Hania Szajewska

Hania Szajewska
Medical University of Warsaw · Department of Paediatrics

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348
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Introduction

Publications

Publications (348)
Article
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Food allergy affects approximately 2–4% of children and adults. This guideline provides recommendations for managing food allergy from the Global Allergy and Asthma European Network (GA2LEN). A multidisciplinary international Task Force developed the guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework and th...
Article
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Background Allergy to cow's milk is the most common food allergy in infants and it is usually outgrown by 5 years of age. In some individuals it persists beyond early childhood. Oral immunotherapy (OIT, oral desensitization, specific oral tolerance induction) has been proposed as a promising therapeutic strategy for persistent IgE-mediated cow's mi...
Article
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Background: Synbiotics are a mixture comprising of live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host. There is an increasing number of studies investigating their role in different diseases and disorders. Aim: The purpose of this manuscript is to provide recommendations for...
Article
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CoMiSS® was developed 7 years ago to increase the awareness of health care professionals towards the possibility that symptoms presented by infants could be related to cow's milk. While CoMiSS was conceived mostly on theoretical concepts, data is now available from 25 clinical trials. Based on this extensive research using the tool since 2015, we a...
Article
Importance: The efficacy of multispecies probiotic formulations in the prevention of antibiotic-associated diarrhea (AAD) remains unclear. Objective: To assess the effect of a multispecies probiotic on the risk of AAD in children. Design, setting, and participants: This randomized, quadruple-blind, placebo-controlled trial was conducted from F...
Article
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The Cow’s Milk-related Symptom Score (CoMiSS™) was developed as a clinical tool aimed at increasing the awareness of health care professionals for the presence and intensity of clinical manifestations possibly related to cow’s milk (CM) intake. This review summarizes current evidence on CoMiSS. We found twenty-five original studies, one pooled anal...
Article
The aim of this study was to assess the compliance between current guidelines on the diagnosis and management of children with cow’s milk allergy (CMA) and clinical practice by a survey of Polish physicians. An online cross-sectional survey involving a convenience series of participants was performed from January 15 to March 20, 2020. Data provided...
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Background The prevalence of cow's milk allergy (CMA) is approximately 2–4.5% in infants and less than 0.5% in adults. Most children outgrow cow's milk allergy in early childhood, particularly that to the baked milk products. Immunotherapy with unheated cow's milk has been used as a treatment option for those who have not yet outgrown CMA, but the...
Article
BACKGROUND AND AIMS Screening for celiac disease (CD) is recommended in children with affected first-degree relatives (FDR). However, the frequency of screening and at what age remain unknown. Aims:to detect variables influencing the risk of CD-development and develop and validate clinical prediction models to provide individualized screening advic...
Article
Introduction A better understanding of current infant feeding practices and factors influencing them may improve the implementation of infant feeding guidelines in the future. Aim To assess the confidence in knowledge and knowledge of selected infant feeding statements, and to assess selected infant feeding practices among parents of infants aged...
Article
p>In the original Supplementary Table associated with this Correspondence, the terms “postbiotic” and “ISAPP” were misspelled in the column heading and footnote, respectively. These errors have now been corrected and the Supplementary information updated online; for transparency, the updated Supplementary Table is available in the online version of...
Article
Background: Evidence for the management of pediatric functional abdominal pain disorders (FAPD) is lacking. The aim of this systematic review was to update evidence on the efficacy and safety of implementing low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) dietary restrictions for the management of children w...
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Uncertainty remains in regard to when, how, and in what form gluten should be introduced into the diet, particularly of infants genetically predisposed to developing celiac disease (CD). MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials databases will be searched from inception. Randomized controlled trials (RCTs) and obs...
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Since the World Allergy Organization (WAO) Diagnosis and Rationale against Cow's Milk Allergy (DRACMA) Guidelines were published 10 years ago, new evidence has accumulated about the diagnosis, therapy, and specific immunotherapy for cow's milk allergy (CMA). For this reason, WAO has felt the need to update the guidelines. We introduce here this upd...
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Objectives The MOSAIC study aimed to evaluate if the Cow’s Milk-related Symptom Score (CoMiSS) can be used as a stand-alone diagnostic tool for cow’s milk protein allergy (CMPA). Design Single-blinded, prospective, multicentre diagnostic accuracy study. Setting 10 paediatric centres in China. Participants 300 non-breastfed infants (median age 16...
Article
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Background Since the publication of The World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines in 2010, a number of other guidelines, expert opinions, and position papers relating to the management of cow's milk allergy (CMA) have been published. We aimed to systematically review the quali...
