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Could the bacteria described in this research be another probiotic or beneficial bacteria (besides Lactobacillus sakei) that helps protect against sinusitis? New research found that the harmless bacteria Corynebacterium accolens is "overrepresented" in children free of Streptococcus pneumoniae (pneumococcus) -  which commonly colonizes in children's noses (and that can live harmlessly as part of a healthy microbiome), but it is also an important infectious agent. Streptococcus pneumoniae is a major cause of pneumonia, septicemia, meningitis, otitis media (ear infections), and sinusitis in children and adults worldwide.

The researchers did an analysis on the microbes in the nasal passages of children and found that the nasopharyngeal (nostrils) microbiome was different in children with and without pneumococcal nasopharyngeal colonization. This revealed that Corynebacterium species and Dolosigranulum were "overrepresented" in children negative for pneumococcal colonization, whereas Streptococcus was "overrepresented" in children positive for Streptococcus  pneumoniae colonization.

The researchers found that higher numbers of  Corynebacterium accolens cells deter and limit S. pneumoniae nostril colonization, which might partly explain why children without S. pneumoniae colonization have higher levels of nasal Corynebacterium species. The researchers write that "there is direct antagonism" between Corynebacterium spp. and S. pneumoniae in the human nose. How do children get this beneficial bacteria? Interestingly, at 6 weeks of age, Corynebacterium species. and Dolosigranulum species are also "overrepresented" in the nasopharyngeal microbiota of breastfed infants compared to formula-fed infants. From Science Daily:

Good bacteria might help prevent middle ear infections, pneumonia

A new study is helping to shed more light on the important connections among the diverse bacteria in our microbiome. According to research published in mBio, scientists at Forsyth, led by Dr. Katherine P. Lemon, along with their collaborator at Vanderbilt University, have demonstrated that a harmless bacterium found in the nose and on skin may negatively impact the growth of a pathogen that commonly causes middle ear infections in children and pneumonia in children and older adults.

This study provides the first evidence that Corynebacterium accolens, a harmless bacterial species that commonly colonizes the nose, can help inhibit Streptococcus pneumoniae (S. pneumoniae) -- a major cause of pneumonia, meningitis, middle ear infection and sinusitis. According to the World Health Organization, S. pneumoniae leads to more than 1 million deaths each year, primarily in young children in developing countries. Although most people that host S. pneumoniae do not develop these infections, colonization greatly increases the risk of, and is a perquisite for, infection and transmission.

The study, titled, "Corynebacterium accolens (C. accolens) Releases Antipneumococcal Free Fatty Acids from Human Nostril and Skin Surface Triacylglycerols," is published on January 5, 2016 in mBio. In this study, first-author Dr. Lindsey Bomar and her colleagues show that C. accolens are overrepresented in the noses of children that are not colonized by S. pneumoniae, which is commonly found in children's noses and can cause infection. In laboratory research, the team further found that C. accolens modifies its local habitat in a manner that inhibits the growth of S. pneumoniae by releasing antibacterial free fatty acids from representative host skin surface triacylglycerols. The team went on to identify the C. accolens enzyme needed for this. These results pave the way for potential future research to determine whether C. accolens might have role as a beneficial bacterium that could be used to control pathogen colonization.

More evidence that traditional toys and books are superior to electronic toys in both verbal parent-child interactions and non-verbal interactions for young children. Parent-child verbal interactions are so important because they teach young children language, lay the groundwork for literacy skills, teach role-playing, teach emotional and social skills such as turn-taking and accepting others' leads. In other words, put down the electronic gadgets and go spend time talking and interacting with your young child with old style traditional toys and books. From Science Daily:

How does type of toy affect quantity, quality of language in infant playtime?

Electronic toys for infants that produce lights, words and songs were associated with decreased quantity and quality of language compared to playing with books or traditional toys such as a wooden puzzle, a shape-sorter and a set of rubber blocks, according to an article published online by JAMA Pediatrics.

