Importance of human milk for infants in the clinical setting: Updates and mechanistic links.

Ellen Demerath, Emily M Nagel, Kristin M Elgersma, Tiffany T Gallagher, Kelsey E Johnson, Cheryl A Gale

Journal: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition 2023;38 Suppl 2(Suppl 2):S39-S55

PMID: 37721461

Abstract

INTRODUCTION

Human milk (HM) is the optimal source of nutrition for infants and has been implicated in multiple aspects of infant health. Although much of the existing literature has focused on the individual components that drive its nutrition content, examining HM as a biological system is needed for meaningful advancement of the field. Investigation of the nonnutritive bioactive components of HM and the maternal, infant, and environmental factors which affect these bioactives is important to better understand the importance of HM provision to infants. This information may inform care of clinical populations or infants who are critically ill, hospitalized, or who have chronic diseases and may benefit most from receiving HM.

METHODS

In this narrative review, we reviewed literature examining maternal and infant influences on HM composition with a focus on studies published in the last 10 years that were applicable to clinical populations.

RESULTS

We found multiple studies examining HM components implicated in infant immune and gut health and neurodevelopment. Additional work is needed to understand how donor milk and formula may be used in situations of inadequate maternal HM. Furthermore, a better understanding of how maternal factors such as maternal genetics and metabolic health influence milk composition is needed.

CONCLUSION

In this review, we affirm the importance of HM for all infants, especially clinical populations. An understanding of how HM composition is modulated by maternal and environmental factors is important to progress the field forward with respect to mechanistic links between HM biology and infant health outcomes.

© 2023 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition.

Address: School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA.; School of Nursing, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA.; Department of Genetics, Cell Biology, and Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA.; Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA.

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