Chapter
Alterations in the gut microbiota (dysbiosis), at least in part, contribute to the development of gastrointestinal and extraintestinal diseases such as irritable bowel syndrome, inflammatory bowel disease, antibiotic-associated diarrhea, necrotizing enterocolitis, allergy, obesity, type 1 diabetes, and autism (in addition to other factors such as g...
Chapter
Postbiotic research has increased rapidly, and the need for consistent terminology is well-recognized. The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus panel defined a postbiotic as a “preparation of inanimate microorganisms and/or their components that confers a health benefit on the target host.” Effective...
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Background & Aims Celiac disease (CeD), an immune-mediated disease with enteropathy triggered by gluten, affects ~1% of the general European population. Currently, there are no biomarkers to predict CeD development. MicroRNAs (miRNAs) are short RNAs involved in post-transcriptional gene regulation, and certain disease- and stage-specific miRNA prof...
Article
Global prescriptions for proton pump inhibitors (PPIs) have been steadily increasing, particularly for infants. A recent study reported an increase from 137 per 10,000 eligible infants in 2009 to 450 in 2018.¹ There are several well-documented indications for using PPIs for children with acid-related disorders, including erosive gastroesophageal re...
Article
In 2010, British Journal of Nutrition published a consensus review article entitled Prebiotic effects: metabolic and health benefits(1). This was commissioned by International Life Sciences Institute, Europe and had twenty-one co-authors. The current article summarises how this review was planned and written. It deals with three questions regarding...
Article
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Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labelling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allerge...
Article
p>Acute respiratory infections are a common cause of morbidity in infants and young children. This high rate of respiratory infections in early life has a major impact on healthcare resources and antibiotic use, with the associated risk of increasing antibiotic resistance, changes in intestinal microbiota composition and activity and, consequently,...
Article
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This cross-sectional online survey performed in Poland aimed to improve understanding of how COVID-19 pandemic restrictions affected complementary feeding practices among parents of infants aged 4 to 12 months. Self-selected parents were recruited through the internet. The anonymous questionnaire was opened during two intervals during COVID-19 rest...
Article
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Helicobacter pylori (Hp) eradication therapy alters gut microbiota, provoking gastrointestinal (GI) symptoms that could be improved by probiotics. The study aim was to assess the effect in Hp patients of a Test fermented milk containing yogurt and Lacticaseibacillus (L. paracasei CNCM I-1518 and I-3689, L. rhamnosus CNCM I-3690) strains on antibiot...
Article
Purpose: The Cow's Milk-related Symptom Score (CoMiSS™) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS™ values of symptomatic infants based on retrospectively or prospectively obtained infor...
Article
Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, fo...
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p>In the original version of this Consensus Statement article published online, a bar in Figure 1 was incorrectly labelled as “parabiotics” when it should have been labelled as “paraprobiotics”. This error has now been corrected in the HTML and PDF version of the article. Figure 1 | Total number of mentions in the literature of different terms refe...
Article
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In 2019, the International Scientific Association for Probiotics and Prebiotics (ISAPP) convened a panel of experts specializing in nutrition, microbial physiology, gastroenterology, paediatrics, food science and microbiology to review the definition and scope of postbiotics. The term ‘postbiotics’ is increasingly found in the scientific literature...
Article
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Background This guideline from the European Academy of Allergy and Clinical Immunology (EAACI) recommends approaches to prevent the development of immediate‐onset / IgE‐mediated food allergy in infants and young children. It is an update of a 2014 EAACI guideline. Methods The guideline was developed using the AGREE II framework and the GRADE appro...
Article
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Introduction The gut microbiota may be relevant in the development of type 1 diabetes (T1D). We examined the effects of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed T1D. Research design and methods Children aged 8–17 years with newly (within 60 days) diagnosed T1D were enrolled i...
Preprint
Full-text available
BACKGROUND: Helicobacter pylori (Hp) eradication therapy can alter gut microbiota, provoking gastro-intestinal (GI) symptoms that can be improved by probiotics. The effect on Hp patients of a Test fermented milk containing yogurt and three Lacticaseibacillus (L. paracasei CNCM I-1518, CNCM I-3689, L. rhamnosus CNCM I-3690) strains was assessed on a...
Article
Full-text available
Background: Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared wi...
Chapter
Early gut microbial colonization plays an important role in health and disease. Alterations in the gut microbiome (dysbiosis) during this period, at least in part, contribute to the development and progression of diseases such as allergy, obesity, irritable bowel syndrome, necrotizing enterocolitis, type 1 diabetes, and autism (in addition to other...
Article
Pediatricians and allergists often have to deal with parents and caregivers, who are aware that cow’s milk allergy (CMA) is not a permanent allergic disorder. About 80% of children with milk allergy are able to tolerate cow’s milk (CM) by 15 years of age.¹ Referral studies indicate that in most cases spontaneous tolerance is achieved within 4 to 5...
