Skip to content

Author: Sima

Published on

Every time you inhale, you suck in thousands of microbes. And depending on where you live, the microbes will vary. From Wired:

An Atlas of the Bacteria and Fungi We Breathe Every Day

EVERY TIME YOU inhale, you suck in thousands of microbes. (Yes, even right then. And just then, too.) But which microbes? Scientists mostly assumed that the living components of air—at the tiniest scales, anyway—were the same no matter where you went.

And? Not true, it turns out. Thanks to a 14-month citizen-science project that sampled and analyzed airborne dust around the country, researchers have constructed the first atlas of airborne bacteria and fungi across the continental US. And airborne microscopic life is really diverse.

More than 1,400 volunteers swabbed surfaces in 1,200 houses around the country, focusing on the places people don’t usually clean. The dust there passively collects microbes. In the end those swabs revealed about 112,000 bacterial and 57,000 fungal phylotypes (i.e. familial groups).

Most of these little guys were harmless. The few pathogens and allergens ended up being location-specific. Alternaria, a fungal genus that’s also a common allergen, is ubiquitous but concentrates most in the midwest. The fungus Cladosporium has smaller hotspots scattered all over the country east of Texas, most frequently in the South and Mid-Atlantic. Meanwhile, the bacterial genus Cellulomonas, an normally harmless microbe (but an emerging pathogen according to one study), is much more common in the west.

The two biggest factors that shape this airborne environment, according to study author and University of Colorado microbial ecologist Noah Fierer, are the types of soil and plants that are located in the area (affecting the acidity in the environment), and the climate (humidity, temperature, etc.) Cities, for example, tended to be more like other cities than the rural areas nearby, which Fierer attributes to urban areas tending to plant the same types of trees and flowers and playing host to the same types of wildlife (pigeons, rats, etc).

Clasdosporium is a genus of fungi including some of the most common indoor and outdoor molds. Credit: Wikipedia.

Published on

Since so many people are taking Vitamin D supplements because of its supposed health benefits, the question becomes - how much is too much? For those desiring to take vitamin D supplements, what is a good maintenance dosage to take daily? That question has not been answered from the studies I've seen other than 1000 units per day is safe. However, sunlight is the best and safest source of vitamin D (even though that makes dermatologists nuts because of their concern with sunlight leading to skin cancer).From Science Daily:

Vitamin D toxicity rare in people who take supplements, researchers report

Over the last decade, numerous studies have shown that many Americans have low vitamin D levels and as a result, vitamin D supplement use has climbed in recent years. Vitamin D has been shown to boost bone health and it may play a role in preventing diabetes, cancer, cardiovascular disease and other illnesses. In light of the increased use of vitamin D supplements, Mayo Clinic researchers set out to learn more about the health of those with high vitamin D levels. They found that toxic levels are actually rare.

A vitamin D level greater than 50 nanograms per milliliter is considered high. Vitamin D levels are determined by a blood test called a serum 25-hydroxyvitamin D blood test. A normal level is 20-50 ng/mL, and deficiency is considered anything less than 20 ng/mL, according the Institute of Medicine (IOM).

The researchers analyzed data collected between 2002 and 2011 from patients in the Rochester Epidemiology Project...Of 20,308 measurements, 8 percent of the people who had their vitamin D measured had levels greater than 50 ng/mL, and less than 1 percent had levels over 100 ng/mL.

"We found that even in those with high levels of vitamin D over 50 ng/mL, there was not an increased risk of hypercalcemia, or elevated serum calcium, with increasing levels of vitamin D," says study co-author Thomas D. Thacher, M.D., a family medicine expert at Mayo Clinic. Hypercalcemia, or high blood calcium, can occur when there are very high levels of vitamin D in the blood. Too much calcium in the blood can cause weakness, lead to kidney stones, and interfere with the heart and brain, and even be life threatening.

The Mayo researchers also found that women over age 65 were at the highest risk of having vitamin D levels above 50 ng/mL. The result was not surprising because that's a group that often takes vitamin D supplements, Dr. Thacher says. Another notable outcome: The occurrence of high vitamin D levels over 50 ng/mL increased during the 10-year period of the study, from nine per 100,000 people at the start of the study up to 233 per 100,000 by the end.

