the raw egg, and therefore he had a negative test result. He can now safely eat egg in all forms. I was given the go-ahead to start serving him eggs, and this time they don’t have to be baked for 30 minutes in bread or cake at 200°C.

Back at home, he’s been gobbling up the egg-based version of already familiar foods, such as waffles, pancakes and crêpes. He’s a little more reluctant to try savory eggs, like in one-eyed monsters sprinkled with salt and pepper. With time, I’m sure this will improve.

As with every negative food challenge, I’m thrilled to start cooking and purchasing new foods. Once again, we’re feeling incredibly lucky.

What was the result for your food challenge with raw or lightly cooked egg? I’m always curious to hear how our experience in Switzerland compares to others. Please leave a comment below, if you have the chance.


Next Steps: Baked Milk Challenge in 2015

In January 2015, my son will repeat a food challenge for baked milk. This time, I’ll be making the cake with a recipe provided by his allergist. A successful test would mean he could move on to food challenges with other forms of milk, like baked yogurt and baked cheese. I don’t know what the future will bring, but there’s a good chance he’ll outgrow his milk allergy as well. As usual, I’m cautiously optimistic, and as I’m required to do, I still always carry two adrenaline auto-injectors, an antihistamine and an allergy action plan with us at all times, just in case.

Thanks for your continued support, advice and encouragement! I hope you’ll be getting some good news about food allergies soon too.

Finally, don’t forget that Bundt Day is November 15! Here’s a video to inspire some Bundt cake baking. I hope to share a new dairy-free Bundt recipe later this week.

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Making Madeleines with Baked Egg

Since my son’s successful “baked egg” food challenge last month, we’ve started introducing overcooked eggs into his diet. Along with egg noodles, I’ve been serving him a few homemade baked goods that contain eggs. He’s primarily had Dutch Baby Pancakes, but I’ve also recently started making madeleines.

Madeleines, which you’ve likely eaten before, are small golden cakes that typically have a scalloped shell-like shape (although today, I found round ones at a local bakery). These petite cakes are originally from France, but we see them all over here in French-speaking Switzerland (i.e., “Suisse-Romande”). If you’re craving more information about the history of these delicious cakes, along with a recipe that influenced the one I’ve shown below, check out this 1983 NY Times article.

madeleine collage2

Trying the real thing or doing “research” – delicious, Suisse-Romande madeleines

The first time I baked madeleines with eggs, I used a recipe from Joy of Cooking that calls for 3 eggs and an egg yolk, with a baking time of 10 minutes at 230°C/450°F degrees. While our allergist recommended 30 minutes at 200°C/400°F for whenever we make something with eggs at home, I figured the smaller size of the cookie and the super-high baking temperature would meet this minimum baking standard.

Well, it turns out I was wrong. My son ate the cookies and broke out in almost unnoticeable, but still recognizable red hives around his mouth. Luckily, that was it! I feel absolutely sick this happened, and I’m so relieved (and we’re very lucky) his reaction wasn’t worse. I should have talked to our allergist first to be absolutely sure the recipe I found was OK.

Afterwards, I did check in with our allergist, and she sent me a new madeleine recipe, which calls for only one egg and a much longer baking time. I’ve made them several times now with a few slight revisions. Thankfully, the little guy hasn’t had any reactions, so we’ll be using this recipe again and again.


Why are Baked Eggs Okay?

What happens to a baked egg that makes it safe for my son? Why can’t we just make him scrambled eggs for breakfast like everyone else? I’ve been asking myself these questions a lot lately. Especially since my first attempt at madeleines caused my son to have a very mild allergic reaction. Here’s what I can tell you, based on my limited research:

  • Eggs are one of the most common food allergens in infants and children.
  • Eggs whites are the problem. The yellow yolk generally doesn’t contain the egg proteins people react to, but it’s impossible to separate the yolk from the egg white without any cross-contamination.
  • The majority of egg-allergic kids can tolerate eating a “baked egg.” And, a 2012 study found that introducing baked egg helps children to accelerate their tolerance for regular, uncooked eggs.
  • Heating an egg changes its proteins. So, it lessens the egg’s capacity to trigger an allergic reaction. The study mentioned above used homemade baked goods made with 2 eggs baked for 30 minutes at 190°C/375°F.
  • Outgrowing an egg allergy can happen. According to FARE, most kids will eventually outgrow an egg allergy.