Anna V. Sosa, Ph.D., of Northern Arizona University, Flagstaff, and colleagues conducted a controlled experiment involving 26 parent-infant pairs with children who were 10 to 16 months old. Researchers did not directly observe parent-infant play time because it was conducted in participants' homes. Audio recording equipment was used to pick up sound. Participants were given three sets of toys: electronic toys (a baby laptop, a talking farm and a baby cell phone); traditional toys (chunky wooden puzzle, shape-sorter and rubber blocks with pictures); and five board books with farm animal, shape or color themes.

While playing with electronic toys there were fewer adult words used, fewer conversational turns with verbal back-and-forth, fewer parental responses and less production of content-specific words than when playing with traditional toys or books. Children also vocalized less while playing with electronic toys than with books, according to the results.

Results also indicate that parents produced fewer words during play with traditional toys than while playing with books with infants. Parents also used less content-specific words when playing with traditional toys with their infants than when playing with books. The authors note results showed the largest and most consistent differences between electronic toys and books, followed by electronic toys and traditional toys.

"These results provide a basis for discouraging the purchase of electronic toys that are promoted as educational and are often quite expensive. These results add to the large body of evidence supporting the potential benefits of book reading with very young children. They also expand on this by demonstrating that play with traditional toys may result in communicative interactions that are as rich as those that occur during book reading. ... However, if the emphasis is on activities that promote a rich communicative interaction between parents and infants, both play with traditional toys and book reading can be promoted as language-facilitating activities while play with electronic toys should be discouraged," the study concludes.

EDITORIAL: "Electronic toys that make noises or light up are extremely effective at commanding children's attention by activating their orienting reflex. This primitive reflex compels the mind to focus on novel visual or auditory stimuli. The study by Sosa in this issue of JAMA Pediatrics suggests that they may do more than just command children's attention; they appear to reduce parent-child verbal interactions. Why does this matter? Conversational turns during play do more than teach children language. They lay the groundwork for literacy skills, teach role-playing, give parents a window into their child's developmental stage and struggles, and teach social skills such as turn-taking and accepting others' leads.

Verbal interactions of course are only part of the story. What is missing from this study is a sense of how nonverbal interactions, which are also an important source of social and emotional skills, varied by toy type," write Jenny S. Radesky, M.D., of the University of Michigan Medical School, Ann Arbor, and Dimitri A. Christakis, M.D., M.P.H., of Seattle Children's Hospital and a JAMA Pediatrics associate editor, in a related editorial.

The results of this study lead me to say DUH...of course spending time with children and being responsive to them, talking and interacting a lot with them, being affectionate and loving with them is best. So in this holiday season, don't just give gifts and toys to your children and think you can leave them to their own devices  or with others, but spend time with them, talk a lot to them, play games with them, interact, and do things with them. Put down your own electronic devices (cell phone, laptop, tablet, etc) and go spend time with your child. From Science Daily:

Parent touch, play and support in childhood vital to well-being as an adult

Did you receive affection, play freely and feel supported in childhood? Childhood experiences like these appear to have a lot to do with well-being and moral capacities in adulthood. In a forthcoming article in the journal Applied Developmental Science, University of Notre Dame professor of psychology Darcia Narvaez and colleagues Lijuan Wang and Ying Cheng, associate professors of psychology, show that childhood experiences that match with evolved needs lead to better outcomes in adulthood.

According to Narvaez, one of the reasons that the well-being of children in the United States lags behind that of children in other advanced nations is because "we have forgotten that we are social mammals with specific evolved needs from birth."

"Humans evolved with a nest of care for their young that matches up with the maturational schedule of the child. It was shaped over 30 million years ago and modified through human evolution," Narvaez said. "We call it the evolved developmental niche." In describing this niche, Narvaez emphasizes six components: Soothing, naturalistic perinatal experiences; responsiveness to a baby's needs including sensitivity to the signals of the baby before the baby cries; constant physical presence with plenty of affectionate touch; extensive breastfeeding; playful interactions with caregivers and friends; and a community of affectionate, mindful caregivers.

Narvaez, Wang and Cheng asked adults to reflect on their childhoods according to several components of the evolved developmental niche (EDN): How much did they receive physical affection? Play freely outside and inside? Do things as a family inside and outside the home? Feel supported?