Only one case over the 10-year study period was identified as true acute vitamin D toxicity; the person's vitamin D level was 364 ng/mL. The individual had been taking 50,000 international units (IU) of vitamin D supplements every day for more than three months, as well as calcium supplements. The IOM-recommended upper limit of vitamin D supplementation for people with low or deficient levels is 4,000 IU a day. 

Some natural sources of vitamin D include oily fish such as mackerel and salmon, fortified milk, and sunlight.

Published on

This nice general summary of what scientists know about the microbial community within us was just published by a division of the NIH (National Institutes of Health). Very simple and basic. From the National Institute of General Medical Sciences (NIGMS):

Facts about our microbial menagerie

Trillions of microorganisms inhabit us -- inside and out. Scientists are surveying these microbial metropolises to learn more about their role in health. Microbiologists Darren Sledjeski of the National Institutes of Health (NIH) and Andrew Goodman of Yale University share a few details of what researchers have learned so far.

1. The majority of the microbes that inhabit us are bacteria. The rest of the microbial menagerie is fungi and viruses, including ones that infect the bacteria! Collectively, our resident microorganisms are referred to as the human microbiota, and their genomes are called the human microbiome.

2. Our bodies harbor more bacterial cells than human ones. Even so, the microbiota accounts for less than 3 percent of a person's body mass. That's because our cells are up to 10,000 times bigger in volume than bacterial cells.

3. Your collection of bacteria has more genes than you do. Scientists estimate that the genomes of gut bacteria contain 100-fold or more genes than our own genomes. For this reason, the human microbiome is sometimes called our second genome.

4. Most of our microbes are harmless, and some are helpful. For example, harmless microbes on the skin keep infectious microbes from occupying that space. Microbes in the colon break down lactose and other complex carbohydrates that our bodies can't naturally digest.

5. Different microbes occupy different parts of the body. Some skin bacteria prefer the oily nooks near the nose, while others like the dry terrain of the forearm. Bacteria don't all fare well in the same environment and have adapted to live in certain niches.

6. Each person's microbiota is unique. The demographics of microbiota differ among individuals. Diet is one reason. Also, while a type of microbe might be part of one person's normal microbial flora, it might not be part of another's, and could potentially make that person sick.

7. Host-microbial interactions are universal. Microbial communities may vary from person to person, but everyone's got them, including other creatures. For this reason, researchers can use model organisms to tease apart the complexities of host-microbial interactions and develop broad principles for understanding them. The mouse is the most widely used animal model for microbiome studies.

8. The role of microbiota in our health isn't entirely clear. While it's now well accepted that the microbial communities that inhabit us are actively involved in a range of conditions -- from asthma to obesity -- research studies have not yet pinpointed why or how. In other words, the results may suggest that the presence of a bacterial community is associated with a disease, but they don't show cause and effect.

9. Most of our microbes have not been grown in the lab. Microbes require a certain mix of nutrients and other microbes to survive, making it challenging to replicate their natural environments in a petri dish. New culturing techniques are enabling scientists to study previously uncultivated microbes.

10. The impact of probiotic and prebiotic products isn't clear. Fundamental knowledge gaps remain regarding how these products may work and what effects they might have on host-microbial interactions. A new NIH effort to stimulate research in this area is under way.

11. There's even more we don't know! Additional areas of research include studying the functions of microbial genes and the effects of gut microbes on medicines. The more we learn from these and other studies, the more we'll understand how our normal microbiota interacts with us and how to apply that knowledge to promote our health.

Lactobacilli. Credit: Wikipedia.

Published on

A recent study confirms all my recent posts on the importance of fiber, fruits, vegetables, whole grains, seeds, nuts, and legumes for beneficial gut bacteria health (have to feed the them!). This study found dramatic changes in the colon (specifically in the colonic mucosa) from dietary changes in as little as 2 weeks.

In the study, for 2 weeks the Americans ate the typical low-fat, high fiber diet of South Africa which included foods such as hi-maize corn fritters, beans, salmon croquettes, spinach, red pepper and onions, homemade tater tots, mango slices,okra, tomatoes, corn muffins, black-eyed peas, catfish nuggets, navy bean soup, banana, lentils, rice, fish taco (tilapia), and pineapple. Meanwhile, people in South Africa ate an “American” high-fat, low-fiber diet. Foods included beef sausage links and pancakes for breakfast; hamburger and French fries for lunch; and meatloaf and rice for dinner. Plus all sorts of American favorites such as macaroni and cheese, steak, beef hot dog and beans.