I don’t know all the science behind what happens to egg proteins, but this information gives us hope for my son and others living with an egg allergy. It hopefully won’t last forever!

 

Easy Dairy-Free Madeleines

If you would like a dairy-free madeleine recipe, here’s my adaptation of the French version from our allergist (also shown below):

1/4 cup sugar
1 egg
1 teaspoon lemon peel (optional)
1/4 cup vegetable-based margarine, melted and cooled
1/2 cup flour
1/2 teaspoon baking powder

1. Whisk egg, sugar and lemon peel together. Slowly add the melted and cooled margarine until well-blended.

2. Sift flour and baking powder into this mixture. Then, fold in the dry ingredients just until blended.

3. Divide batter among a prepared madeleine mold (makes about 9 cakes). Bake in a preheated oven for 30 minutes at 180°C/350°F.

madeleine collage

Remove immediately from pan and place on a wire rack to cool. Store in an airtight container.

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If you can tolerate baked eggs and dairy, here’s the recipe (in French) for madeleines from our Swiss allergist:

Madeleines Faciles

Ingrédients:
50 g de beurre
50 g de sucre
1 petit œuf (50g)
50 g de farine
1 pointe de couteau de poudre à lever

Préparation:
1. Battre en mousse le beurre ramolli et le sucre jusqu’à ce que le mélange blanchisse.
2. Ajouter l’œuf battu et bien mélanger.
3. Ajouter la farine tamisée et la poudre à lever.
4. Mettre dans un petit moule à madeleine, beurré et enfariné.
5. Faire cuire à four préchauffé pendant 30-40 minutes à 180°C.


I need to make some more dairy and almond-free recipes with baked eggs. I’ll likely try chocolate madeleines next, but still need to expand my repertoire. If you have any baked egg recipes to share, please send them my way. Thanks!

Welcome Back, Baked Eggs!

DSC08319Last week, our son had his long-awaited “baked egg” food challenge at a nearby Swiss hospital. Since he had never consumed egg before—our avoidance of l’œuf was based solely on positive skin and blood test results—we really had no idea what would happen. Hives? Itchy throat? Full-blown anaphylaxis?

Obviously, our allergists wouldn’t have recommended a food challenge if they didn’t think he would “pass.” So, while I remained positive, I prepared myself for the worst. Luckily, the best possible result happened, and here’s a quick summary of our crazy morning:

5:45 AM – Meant to get up at 5:00, but slept in. Quickly got dressed and packed lots of allergy-friendly snacks (some of which were baked in the wee hours the night before).

6:00 AM – Woke up the boys. Our food-allergic son could only have water before the test, so he skipped breakfast while I poured some cold cereal for my oldest son. My husband also left at this time to pick up a rental car, since we no longer own one. We would usually just take the train, but decided a car was the easiest option, given the uncertainty of our visit.

6:30 AM – Car seats and children in place, we left for Vevey.

7:45 AM – Arrived at the hospital.

8:30 AM – After getting checked in by the doctor and nurse, my son took his first small dose of very cooked egg. After this initial dose, every 20 minutes he got another increasing amount of egg mixed with applesauce. His heart rate and blood pressure were monitored before each dose. He only wore a diaper, so the staff could watch his skin for any potential changes. He also wore his superhero cape (thanks, Grandma!) and goggles, which made him feel a little more comfortable in the hospital bed.

10:30 AM – My son finished his final and largest bowl of baked egg. Then, we waited a full hour to make sure he had no reaction. We shared a room with two other patients also undergoing food challenges, and everyone had good results—such a relief! The doctor said that about 50 percent of their food challenges involve baked egg.

11:30 AM – After having no reaction whatsoever, my son was free to leave the hospital. The food challenge was over. Now, it seems we have three more challenges ahead of us: (1) milk, (2) almond and (3) raw egg.

Beautiful mountain views as we're leaving Vevey

Beautiful mountain views as we’re leaving Vevey

Given my son’s non-reaction to baked egg, we can now feed him:

  • Pasta made with eggs
  • Baked goods, such as cakes and cookies, cooked for approximately 30 minutes at 200°C/400°F.