Article
Paediatric functional abdominal pain disorders, currently referred to as disorders of gut–brain interaction, comprise irritable bowel syndrome, functional dyspepsia, abdominal migraine and functional abdominal pain not otherwise specified, as defined by the Rome IV diagnostic criteria. Functional abdominal pain disorders are common disorders with a...
Article
Exclusive breastfeeding ideally up to 6 months of life is the feed of choice for infants and should be promoted by healthcare professionals. However, when human milk is not sufficient or not available, infant formula, generally cow's milk-based, meeting strictly regulated nutritional and safety requirements, are recommended. Human breastmilk feedin...
Article
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We compared fecal samples from responders and non-responders to administration of Lactobacillus reuteri DSM 17938. Data for this post hoc analysis were collected from an RCT assessing the efficacy of L. reuteri for the management of acute gastroenteritis. Responders were defined as subjects with diarrhea lasting no longer than 48 h. 44 children (17...
Preprint
Full-text available
Background Evidence from studies in adults documents that fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) may be triggers of symptoms in individuals with functional abdominal pain disorders (FAPDs). However, in children, the evidence is very limited. We aim to assess the effects of a low-FODMAP diet compared with...
Article
Full-text available
Background: Early antibiotic exposure may be contributing to the onset of childhood allergies. The main objective of this study was to conduct a systematic review on the relationship between early life antibiotic exposure and childhood asthma, eczema and hay fever. Methods: Pubmed and Embase were searched for studies published between 01-01-2008...
Article
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Celiac disease (CeD) is an immune-mediated disorder triggered by exposure to dietary gluten proteins in genetically predisposed individuals. In addition to the host genome, the microbiome has recently been linked to CeD risk and pathogenesis. To progress in our understanding of the role of breast milk microbiota profiles in CeD, we have analyzed sa...
Article
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Introduction Routine use of probiotics during antibiotic therapy in children remains a subject of discussion. To facilitate synthesis of individual study results and guideline formulation, it is important to assess predefined, similar, and clinically important outcomes. Core outcome sets are a proposed solution for this issue. The aim of this revie...
Article
Background This systematic review of ways to prevent immediate‐onset/IgE‐mediated food allergy will inform guidelines by the European Academy of Allergy and Immunology (EAACI). Methods The GRADE approach was used. Eleven databases were searched from 1946 to October 2019 for randomised controlled trials (and large prospective cohort studies in the...
Article
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More than 10,000 preterm infants have participated in randomised controlled trials on probiotics worldwide, suggesting that probiotics in general could reduce rates of necrotising enterocolitis (NEC), sepsis, and mortality. However, answers to relevant clinical questions as to which strain to use, at what dosage, and how long to supplement, are not...
Article
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Purpose: Proton-pump inhibitors (PPIs) are frequently used to treat gastroesophageal reflux disease (GERD) in children, but recent evidence suggests a potential association between PPI treatment and some types of infections. The aim of this study was to assess the effectiveness of Lactobacillus rhamnosus GG (LGG) for the prevention of gastrointest...
Article
Objective To summarize evidence on the efficacy and safety of the use of extensively hydrolyzed formulas (EHFs) for the treatment of children with cow's milk allergy (CMA). Design Systematic review of randomized controlled trials (RCTs) per PRISMA guidelines. The risk of bias of included RCTs was assessed using the Cochrane Collaboration's risk of...
Article
Introduction Growth impairment has often been described in children who develop coeliac disease (CD). Based on data from the multicentre, longitudinal PreventCD study, we analysed the growth patterns of infants at genetic risk of CD, comparing those who developed CD by 6 years of age (CD ‘cases’, 113 infants) versus those who did not develop CD by...
Article
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Background: There is still controversy with regard to the efficacy of individual probiotic strains for the management of acute gastroenteritis. Aim: To update evidence on use of Saccharomyces boulardii for treating acute gastroenteritis in children. Methods: The Cochrane Library, MEDLINE and EMBASE databases were searched from inception to Dec...
Article
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Since the publication of the 2014 ESPGHAN Working Group (WG) on Probiotics & Prebiotics guidelines on probiotics for management of acute gastroenteritis (AGE), new evidence concerning the efficacy of probiotics has become available. This document provides updated recommendations on the use of probiotics for the treatment of AGE in previously presum...
Article
Purpose: The Cow's Milk-related Symptom Score (CoMiSS™), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. T...
Article
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Background: While the literature indicates that probiotics are effective for the treatment or prevention of several conditions, data in children specifically focusing on individual probiotic strains are still limited. Purpose: To conduct a narrative review that summarizes data on the efficacy and safety of two common probiotic strains – Lactobacill...