Adults who report receiving more of such parenting practices in their childhoods display less depression and anxiety, greater ability to take the perspective of others and an orientation toward compassion. Adults who report less of these parenting practices in their childhood have poorer mental health, more distress in social situations and are less able to take another's point of view.

"Our research shows that when we don't provide children with what they evolved to need, they turn into adults with decreased social and moral capacities," Narvaez said. "With toxic stress in childhood, the good stuff doesn't get a chance to grow and you become stress reactive. It's hard to be compassionate when you are focused on yourself. We can see adults all around us who were traumatized or undercared for at critical times." In prior research, Narvaez and her colleagues found that children who experienced more of the evolved developmental niche exhibit, for example, more empathy, self-control and conscience.

Drawing of colon seen from front (appendix is colored red). Credit: Wikipedia

This is the second time I've seen research finding that antibiotics  alone could be used (instead of surgery) for the treatment of uncomplicated appendicitis (June 17, 2015 post), but this time in children. Appendicitis is inflammation of the appendix.  At the one year follow-up the researchers found that 75.7% of patients with uncomplicated appendicitis had been successfully treated with antibiotics alone and had not had any recurrences of appendicitis.

This is a major finding because for years the gold standard for appendicitis treatment has been an appendectomy. The times are a changing.

From Science Daily: Antibiotics alone can be a safe, effective treatment for children with appendicitis

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children's Hospital found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

"Surgery has long been the 'gold standard' of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back," said Dr. Deans. "However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete and I asked ourselves: do they really need to have surgery?"

In the first study conducted and published in the United States examining non-operative management for appendicitis, they enrolled 102 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis at Nationwide Children's between October 2012 and October 2013. Participants had early/mild appendicitis, meaning that they experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller; and had no evidence of an abscess or fecalith, which is hard stone-like piece of stool.

Thirty-seven families chose antibiotics alone and 65 opted for surgery. Those patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Among those patients, 95% showed improvement within 24 hours and were discharged without undergoing surgery. Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children, sending more than 70,000 young people to the operating room each year. Although many of these cases are severe and require surgery, there are a good number that would be candidates for treatment with antibiotics alone, Dr. Minneci said.

According to the study results, patients who were transferred to Nationwide Children's from other institutions expressed concerns about the distance and time necessary to come back if the appendicitis recurred. These families opted for surgery more often. Patients whose families spoke primary languages other than English were more likely to choose antibiotics as a course of treatment due to cultural values to avoid surgery if at all possible.

A large study found that using antidepressants during the second or third trimester of pregnancy increases the risk that the child will have autism by 87%,  especially if the mother takes selective serotonin reuptake inhibitors (SSRIs). A drawback was that the study looked at associations rather than actual cause (which would have meant randomly assigning women to either treatment or no treatment - which is unethical). From Medical Xpress:

Taking antidepressants during pregnancy increases risk of autism by 87 percent

Using antidepressants during pregnancy greatly increases the risk of autism, Professor Anick Bérard of the University of Montreal and its affiliated CHU Sainte-Justine children's hospital revealed today. Prof. Bérard, an internationally renowned expert in the fields of pharmaceutical safety during pregnancy, came to her conclusions after reviewing data covering 145,456 pregnancies.

"The variety of causes of autism remain unclear, but studies have shown that both genetics and environment can play a role," she explained. "Our study has established that taking antidepressants during the second or third trimester of pregnancy almost doubles the risk that the child will be diagnosed with autism by age 7, especially if the mother takes selective serotonin reuptake inhibitors, often known by its acronym SSRIs." Her findings were published today in JAMA Pediatrics.

Bérard and her colleagues worked with data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. In addition to information about the mother's use of antidepressants and the child's eventual diagnosis of autism, the data included a wealth of details that enabled the team to tease out the specific impact of the antidepressant drugs. 

"We defined exposure to antidepressants as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy. This period was chosen as the infant's critical brain development occurs during this time," Prof. Bérard said. "Amongst all the children in the study, we then identified which children had been diagnosed with a form of autism by looking at hospital records indicating diagnosed childhood autism, atypical autism, Asperger's syndrome, or a pervasive developmental disorder. Finally, we looked for a statistical association between the two groups, and found a very significant one: an 87% increased risk." 

