Skip to main content

Egg ladder reintroduction programme - a structured way back to egg.

For children with egg allergy working their way back to normal egg in the diet. A consultant paediatric allergist, a paediatric dietitian, and the BSACI egg ladder used properly.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private egg ladder reintroduction costs in the UK.

In short

Egg ladder pathway: £800–£1,800 from first consult to top-of-ladder.

ItemIndicative range
Paediatric allergy consultation£250–£450
Paediatric dietitian session£150–£280
Skin prick and specific IgE (egg components)£220–£500
Baked egg oral food challenge£600–£900
Lightly cooked egg challenge£600–£900
Loosely cooked / raw-in-food egg challenge£700–£1,000
Follow-up review + written plan£150–£280

The problem

Dietitian and allergist working together, from first muffin to a runny yolk.

  • Most egg-allergic children outgrow it

    Around two thirds tolerate baked egg early and most reach loosely cooked egg by school age.

  • Dietitian on the team

    Egg is a key protein source in early years - the plan needs proper input.

  • Baked, cooked and loosely cooked are different tests

    We do them in order, in a resus-equipped clinic, with a plan for each.

When it helps

When egg ladder reintroduction is the right step.

  • Confirmed IgE-mediated egg allergy, settled

    A child avoiding egg for months with falling IgE and clear reaction-free window.

  • Non-IgE egg allergy (delayed symptoms)

    Vomiting or GI symptoms rather than urticaria.

  • Egg allergy and the MMR question

    Most egg-allergic children can have MMR safely - we say when hospital administration is needed.

  • Flu vaccination and egg allergy

    Modern flu vaccines are usually safe - the plan matters for each season.

  • Baby ready for baked egg

    Around 12 months in a suitable child, in a clinic.

  • Older child stuck at baked egg

    Ready to try cooked and lightly cooked egg.

  • Not for FPIES to egg

    Classic FPIES needs a different, hospital-based challenge pathway.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Options

The ladder is the framework - these are the checkpoints.

  • BSACI egg ladder

    The standard UK ladder - muffin through cake, scrambled and fried egg.

  • Baked egg challenge

    Muffin-based, standardised - the classic first rung after IgE testing.

  • Lightly cooked egg challenge

    Well-cooked scrambled egg - the mid-ladder step.

  • Loosely cooked egg challenge

    Runny yolk, mayonnaise and lightly cooked meringue - the top rung.

  • Egg component testing (ovomucoid, ovalbumin)

    Ovomucoid resistance predicts baked-egg tolerance.

  • MMR-in-clinic protocol

    When a child needs the vaccine given in a hospital setting.

  • Flu vaccine planning

    Age-appropriate LAIV or inactivated vaccine advice.

  • Dietetic support and calcium/protein planning

    While the ladder is in progress.

Safety and recovery

What to expect - honestly.

  • First rung in clinic for IgE-mediated

    Baked egg challenge always in a resus-equipped clinic.

  • Home advance with written rules

    Portion sizes and frequency in writing, not text messages.

  • Late reactions

    Non-IgE reactions may show hours later - parents briefed.

  • Growth and nutrition monitored

    Weight, height and protein intake tracked.

  • Eczema flares

    Sometimes real, sometimes coincidence - dietitian and allergist untangle.

  • Illness pauses the ladder

    A febrile illness or gastroenteritis means stepping back a rung.

  • Anaphylaxis pathway on hand

    For IgE-mediated egg allergy, adrenaline is always available.

  • Red flag: airway swelling, breathlessness or collapse

    Adrenaline first, 999 second. Every family with a diagnosed allergy needs to be clear on this.

Your notes

Your report in four parts.

A UK consultant reviewing notes
  1. Header

    Diagnosis and current rung

    IgE or non-IgE egg allergy and where the child sits on the ladder.

  2. Technique

    Challenge protocol and home advance plan

    What was tried in clinic and the home schedule.

  3. Findings

    Tolerance and any reactions

    What was tolerated and any reactions.

  4. Impression

    Next rung, MMR and flu vaccine advice

    Read this first: what to eat, what to avoid, and vaccine plans.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Paediatric allergy is available on the NHS but 6–18 months waits are typical for a first specialist appointment; it is usually covered by private insurers when medically indicated.

Frequently asked

Everything we get asked about egg ladder reintroduction.

  • When can a child with egg allergy start the egg ladder?

    Usually from around 12 months once symptoms have settled on strict avoidance, IgE levels are trending down and the child is otherwise well. IgE-mediated children start the first rung in a clinic; non-IgE children can often start at home with dietitic guidance.

  • What does the egg ladder involve?

    A structured ladder from small amounts of baked egg in a muffin, through cakes, well-cooked scrambled egg and finally lightly cooked or runny egg. Each rung is tolerated for several weeks before moving up.

  • How much does a private egg ladder programme cost in the UK?

    Roughly £250–£450 for the initial consultation, £150–£280 for each dietitian session and £600–£1,000 for each clinic challenge. A full pathway usually runs £800–£1,800.

  • Is an egg ladder programme available on the NHS?

    Yes, through paediatric allergy and dietetic clinics, but waits are often 6–18 months and dietetic support is patchy.

  • Can my egg-allergic child have MMR and flu vaccines?

    Most egg-allergic children can have MMR safely in a normal setting, and modern inactivated flu vaccines are safe for almost all. LAIV (nasal spray) is safe unless egg allergy has caused anaphylaxis needing ITU. Your allergist confirms each case.

  • Will my child grow out of egg allergy?

    Around two thirds of egg-allergic children tolerate baked egg early and most reach normal egg by school age. A minority persist and need long-term avoidance.

Related treatments

Looking for something else?