The African style low fat and high fiber diet contained about 55 grams of fiber per day, and the American diet (low fiber and high fat ) had about 14 grams of fiber per day (which is typical of a Western diet). Bottom line: fiber feeds beneficial microbes in the gut, which results in beneficial changes in the gut (in the mucosa of the colon). From Science Daily:

Diet swap has dramatic effects on colon cancer risk for Americans and Africans

Scientists have found dramatic effects on risk factors for colon cancer when American and African volunteers swapped diets for just two weeks. Western diets, high in protein and fat but low in fibre, are thought to raise colon cancer risk compared with African diets high in fibre and low in fat and protein.The new study, published in Nature Communications today, confirms that a high fibre diet can substantially reduce risk, and shows that bacteria living in the gut play an important role in this effect.

Colon cancer is the fourth commonest cause of death from cancer worldwide, accounting for over 600,000 deaths per year. Colon cancer rates are much higher in the western world than in Africa or the Far East, yet in the United States, African Americans shoulder the greatest burden of the disease.

To investigate the possible roles of diet and gut bacteria, an international team including scientists from the University of Pittsburgh and Imperial College London carried out a study with a group of 20 African American volunteers and another group of 20 participants from rural South Africa. The two groups swapped diets under tightly controlled conditions for two weeks.... At the start, when the groups had been eating their normal diets, almost half of the American subjects had polyps -- abnormal growths in the bowel lining that may be harmless but can progress to cancer. None of the Africans had these abnormalities.

After two weeks on the African diet, the American group had significantly less inflammation in the colon and reduced biomarkers of cancer risk. In the African group, measurements indicating cancer risk dramatically increased after two weeks on the western diet.

"The findings suggest that people can substantially lower their risk of colon cancer by eating more fibre. This is not new in itself but what is really surprising is how quickly and dramatically the risk markers can switch in both groups following diet change. These findings also raise serious concerns that the progressive westernization of African communities may lead to the emergence of colon cancer as a major health issue."

Professor Stephen O'Keefe at the University of Pittsburgh, who directed the study, said: "Studies on Japanese migrants to Hawaii have shown that it takes one generation of westernization to change their low incidence of colon cancer to the high rates observed in native Hawaiians. Our study suggests that westernization of the diet induces changes in biomarkers of colon cancer risk in the colonic mucosa within two weeks. Perhaps even more importantly, a change in diet from a westernized composition to a 'traditional African' high fiber low fat diet reduced these biomarkers of cancer risk within two weeks, indicating that it is likely never too late to change your diet to change your risk of colon cancer."

The study found that a major reason for the changes in cancer risk was the way in which the bacteria in the gut -- known as the microbiome -- altered their metabolism to adapt to the new diet. In the American group, the researchers found that the African diet led to an increase in the production of butyrate, a byproduct of fibre metabolism that has important anti-cancer effects.

Published on

Another study finding negative effects of air pollution - this time high levels of traffic-related air pollution is linked to slower cognitive development among 7 to 10 year old children in Barcelona, Spain. From Science Daily:

Air pollution linked to slower cognitive development in children

Attendance at schools exposed to high levels of traffic-related air pollution is linked to slower cognitive development among 7- to 10-year-old children in Barcelona, according to a new study.

The researchers measured three cognitive outcomes (working memory, superior working memory, and attentiveness) every 3 months over a 12-month period in 2715 primary school children attending 39 schools. By comparing the development of these cognitive outcomes in the children attending schools where exposure to air pollution was high to those children attending a school with a similar socio-economic index where exposure to pollution was low, they found that the increase in cognitive development over time among children attending highly polluted schools was less than among children attending paired lowly polluted schools, even after adjusting for additional factors that affect cognitive development.

Thus, for example, there was an 11.5% 12-month increase in working memory at the lowly polluted schools but only a 7.4% 12-month increase in working memory at the highly polluted schools. These results were confirmed using direct measurements of traffic related pollutants at schools.

The findings suggest that the developing brain may be vulnerable to traffic-related air pollution well into middle childhood, a conclusion that has implications for the design of air pollution regulations and for the location of new schools. While the authors controlled for socioeconomic factors, the accuracy of these findings may be limited by residual confounding, that is, the children attending schools where traffic-related pollution is high might have shared other unknown characteristics that affected their cognitive development.

Published on

Long-term air pollution can cause damage to the brain: covert brain infarcts ("silent strokes") and smaller brain volume (equal to one year of brain aging).