The findings are hugely important as six to ten percent of pregnant women are currently being treated for depression with antidepressants. In the current study, 1,054 children were diagnosed with autism (0.72% of the children in the study), on average at 4.5 years of age. Moreover, the prevalence of autism amongst children has increased from 4 in 10,000 children in 1966 to 100 in 10,000 today. While that increase can be attributed to both better detection and widening criteria for diagnosis, researchers believe that environmental factors are also playing a part.

"It is biologically plausible that anti-depressants are causing autism if used at the time of brain development in the womb, as serotonin is involved in numerous pre- and postnatal developmental processes, including cell division, the migration of neuros, cell differentiation and synaptogenesis - the creation of links between brain cells," Prof. Bérard explained. "Some classes of anti-depressants work by inhibiting serotonin (SSRIs and some other antidepressant classes), which will have a negative impact on the ability of the brain to fully develop and adapt in-utero".

 Just a few years ago the type of pesticide (organophosphate, for example chlorpyrifos) looked at in this study was commonly used everywhere - in schools, homes, agriculture. It was easy to buy in stores (e.g., Raid spray), and was considered "safer" than older pesticides. Over time problem after problem has been found with them - with the latest being decreased lung function in children exposed to organophosphates early in life.

Keep in mind that with all current pesticides we know very little about long-term effects, especially on developing fetuses and children, and so we should be very, very careful about using them and avoid unnecessary use. Yes, that means using them for harmless lawn weeds is an unnecessary use. Common lawn weeds can not give a person cancer, birth defects, health problems, or illnesses, but pesticides can. From Medical Xpress:

Weaker breaths in kids linked to early pesticide exposure

Taking a deep breath might be a bit harder for children exposed early in life to a widely used class of pesticides in agriculture, according to a new paper by researchers at the University of California, Berkeley. A new study has linked the levels of organophosphate pesticide metabolites in the urine of 279 children living in California's Salinas Valley with decreased lung function. Each tenfold increase in concentrations of organophosphate metabolites was associated with a 159-milliliter decrease in lung function, or about 8 percent less air, on average, when blowing out a candle. The magnitude of this decrease is similar to a child's secondhand smoke exposure from his or her mother.

"Researchers have described breathing problems in agricultural workers who are exposed to these pesticides, but these new findings are about children who live in an agricultural area where the organophosphates are being used," said study senior author Brenda Eskenazi, a professor of epidemiology and of maternal and child health. "This is the first evidence suggesting that children exposed to organophosphates have poorer lung function."

The children were part of the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), a longitudinal study in which the researchers follow children from the time they are in the womb up to adolescence. The researchers collected urine samples five times throughout the children's lives, from age 6 months to 5 years, and measured the levels of organophosphate pesticide metabolites each time. When the children were 7 years old, they were given a spirometry test to measure the amount of air they could exhale.

"The kids in our study with higher pesticide exposure had lower breathing capacity," said study lead author Rachel Raanan, who conducted the research while she was a postdoctoral scholar in Eskenazi's lab. "If the reduced lung function persists into adulthood, it could leave our participants at greater risk of developing respiratory problems like COPD (chronic obstructive pulmonary disease)."

The study did not examine the pathways for the children's exposure to pesticides, but the researchers did recommend that farmworkers remove their work clothes and shoes before entering their homes. They also suggested that when nearby fields are being sprayed with pesticides, children be kept away and, if indoors, windows should be closed. Pesticide exposure can also be reduced by washing fruits and vegetables thoroughly before eating.

The authors noted that although organophosphate pesticides are still widely used, most residential uses of organophosphate pesticides in the United States were phased out in the mid-2000s. In California, use of organophosphates in agriculture has also declined significantly from 6.4 million pounds in 2000, when the study began, to 3.5 million pounds in 2013, the year with the most recent pesticide use data. 

The mother is an important source of the first microbiome for infants by "seeding" the baby's microbiome - from the vaginal birth and then breastfeeding. However, research finds that infants born by C-section acquire bacteria commonly found on skin (Staphylococcus, Corynebacterium, and Propionibacterium) rather than the bacteria acquired during a vaginal birth.