Article
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To determine whether a gluten-free diet (GFD) compared with a gluten-containing diet (GD) influences functioning of children with autism spectrum disorders (ASD), we performed a randomized, controlled, single-blinded trial. Sixty-six children (36–69 months) with ASD, within the normal IQ (> 70) range, who had been on a GFD for at least 8 weeks befo...
Article
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The incidence of gastroenteritis has greatly reduced due to improved hygiene conditions in developing countries and the use of Rotavirus vaccine. However, still thousands of children die from gastroenteritis, most of them in poor countries. Yet gastroenteritis management is simple, inexpensive, and effective and is largely the same all over the wor...
Preprint
Full-text available
Introduction: Routine use of probiotics during antibiotic therapy in children remains a subject of discussion. To facilitate synthesis of individual study results and guideline formulation, it is important to assess predefined, similar, and clinically important outcomes. Core outcome sets are a proposed solution for this issue. Aim of this review w...
Article
This study aimed to assess the evidence regarding the relationship between early-life antibiotic exposure and childhood overweight/obesity by reviewing observational studies on prenatal antibiotic exposure and systematic reviews on infant antibiotic exposure. A search in Pubmed, Embase and Google Scholar covering the period 1st January till 1st Dec...
Article
Full-text available
The effectiveness of Lactobacillus reuteri DSM 17938 (L. reuteri) for the management of acute gastroenteritis (AGE) has been recently questioned. We performed a systematic review to update evidence on L. reuteri for treating AGE in children. We searched MEDLINE, EMBASE, the Cochrane Library databases, and additional data sources from January 2016 (...
Article
Background: More than 17 million people across Europe have allergies to food and the burden of food allergies is increasing. In 2014 the European Academy of Allergy and Clinical Immunology (EAACI) published guidelines for preventing food allergy. Important research has been published since then and it is essential to ensure the guidelines reflect...
Article
Food allergy affects a small but significant number of children and adults. Food allergy is responsible for considerable morbidity and is the commonest cause of anaphylaxis in children. One of the aims of the European Union funded “Integrated Approaches to Food Allergen and Allergy Risk Management” (iFAAM) project was to improve our understanding o...
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We systematically reviewed evidence from observational studies on the associations between autism spectrum disorders (ASD) and early-life antibiotic exposure. Eleven articles were included in the review. Prenatal antibiotic exposure was associated with a slightly increased risk of ASD in two cohort studies on overlapping populations and in one case...
Article
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LINKED CONTENT This article is linked to Szajewska et al and Schnadower et al papers. To view these articles, visit https://doi.org/10.1111/apt.15267 and https://doi.org/10.1111/apt.15418.
Article
The gastrointestinal microbiome is a hot topic in clinical research. Beneficial effects of selected probiotics in the prevention of gastrointestinal disorders are mainly restricted to acute gastroenteritis, antibiotic-associated diarrhoea, infantile colic, and necrotising enterocolitis. However, no broad consensus exists to recommend the use of pro...
Article
Full-text available
Background Recently, evidence from a large randomised controlled trial (RCT) negated efficacy of Lactobacillus rhamnosus GG for treating acute gastroenteritis in children. Aim To review RCTs in which L rhamnosus GG was used to treat acute gastroenteritis in children. Methods The Cochrane Library, MEDLINE, and EMBASE databases were searched from M...
Article
Objective Whether prenatal or postnatal exposure to antibiotics is associated with an increased risk of coeliac disease (CD) is unclear. We systematically reviewed studies on the association between early life antibiotic exposure and the risk of CD or CD autoimmunity. Design Systematic review of observational studies. Data sources The PubMed and...
Article
Objective: To assess the efficacy of water-soluble dietary fiber, glucomannan supplementation, on the body mass index (BMI) in children with overweight or obesity. Study design: In this randomized, double-blind, placebo-controlled trial, we enrolled 96 children aged 6-17 years with overweight or obesity based on the World Health Organization gro...
Article
Abstract OBJECTIVE: To assess the efficacy of Lactobacillus reuteri DSM 17938 (L. reuteri) for the treatment of acute gastroenteritis in children. STUDY DESIGN: Children younger than 5 years with acute diarrhea, defined as a change in stool consistency to a loose or liquid form and/or an increase in the frequency of evacuations (≥3 in 24 hours), l...
Article
Introduction: Growth patterns of breastfed and formula-fed infants differ, but the influence of breastfeeding duration on early growth remains unclear. The objective of this study is to evaluate current evidence on the association of exclusive and partial breastfeeding duration with different growth parameters during infancy. Materials and method...