Egg-based items that we still need to avoid:

  • Scrambled, fried or hard-boiled eggs
  • Pancakes and French toast
  • Egg-based desserts, like tiramisu or chocolate mousse

To welcome baked eggs back to our home, I made a Dutch Baby for breakfast this morning—a delicious fluffy pancake that just isn’t the same without real eggs. I used to make this often before we learned about our son’s allergies. Here’s the quick recipe, if you haven’t tried one, adapted from my favorite Betty Crocker cookbook. I made sure to bake it for 30 minutes at 200°C/400°F, so it was safe for my son, but if you can tolerate eggs, 25 minutes would probably be enough.

 

Dutch Baby Pancake

(dairy/nut-free)

2 tablespoons vegetable-based margarine
2 eggs
1/2 cup flour
1/2 cup soy or rice milk
1/2 teaspoon vanilla sugar or vanilla
1/4 teaspoon salt
Powdered sugar and lemon juice
Optional – top with fresh fruit or jam

1. Heat oven to 200°C/400°F.

2. Melt butter in a 10-inch cast iron skillet over medium heat. Brush or swirl margarine onto sides of the skillet.

3. Whisk eggs until fluffy. Then, mix in remaining ingredients just until blended (do not overbeat).

4. Pour batter into the heated skillet. Place in oven and cook for 25-30 minutes (in our case, I baked it for the full 30 minutes). Remove from oven when nicely browned. Sprinkle with lemon juice and powdered sugar. Serve immediately.

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Our family is overjoyed with these test results. We also scheduled a food challenge for milk in mid-June, and as always, I’m trying to be cautiously optimistic… Regardless of what happens next, for now, we’re enjoying the return of baked eggs to our household on a more regular basis!

Easter sans Eggs and Bunny Rolls

This will be our first Easter in Switzerland, and our first time celebrating the holiday without eggs. Since learning of our youngest son’s positive test result for an egg allergy last summer, we’ve been avoiding eggs—including all products with eggs as ingredients or potential traces of eggs.

Picnic eggs - Pre-decorated, hard-boiled eggs from the grocery storeŒuf suisses pique-nique or “picnic eggs”–pre-decorated, hard-boiled eggs from the grocery store


Egg Ingredient Translations

Similar to the post I did on milk ingredients in French, Italian and German, here are some ingredient translations for eggs, based on a list provided by one of our allergists. Food labels can apparently use the following terms to indicate the presence of eggs.

English French German Italian
Egg(s) Œuf(s) Ei, eier Uovo, uova
Egg proteins Protéines d’œuf Ei proteine Uova proteine
Egg white, albumin Blanc d’oeuf, albumine Eiweiss, albumen Bianco d’uovo, albumina
Animal proteins Protéines animales Tierische proteine Proteine ​​animali
Ovalbumin Ovalbumine Ovalbumin Ovoalbumina
Egg powder Poudre d’œuf Eipulver Uova in polvere


Celebrating Easter without Eggs

When I was growing up, we always grabbed a branch from our yard and decorated it with colorful Easter eggs. This year, I bought plastic eggs from Migros, which we painted and hung from branches we found at a local park. The kids loved this project, and I don’t think it made a difference that we didn’t use real eggs. Plus, I avoided having to poke holes and blow out the eggs from their shells!

DSC07897Our Easter Egg tree with plastic, painted eggs

In terms of candy, the Easter bunny has struggled to find allergy-friendly candy (dairy/egg/nut-free) this year. I’ve only seen a few allergy-friendly Easter candy options in the stores. As such, the Easter bunny will hide some jelly beans, along with a few little animal figurines that I’m planning to purchase yet (although I’m starting to run out of time!). I’ll figure something out, making sure both my sons get some tasty and safe Easter treats, one way or another. And, both will get chocolate, although my food-allergic son’s may not be in a bunny shape. Yet, I’m tempted to buy a mold and make some myself! To be determined…

Huge Swiss, chocolate bunnies for EasterHuge Swiss, chocolate bunnies for Easter

 

Zopfhasen: Bunny Rolls

Lately, the boulangeries around us are making Zopfhasen or what I fondly refer to as “bunny rolls”–delicious little breads shaped like Easter bunnies with raisin eyes (Zopf is a very traditional Swiss bread). I tracked down a recipe for Zopfhasen online, which I’ve been adapting all week. As with my banana pancake experiments last week, my family is sick of eating bunny rolls. Yesterday, I finally got the recipe right, so here it is. I hope you like it!