This study examined the source of the skin-type bacteria found on C-section babies. The researchers analyzed the dust from operating rooms (which they collected right after C-sections) and found that it contains deposits of human skin bacteria and human skin flakes. The researchers point out that "Humans shed up to 37 million bacterial genomes into the environment per hour." Operating rooms are occupied by humans, lack natural ventilation, and even though they are regularly cleaned, the humans using the operating rooms shed bacteria and skin flakes. From Microbiome:

The first microbial environment of infants born by C-section: the operating room microbes

Newborns delivered by C-section acquire human skin microbes just after birth, but the sources remain unknown. We hypothesized that the operating room (OR) environment contains human skin bacteria that could be seeding C-section born infants. To test this hypothesis, we sampled 11 sites in four operating rooms from three hospitals in two cities. Following a C-section procedure, we swabbed OR floors, walls, ventilation grids, armrests, and lamps....The bacterial content of OR (operating room) dust corresponded to human skin bacteria, with dominance of Staphylococcus and Corynebacterium. Diversity of bacteria was the highest in the ventilation grids and walls but was also present on top of the surgery lamps. 

We conclude that the dust from ORs, collected right after a C-section procedure, contains deposits of human skin bacteria. The OR microbiota is the first environment for C-section newborns, and OR microbes might be seeding the microbiome in these babies. 

In the present study, we used 16S rRNA gene sequencing to show that OR dust, collected right after a C-section procedure, contains bacteria similar to human skin microbiota. Previous studies using culture-dependent methods also showed that over 85 % of air samples from ORs had skin-like bacteria which were mostly coagulase-negative staphylococci and Corynebacterium. These airborne skin-bacteria could be from individuals present during C-section but could also be shed by cleaning personnel between operations.

In our study, 30 % of samples failed to yield sufficient DNA sequences to be analyzed. While there are no published data on the microbiota in operating rooms using 16S rRNA gene sequencing, very few bacteria (average 3.3–3.5 CFU/10 cm2) were detected in ORs after regular decontamination using standard culturing methods, consistent with the low sequence numbers in our study.

In addition, we found that the microbiota of OR samples was more similar to human skin microbiota than oral microbiota and that OR dust contains deposits of human skin flakes. These results reveal that while the use of surgical masks has limited effectiveness at curtailing oral microbial shedding, skin flakes from individuals present during C-section and/or from cleaning personnel between operations could be a more influential factor contributing to the structure of OR microbiota.

Our SourceTracker analysis results suggest that the OR microbes could play a role in seeding infants born by C-section. C-section born infants, in particular, may be solely receiving this inoculum, while vaginally born infants have exposure to vaginal bacteria. The results of these further studies could be relevant to the possible effects on the priming of the immune system by skin bacteria from environmental sources as the primordial inoculum seeding the infant microbiome. This might be relevant to the increased risk of immune diseases observed in C-section born infants.

New research showed that eight days after a concussion, the concussed athletes (football players) looked and felt like they had recovered (clinical recovery), but MRIs showed that there were still neurophysiological abnormalities (significant blood flow decrease) in their brains. They did not look at if and when the blood flow returned to normal, but that research also needs to be done.

It is very disturbing to look at both this research and also the finding that the off-season is not enough for high school football players to recover from the repeated hits (not concussions, but sub-concussive hits) that they receive during the football season (Nov. 24, 2015 post). Do student football players really know and understand the dangers to their brains from the repeated hits and also concussions that occur in football? From Medical Xpress:

Reduced blood flow seen in brain after clinical recovery of acute concussion

Some athletes who experience sports-related concussions have reduced blood flow in parts of their brains even after clinical recovery, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA). The results suggest a role for MRI in determining when to allow concussed athletes to return to competition.

Decisions to clear concussed athletes to return to action are typically based on symptoms and cognitive and neurological test results. However, there is increasing evidence that brain abnormalities persist beyond the point of clinical recovery after injury. To find out more, researchers from the Medical College of Wisconsin in Milwaukee studied concussed football players with arterial spin labeling, an advanced MRI method that detects blood flow in the brain.

