Neonatal Eye Infections: Microbial Risks, Transmission Routes, and the Paradox of Traditional Human Milk Applications

This review critically evaluates the microbial risks, transmission routes, and cultural context of using expressed human milk as a topical remedy for neonatal eye conditions, and to reconcile its traditional use with current evidence-based neonatal care.

Breastfeeding is essential for neonatal nutrition, promoting growth and immune protection. In some cultures, expressed human milk is used as a remedy for neonatal eye issues like redness and infections, due to its perceived antimicrobial properties. However, recent microbiological evidence reveals that milk can also harbor and transmit ocular pathogens.

This review examines the microbial profile of human milk, encompassing beneficial commensals. Immunoglobulin-rich human milk contains antimicrobial peptides and oligosaccharides that contribute to neonatal immune defense. Still, it may also harbor potential contaminants such as Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. This article explores the potential transmission pathways of microorganisms through human milk, including maternal skin and nipple colonization, retrograde contamination during expression, and inadequate storage or handling. It highlights the microbial diversity of human milk and examines evidence of its role in neonatal eye infections.

This paper highlights the interplay between traditional practices and evidence-based neonatal care, advocating culturally sensitive messaging that promotes breastfeeding proven benefits while discouraging unverified ocular use to safeguard infant eye health.