The authors of a study looking at 900 men in the Boston area concluded that, on average, participants who lived in more polluted areas had the brain volume of someone 1 year older vs participants who lived in less polluted areas, and they also had a 46% higher risk for silent strokes. While the mechanisms of how air pollution may affect brain aging is unclear, the researchers think that inflammation resulting from the deposit of fine particles in the lungs is important. From Science Daily:

Long-term exposure to air pollution may pose risk to brain structure, cognitive functions

Air pollution, even at moderate levels, has long been recognized as a factor in raising the risk of stroke. A new study led by scientists from Beth Israel Deaconess Medical Center and Boston University School of Medicine suggests that long-term exposure can cause damage to brain structures and impair cognitive function in middle-aged and older adults. 

Writing in the May 2015 issue of Stroke, researchers who studied more than 900 participants of the Framingham Heart Study found evidence of smaller brain structure and of covert brain infarcts, a type of "silent" ischemic stroke resulting from a blockage in the blood vessels supplying the brain.

The study evaluated how far participants lived from major roadways and used satellite imagery to assess prolonged exposure to ambient fine particulate matter, particles with a diameter of 2.5 millionth of a meter, referred to as PM2.5. These particles come from a variety of sources, including power plants, factories, trucks and automobiles and the burning of wood. They can travel deeply into the lungs and have been associated in other studies with increased numbers of hospital admissions for cardiovascular events such as heart attacks and strokes.

Study participants were at least 60 years old and were free of dementia and stroke. The evaluation included total cerebral brain volume, a marker of age-associated brain atrophy; hippocampal volume, which reflect changes in the area of the brain that controls memory; white matter hyperintensity volume, which can be used as a measure of pathology and aging; and covert brain infarcts.

The study found that an increase of only 2µg per cubic meter in PM2.5, a range commonly observed across metropolitan regions in New England and New York, was associated with being more likely to have covert brain infarcts and smaller cerebral brain volume, equivalent to approximately one year of brain aging...."This is concerning since we know that silent strokes increase the risk of overt strokes and of developing dementia, walking problems and depression."

Published on

There has been a lot of discussion in the last few years of our gut bacteria (hundreds of species), the microbiome (the community of microbes living within and on a person (gut, nasal cavities, mouth, sinuses, etc.), probiotics, the finding of a link between bacteria and some chronic diseases, and how the modern lifestyle and antibiotics are wiping out our beneficial gut microbes. I am frequently asked how one can improve or nurture the beneficial bacteria in our bodies.

While no one knows what exactly is the "best" or "healthiest" microbial composition of the gut, it does look like a diversity of bacteria is best (may make you healthier and more able to resist diseases). Research also suggests that the diversity and balance of bacteria living in the body can be changed and improved, and changes can occur very quickly. And that the microbial communities fluctuate for various reasons (illness, diet,etc.). Diet seems to be key to the health of your gut microbial community. Prebiotics feed the beneficial bacteria in the gut, probiotics are live beneficial bacteria, and synbiotics are a combination of prebiotics and probiotics. But don't despair - you can improve your gut microbial community starting now. The following are some practical tips, based on what scientific research currently knows.

SOME STEPS TO FEED AND NURTURE YOUR GUT MICROBES:

Eat a wide variety of foods, especially whole foods that are unprocessed or as minimally processed as possible. Eat everything in moderation.

Eat a lot of plant based foods: fruits, vegetables, whole grains, seeds, nuts, and legumes. Think of Michael Pollan's advice: "Eat food. Not too much. Mostly plants."

Eat more washed and raw fruits and vegetables (lots of bacteria and fiber to feed and nurture the bacteria). Some every day would be good.

Eat more soluble and insoluble types of fiber, and increase how many servings you eat every day. A variety of  fiber foods every day, and several servings at each meal, is best. Think fruits, vegetables, whole grains, legumes, nuts, seeds. (See How Much Dietary Fiber Should We Eat? - also has a chart with high fiber foods, and Recent Studies Show Benefits of Dietary Fiber)

Eat as many organic foods as possible. There is much we don't yet know, and pesticides are like antibiotics - they kill off microbes, both good and bad. Somehow I think that lowering the levels in your body of pesticides (as measured in blood and urine) can only be beneficial. Also, organic foods don't contain added antibiotics and hormones. (Eat Organic Foods to Lower Pesticide Exposures).  But even if you can't or won't eat organic foods, it is still better to eat non-organic fruits, vegetables, and whole grains than to not eat them.