Dr. Wang and colleagues studied 18 concussed players and 19 non-concussed players. They obtained MRI of the concussed players within 24 hours of the injury and a follow-up MRI eight days after the injury and compared results with those of the non-concussed players. Clinical assessments were obtained for both groups at each time point, as well as at the baseline before the football season.

The concussed players demonstrated significant impairment on clinical assessment at 24 hours post-injury, but returned to baseline levels at eight days. In contrast to clinical manifestation, the concussed players demonstrated a significant blood flow decrease at eight days relative to 24 hours post-injury, while the non-concussed players had no change in cerebral blood flow between the two time points.

"In eight days, the concussed athletes showed clinical recovery," Dr. Wang said. "However, MRI showed that even those in clinical recovery still had neurophysiological abnormalities. Neurons under such a state of physiologic stress function abnormally and may become more susceptible to second injury." "For years, we've relied on what athletes are telling us," Dr. McCrea said. "We need something more objective, and this technology may provide a greater measurement of recovery."

This past week there was discussion of the number of high school football players that die annually while playing football (at least 5). But the bigger risk - because it involves so many players - is the damage to brains that occurs from concussions and from just being hit in football. The response from football enthusiasts is that there are safeguards now - that football players don't play after a concussion until they "heal" (show no obvious symptoms). But do they really heal? And much of the damage is from repeated hits, without having a concussion (sub-concussive blows or hits), what about the damage from that?

This study found that repeated head hits in football can cause changes in brain chemistry and metabolism, even in high school players not diagnosed with concussions. And even after the lengthy off-season (somewhere between two and five months after the season has ended)—the majority of players are still showing that they had not fully recovered. The researchers also made it clear that 2 weeks is not enough time to heal from a concussion. Scary long-term implications - what is happening to brains that never truly heal from past seasons as the players start playing in the next season? From Futurity:

High School Football: Teen Brains Don't Heal During Offseason

Brain scans of high school football players taken before, during, and after the season raise concerns they don’t fully recover from repeated head hits. The researchers used an imaging technique called proton magnetic resonance spectroscopy (1H MRS) to study the brains of 25 high school football players and compared them to the brains of teenagers involved in non-contact sports. The findings suggest repeated head hits in football can cause changes in brain chemistry and metabolism, even in players not diagnosed with concussions. 

We are seeing damage not just to neurons, but also to the vasculature and glial cells in the brain,” says Eric Nauman, professor of mechanical engineering, basic medical sciences, and biomedical engineering at Purdue University. “I was particularly disturbed that when you get to the offseason—we are looking somewhere between two and five months after the season has ended—the majority of players are still showing that they had not fully recovered.”

The 1H MRS data provide details about the blood flow, metabolism, and chemistry of neurons and glial cells important for brain function. The data also revealed a “hypermetabolic response” during the preseason, as though the brain was trying to heal connections impaired from the previous season. “We found that in the preseason for the football players in our study, one part of the brain would be associating with about 100 other regions, which is much higher than the controls,” says Thomas Talavage,  professor of electrical and computer engineering and biomedical engineering and co-director of the Purdue MRI Facility.

“The brain is pretty amazing at covering up a lot of changes. Some of these kids have no outward symptoms, but we can see their brains have rewired themselves to skip around the parts that are affected.”

One of the research papers shows that knowing a player’s history of specific types of hits to the head makes it possible to accurately predict “deviant brain metabolism,” suggesting that sub-concussive blows can produce biochemical changes and potentially lead to neurological problems, which indicates a correlation between players taking the heaviest hits and brain chemistry changes.

The data shows that the neurons in the motor cortex region in the brains of football players produced about 50 percent less of the neurotransmitter glutamine compared to controls. “We are finding that the more hits you take, the more you change your brain chemistry, the more you change your brain’s ability to move blood to the right locations,” Nauman says.

“Recent proton magnetic resonance spectroscopy studies argue that the recommended two-week window of rest is insufficient for full metabolic recovery after concussion,” Nauman says. “Those returning to play prior to full recovery could incur a second concussion with symptoms and metabolic changes more lasting than the first.”