Makes 6 large rolls
(dairy/egg/nut-free)

3 to 3 1/2 cups of flour
1 1/2 teaspoons salt
1 tablespoon sugar
2 1/4 teaspoons yeast
1 1/4 cups soy or rice milk, warmed
1/4 cup vegetable-based margarine, melted
1 tablespoon melted vegetable-based margarine, for brushing
Toppings: Raisins for eyes, and sucre en grains (sugar)

1. Whisk together the dry ingredients—3 cups of flour, salt and sugar.

2. Dissolve yeast in the warmed soy or rice milk. Add the melted margarine, and blend well.

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3. Form a trough in the middle of the dry ingredients and pour in the wet ingredients. Stir together and knead for about 5 minutes into a smooth dough. Add extra flour, as needed. Cover and let rise at room temperature for about an hour.

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4. Punch down the dough and divide into 6 equal portions. Form dough into bunny shapes and let rise on a parchment-covered baking sheet while the oven pre-heats. For a brief bunny-making tutorial (in German), check out Swiss Milk’s video.

5. Using a pastry brush or the back of a spoon, spread melted butter on the top. Place a raisin in an indentation made with your finger for the bunny eye.

6. Bake for 12-15 minutes at 220°C/425°F.

Optional: While warm, spread margarine on top and sprinkle with sugar.

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We’re heading into a 4-day weekend here in Switzerland, as Good Friday and Easter Monday are federal holidays. I’ll be experimenting with some new gâteau recipes, which I’ll be sure to post if they turn out. Bon week-end!

Updated: June 23, 2014

Banana-Cardamom Pancakes and First Food Challenge

We’ve been living in Switzerland now for nearly 8 months. I was looking back at some earlier blog posts when I made banana pancakes without a recipe at our temporary apartment. So much in our lives has changed since then (except my French is still very limited!).

In particular, we know a lot more about our son’s allergies, and next month he’ll have his first “food challenge” at a nearby hospital—which I never thought we’d be doing this soon.

alps-viewAlps view across the lake, never looks the same twice – August 2012


First Food Challenge

Our son’s first food challenge with baked egg will be held in Vevey. At 21 months, he’s never had eggs before—we’ve avoided all egg product or products that may contain traces of eggs.

While we’re still learning what this could mean for him, we were told if he “passes” the test, he could start eating pasta and baked goods made with eggs—as long as they were cooked for at least 30 minutes at 400°F/200°C. Raw or undercooked eggs, such as scrambled eggs or pancakes with eggs, would still be off limits. So, I’ll still need to make my banana pancakes with flax meal. During this last week I worked to perfect my recipe, which appears below.

 

Banana-Cardamom Pancakes

1 tablespoon flax meal
3 tablespoons water
1 ripe, mashed banana
2 tablespoons olive oil
1/2 teaspoon cardamom
1/4 teaspoon salt
1 tablespoon sugar
3 teaspoons baking powder
1 1/2 cups flour
1 1/2 cups soy or rice milk

1. Mix the flax meal with water and let sit and thicken for a few minutes while you mash the banana.

Mashing the banana while the flax meal and water setsMashing the banana while the flax meal and water sets

2. Add the banana to the flax meal mixture and add the next four ingredients: olive oil, cardamom, salt and sugar. Whisk together.

3. Then, whisk in the baking powder, flour and soy or rice milk until blended, but do not overbeat. Batter will be lumpy.

4. Using a measuring cup, pour pancake batter on a medium-high heated skillet. Flip the pancake once the air bubbles throughout the pancake begin to burst. Cook about 1-3 minutes on each side, until light golden brown, and serve warm.

Banana-Cardamom Pancakes with a little whole wheat flourBanana-Cardamom Pancakes with a little whole wheat flour

 

I’ll let you know how the food challenge goes next month. If you have any advice or experiences to share, please leave a comment below. Thanks!

Updated: March 7, 2015