Eat some fermented foods such as kimchi and sauerkraut (they contain live bacteria), kefir, and yogurts with live bacteria. Eat other bacteria containing foods such as cheeses, and again a variety is best (different cheeses have different bacteria).

Try to avoid or eat less of mass-produced highly processed foods, fast-foods, preservatives, colors and dyes, additives, partially hydrogenated oils, and high-fructose corn syrup. Read all ingredient lists on labels, and even try to avoid as much as possible "natural flavors" (these are chemicals concocted in a lab and unnecessary). Even emulsifiers (which are very hard to avoid) are linked to inflammation and effects on gut bacteria.

Avoid the use of triclosan or other "sanitizers" in soaps and personal care products (e.g., deodorants). Triclosan promotes antibiotic resistance and also kills off beneficial bacteria. Wash with ordinary soap and water.

Avoid unnecessary antibiotics (antibiotics kill off bacteria, including beneficial bacteria).

Vaginal births are best - microbes from the birth canal populate the baby as it is being born. If one has a cesarean section, then one can immediately take a swab of microbes from the mother's vagina (e.g., using sterile gauze cloth) and swab it over the newborn baby. (See post discussing this research by Maria Gloria Dominguez Bello )

Breastfeeding is best - breastfeeding provides lots of beneficial microbes and oligosaccharides that appear to enrich good bacteria in the baby’s gut.

Live on a farm, or try to have a pet or two. Having pets, especially in the first year of life,  ups exposure to bacteria to help develop and strengthen the immune system, and prevent allergies. Pets such as dogs and cat expose humans to lots of bacteria.

Get regular exercise or physical activity. Professional athletes have more diverse gut bacterial community (considered beneficial) than sedentary people.

Can consider taking probiotics - whether in foods or supplements. They are generally considered beneficial, but not well studied, so much is unknown. The supplements are unregulated, and the ones available in stores may not be those that are most commonly found in healthy individuals. Research the specific bacteria before taking any supplements. Researchers themselves tend to stay away from probiotic supplements and focus on eating a variety of all the foods mentioned above (fruits, vegetables, whole grains, seeds, nuts, legumes, fermented foods) to feed and nurture beneficial bacteria.

Published on

The statements in this editorial may be obvious to many, but it is nicely written and needs to be said. Basically it says that exercise will not help you overcome the ill effects of a poor diet. I agree with what was said, but felt that what was missing was mention that a poor diet also has negative effects on the microbiome (the community of microbes living within the person) - which we know is linked to health problems.

From Medscape: Workouts Do Not Work Off Ill Effects of Poor Die

Exercise enthusiasts cannot work off the ill effects of an unhealthy diet, say the authors of an editorial published online April 22 in the British Journal of Sports Medicine. "Let us bust the myth of physical inactivity and obesity," the authors write. "You cannot outrun a bad diet."

Physical activity levels in Western nations have remained flat during the past 3 decades, even as obesity rates have exploded. That observation is just one sign that calories, not lack of exercise, are driving the obesity crisis, argue Aseem Malhotra, MD, honorary consultant cardiologist at Frimley Park Hospital, United Kingdom, and science director for Action on Sugar, United Kingdom, and colleagues.

"However, the obesity epidemic represents only the tip of a much larger iceberg of the adverse health consequences of poor diet," the authors write. They say that the Lancet global burden of disease reports concluded that poor diet contributes to more disease than a combination of inadequate physical activity, alcohol, and smoking. As many as 40% of people with normal body weight will suffer from metabolic abnormalities typically associated with obesity, the authors write, including hypertension, dyslipidemia, nonalcoholic fatty liver disease, and cardiovascular disease.

Dr Malhotra and colleagues blame food industry marketing for promoting exercise over diet, comparing food industry public relations with discredited tactics used by the tobacco industry in the past. They say Coca Cola "pushes the message that 'all calories count'; they associate their products with sport, suggesting it is ok to consume their drinks as long as you exercise. However science tells us this is misleading and wrong."

The kind of calorie matters too, they emphasize. Calories from sugar promote fat storage and hunger; fat calories induce satiety. For every 150 calories consumed from sugar, there is an 11-fold increase in the prevalence of type 2 diabetes independent of weight or physical activity levels compared with consumption of 150 calories of fat or protein.