Another excellent reason to breastfeed premature infants - to increase the odds of preventing retinopathy of prematurity (ROP), which is the reason preemies can go blind. It occurs when blood vessels in the retinas of premature infants start to grow out of control. If the abnormal growth continues, the retinas detach, and this can cause blindness.

Sadly, an ROP epidemic occurred in the 1940s and early 1950s when hospital nurseries began using excessively high levels of oxygen in incubators to save the lives of premature infants. During this time, ROP was the leading cause of blindness in children in the US. In 1954, scientists funded by the National Institutes of Health determined that the relatively high levels of oxygen routinely given to premature infants at that time were an important risk factor, and that reducing the level of oxygen given to premature babies reduced the incidence of ROP.

Nowadays ROP is a leading cause of childhood blindness in developed countries. A large US study found that in extremely preterm infants with a gestational age of 22 to 28 weeks, the incidence of ROP was 59% (96% at 22 weeks and 32% at 28 weeks). ROP is considered a  multifactorial disease, and risk factors such as prematurity, low birth weight, oxygen therapy, and oxidative stress have been associated with its development.

This recent study was a meta-analysis of five studies (of 2208 pre-term infants), and it found that the overall incidence of ROP was reduced among infants fed human breast milk compared with those fed formula. The best results in preventing severe ROP was in babies fed exclusively breast milk (up to 90% reduction) or mainly human breast milk feeding. It is thought that breast milk may protect against the development of ROP because of its antioxidant and immune-protective properties.  Note that studies involving donor milk were not included because past studies did not find any advantage for donor milk over formula. This may be possibly related to loss of the breast milk microbes (breast milk normally contains up to 700 species of bacteria) during processing (pasteurizing/heat treatment of milk for 30 minutes) and storage of donor milk. From NPR:

Mother's Milk May Help Prevent Blindness In Preemies

If Stevie Wonder had been born three decades later, we might never have gotten "Superstition" and "Isn't She Lovely" — but the musician might never have gone blind, either. Born premature, Wonder developed retinopathy of prematurity, an eye disease that afflicts more than half of babies born before 30 weeks of gestation.Though treatments were developed in the 1980s, about 400 to 600 U.S. children and 50,000 children worldwide still go blind every year from the condition. Now a study suggests that number could be slashed by more than half if all those preemies received their mothers' milk.

The study, actually a combined analysis of five studies from 2001 through 2013, found that preemies receiving human milk from their mothers had 46 to 90 percent lower odds of retinopathy of prematurity (ROP), depending on how much milk they received and how severe the ROP was. The studies were observational, so they cannot show that breast milk directly caused the lower risk.

Of the infants who develop ROP, most recover and develop well without treatment, but about 10 percent develop severe ROP, increasing their risk of blindness, Chiang said. About half of those infants need treatment, which will prevent blindness in 80 to 90 percent of them.

The new research analyzed the outcomes of 2,208 preterm infants based on whether they received exclusive human milk, any human milk, mainly human milk (more than 50 percent), exclusive formula, any formula or mainly formula. The study did not include donor milk, so all the milk was the mother's pumped or hand-expressed breast milk.

Infants who exclusively received breast milk had 89 percent reduced odds of severe ROP compared to infants who received any formula. Infants who received a mixture of breast milk and formula had roughly half the odds of developing severe ROP compared to infants exclusively receiving formula. The analysis included a very large older study that had found no reduced risk for ROP from breast milk, but most infants in that study received less than 20 percent breast milk.

Until the 1940s and 1950s, ROP did not exist because infants born prematurely rarely survived, Chiang said. As doctors learned to how to keep these tiny babies, usually little more than 3 pounds at birth, alive, they discovered that the blood vessels in their retinas would often start to grow out of control. If the abnormal growth continued, their retinas detached, causing blindness.

The cause of ROP isn't entirely understood, but scientists believe oxidative stress can stimulate the abnormal growth of the blood vessels. Providing preemies with oxygen is often key to their survival, but that oxygen exposure might lead to ROP, according to Jianguo Zhou, a neonatologist in Shanghai, and lead author of the study.