PAEDIATRIC
Development of home introduction guides for egg, soya and wheat in non-IgE-mediated allergy Table 1: Egg-containing food categories included in the egg home introduction guide Baked/well-cooked Plain, shop-bought cakes (avoid royal or fondant icing)
Loosely/lightly cooked (yolk and white cooked solid) Homemade pancakes
Biscuits, e.g. Jaffa cake, sponge fingers, cookies, TUC crackers
Boiled, fried, scrambled or poached egg - choose British Lion stamped eggs
Homemade cakes, biscuits and sponge puddings
Quiche, flan, Spanish tortilla, omelette
Shop-bought pancakes
Egg fried rice, Egg Fu Yung
Undercooked or raw Royal or fondant icing (fresh and powdered), homemade marzipan Some chocolates and sweets contain egg, e.g. nougat, MarsTM bars, Milky WayTM, ChewitsTM, chocolates with fondant/cream fillings, Cadbury Creme EggTM
Egg glaze on pastry
Raw egg in cake mix, other Dried egg noodles, fresh egg pasta uncooked dishes
Gluten-free bread with egg, e.g. GeniusTM, LivwellTM, WarbutonsTM
Fish, meat or vegetables fried in egg-based batter or tempura
Brioche, Cholla, choux pastry, rich shortcrust pastry with egg
Egg in batter or bread crumbs, e.g. Scotch egg
Dried egg pasta, e.g. lasagne, cooked for at least 10 minutes
Yorkshire puddings with soft centres, e.g. sticky batter
Some gravy granules contain egg, e.g. chicken flavoured gravy
Crème Brulee, egg custard, fresh custard
Shop-bought Yorkshire puddings, must be pre-cooked, e.g. frozen
Meringues - well-cooked with no sticky centres
Sausages containing egg (vegetarian and meat varieties), other processed meats, e.g. burgers
Some marshmallows
QuornTM-based products
Lemon curd
Fresh mayonnaise, Horseradish sauce, Tartare sauce, Béarnaise, Hollandaise sauce, mayonnaise, salad cream Cheeses containing egg lysozyme (E1105), e.g. Grana Padano, Manchego Meringues with sticky centres, soft meringue, e.g. lemon meringue pie Some ice-creams and sorbets, especially fresh and luxury types, e.g. Ben and Jerry’sTM, HäagenDazsTM Some mousses (most shop-bought mousses do not contain egg)
Table adapted from BSACI guidelines on management of egg allergy 2010 and updated by dietitian consensus 2018.
Table 2: Recipes containing baked soya included in the home introduction guide for soya Savoury muffins (makes 6) 250g flour or wheat free flour mix 2 ½ teaspoons baking powder 50ml vegetable oil 250ml soya milk 60g soya cheese, grated/sliced Handful spinach (optional)
Method Preheat the oven to 180°C/Gas Mark 4 and line a muffin tin with 6 cases. Mix the flour and baking powder. Mix the oil and soya milk together and add to the dry ingredients. Add the soya cheese and chopped spinach if desired. Loosen the mix with extra soya milk if needed. Bake for 15-20 minutes until golden. Cool on a wire rack. (~1.8g soya protein per muffin)
Veggie Bolognese (4 portions) ½ tablespoon vegetable oil 150g soya mince ½ a small onion, chopped 1 small carrot, diced ½ clove of garlic, crushed 75ml vegetable stock ½ tin chopped tomatoes 2 tsp soya sauce Seasoning
Method Heat the oil in a non-stick pan and cook the onion and carrot for 5 minutes. Add the garlic and cook for a further minute. Add the soya mince, stock, tinned tomatoes, soya sauce and season with salt and pepper. Bring to the boil, reduce the heat and simmer for 15 minutes. Serve with cooked pasta. (4.8g soya protein per portion)
PUBLIC HEALTH
Supporting parents to understand portion sizes Table 2: Examples of portion sizes within each food group Bread, rice, potatoes, pasta and other starchy foods - offer a serving at each meal and some snacks. • ½-1 slice wholegrain or white bread or ¼-3/4 bread roll • 3-6 heaped tbs wholegrain or fortified breakfast cereal without a sugar coating Fruit and vegetables - offer at least one to two servings at each meal and also offer them with some snacks. • 3-10 small berries or grapes • 2-4 tbs raw, freshly cooked, stewed or mashed fruit Milk, cheese and yoghurt - serve three times each day. • 3-4oz (100-120ml) whole cow’s milk as a drink in a cup • 1 small pot (125ml) yoghurt or 2 x 60g pots of fromage frais • About 20g cheese Meat, fish, eggs, nuts and pulses - serve two to three times per day - twice for young children eating meat and fish and three times a day for vegetarians. • 2-4 tbs ground, chopped or cubed lean meats, fish or poultry • ½-1 whole egg Oils, butter and fat spreads - include small amounts twice a day, and choose high omega-3 oils, e.g. rapeseed, olive and soya oils. • 1 tsp oil • 1 tsp butter or fat spread Sugary foods and packet snacks: • Toddlers under two years of age have lower energy requirements and should not be offered any sweet puddings, cakes, biscuits, confectionery, chocolate or savoury snacks such as crisps. • Over two years of age offer small amounts of sweet foods and salty snack foods but these should be limited to: – once a day: ½ -1 digestive biscuit or 1-2 small biscuits or 1 small slice cake or pudding. – if given, limit to once a week only: 4-6 crisps, or 2-4 sweets, or 1 small fun-sized chocolate bar, 1 sweet drink.