Human milk as therapy: neurodevelopment and neonatal brain injury

Human milk (HM) is the gold standard for infant feeding due to its associations with significant reductions in short and long-term serious morbidities. It is also associated with improved brain growth and development and neurodevelopmental outcomes, particularly in the preterm population. The myriad of bioactives found in HM, such as growth factors, stem cells, human milk oligosaccharides, and the human milk microbiome, presumably play a large role in these outcomes. Given the significant improvements in infant outcomes, components of HM are now being studied as targeted neurological therapy for brain injury. This narrative review will summarize the unique components of HM that are thought to be responsible for brain health and how they may affect brain structure and development in the term and preterm neonate. Neurodevelopmental improvements seen with HM feeding will also be reviewed. Finally, pre-clinical and clinical studies utilizing whole HM or HM components to treat brain injury will be summarized so that providers can better share the science of this remarkable biologic with multi-disciplinary teams and families.