Published on

More good news for coffee drinkers! A number of studies have found that coffee drinking is protective against breast cancer (coffee inhibits the growth of tumors), but now research finds it is also protective against breast cancer recurring. The beneficial effects are seen with 2 or more cups of coffee per day. Other studies have found that lifestyle changes (such as weight loss, healthy eating, and exercise) are linked to lower rates of recurrence, but apparently coffee drinking can also be added to the list. This research found that not only is coffee drinking linked to smaller tumors in the first place, but it is also linked to lower rates of recurrence in women also taking tamoxifen. The researchers said: "In summary, this study shows inhibitory effects by caffeine and caffeic acid on breast cancer cell growth." Both caffeine and caffeic acid are present in coffee. From Science Daily:

Coffee protects against breast cancer recurrence, detailed findings confirm

A number of research studies have shown that coffee helps to protect against breast cancer. A new study led by Lund University, has confirmed that coffee inhibits the growth of tumors and reduces the risk of recurrence in women who have been diagnosed with breast cancer and treated with the drug tamoxifen.

The study, which is a follow-up of the results the researchers obtained two years ago, was carried out at Lund University and Skåne University Hospital, in collaboration with researchers in the UK. "Now, unlike in the previous study, we have combined information about the patients' lifestyle and clinical data from 1090 breast cancer patients with studies on breast cancer cells. The study shows that among the over 500 women treated with tamoxifen, those who had drunk at least two cups of coffee a day had only half the risk of recurrence of those who drank less coffee or none at all," explain researchers Ann Rosendahl and Helena Jernström, who obtained the results in collaboration with Jeff Holly and his research team at University of Bristol.

"The study also shows that those who drank at least two cups of coffee a day had smaller tumors and a lower proportion of hormone-dependent tumors. We saw that this was already the case at the time of diagnosis."

In the cell study, the researchers looked more closely at two substances that usually occur in the coffee drunk in Sweden -- caffeine and caffeic acid.

"The breast cancer cells reacted to these substances, especially caffeine, with reduced cell division and increased cell death, especially in combination with tamoxifen. This shows that these substances have an effect on the breast cancer cells and turn off signalling pathways that the cancer cells require to grow.

Published on

For years doctors said babies "didn't feel pain like adults" (they said it was just a "reflex") and so all sorts of procedures and operations were done on infants without pain relief medication. This research shows those doctors were wrong and not giving infants pain relief medications is just cruel. From Medical Xpress:

Babies feel pain 'like adults'

The brains of babies 'light up' in a very similar way to adults when exposed to the same painful stimulus, a pioneering Oxford University brain scanning study has discovered. It suggests that babies experience pain much like adults.

The study looked at 10 healthy infants aged between one and six days old and 10 healthy adults aged 23-36 years....During the research babies, accompanied by parents and clinical staff, were placed in a Magnetic Resonance Imaging (MRI) scanner where they usually fell asleep. MRI scans were then taken of the babies' brains as they were 'poked' on the bottom of their feet with a special retracting rod creating a sensation 'like being poked with a pencil' - mild enough that it did not wake them up. These scans were then compared with brain scans of adults exposed to the same pain stimulus.

The researchers found that 18 of the 20 brain regions active in adults experiencing pain were active in babies. Scans also showed that babies' brains had the same response to a weak 'poke' (of force 128mN) as adults did to a stimulus four times as strong (512mN). The findings suggest that not only do babies experience pain much like adults but that they also have a much lower pain threshold.

'This is particularly important when it comes to pain: obviously babies can't tell us about their experience of pain and it is difficult to infer pain from visual observations. In fact some people have argued that babies' brains are not developed enough for them to really 'feel' pain, any reaction being just a reflex - our study provides the first really strong evidence that this is not the case.' The researchers say that it is now possible to see pain 'happening' inside the infant brain and it looks a lot like pain in adults.

As recently as the 1980s it was common practice for babies to be given neuromuscular blocks but no pain relief medication during surgery [1]. In 2014 a review of neonatal pain management practice in intensive care highlighted that although such infants experience an average of 11 painful procedures per day 60% of babies do not receive any kind of pain medication [2].

Our study suggests that not only do babies experience pain but they may be more sensitive to it than adults,' said Dr Slater. 'We have to think that if we would provide pain relief for an older child undergoing a procedure then we should look at giving pain relief to an infant undergoing a similar procedure.'