BREAST MILK AS AN IMMUNOMODULATOR: SCIENTIFIC ADVANCES AND CLINICAL PERSPECTIVES IN NEONATAL HEALTH
DOI:
https://doi.org/10.36557/2009-3578.2025v11n2p5659-5674Palavras-chave:
Human milk; Immunomodulation; Breastfeeding; Newborn; Human milk oligosaccharides.Resumo
This study aimed to gather and analyze scientific evidence on the immunomodulatory role of breast milk, with emphasis on its bioactive components, protective effects, and clinical implications for neonatal health. It is an Integrative Literature Review, grounded in the principles of Evidence-Based Practice. The research question was structured according to the PICo strategy, considering newborns and infants as the population, the immunomodulatory and bioactive effects of breast milk as the phenomenon of interest, and neonatal health as the context. Searches were conducted between August and September 2025 in the PubMed, SciELO, ScienceDirect, and LILACS databases. Studies published between 2016 and 2025, in Portuguese and/or English, addressing the immunological components of human milk were included. Selection followed the PRISMA protocol and the Joanna Briggs Institute (JBI) levels of evidence. Fifteen studies met the inclusion criteria, demonstrating that breast milk functions as a dynamic immunological system capable of combining passive immunity - primarily mediated by secretory IgA - with active modulation of the infant’s immune response through molecules such as lactoferrin, cytokines, and human milk oligosaccharides (HMOs). These elements exert antimicrobial, anti-inflammatory, and epigenetic actions, promoting intestinal microbiota balance and immune system maturation. Beyond its protective functions, human milk shows therapeutic potential, notably through the use of donor and pasteurized milk in cases of prematurity. It is concluded that breastfeeding is an effective, safe, and low-cost intervention to reduce neonatal morbidity and mortality and to strengthen long-term immunity.
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ALBRECHT, M.; ARCK, P. C. Vertically transferred immunity in neonates: mothers, mechanisms and mediators. Frontiers in Immunology, v. 11, p. 555, 2020. DOI: 10.3389/fimmu.2020.00555. Available at: https://www.frontiersin.org/articles/10.3389/fimmu.2020.00555/full. Accessed on: September 8, 2025.
ANDREAS, N. J. et al. Human breast milk: a review on its composition and bioactivity. Early Human Development, v. 91, n. 11, p. 629–635, 2015. DOI: 10.1016/j.earlhumdev.2015.08.013. Accessed on: September 4, 2025.
AUER, F.; JARVAS, G.; GUTTMAN, A. Recent advances in the analysis of human milk oligosaccharides by liquid phase separation methods. Journal of Chromatography B: Analytical Technologies in the Biomedical and Life Sciences, v. 1162, p. 122497, 2021. DOI: 10.1016/j.jchromb.2020.122497. Available at: https://www.sciencedirect.com/science/article/pii/S1570023220311535. Accessed on: September 7, 2025.
BALLARD, O.; MORROW, A. L. Human milk composition: nutrients and bioactive factors. Pediatric Clinics of North America, v. 60, n. 1, p. 49–74, 2013. DOI: 10.1016/j.pcl.2012.10.002. Accessed on: September 4, 2025.
BRIOLLAIS, L. et al. DNA methylation mediates the association between breastfeeding and early-life growth trajectories. Clinical Epigenetics, v. 13, p. 231, 2021. DOI: 10.1186/s13148-021-01209-z. Available at: https://clinicalepigeneticsjournal.biomedcentral.com/articles/10.1186/s13148-021-01209-z. Accessed on: September 25, 2025.
BURRIS, A. D. et al. Immunologic components in human milk and allergic diseases with focus on food allergy. Seminars in Perinatology, v. 45, n. 2, p. 151386, March 2021. DOI: 10.1016/j.semperi.2020.151386. Available at: https://www.sciencedirect.com/science/article/pii/S0146000520301447. Accessed on: September 9, 2025.
CARR, L. E. et al. Role of human milk bioactives on infants' gut and immune health. Frontiers in Immunology, v. 12, p. 604080, 2021. DOI: 10.3389/fimmu.2021.604080. Available at: https://www.frontiersin.org/articles/10.3389/fimmu.2021.604080/full. Accessed on: September 4, 2025.
KASHYAP, V.; CHOUDHARI, S. G. Unlocking the potential: a systematic literature review on the impact of donor human milk on infant health outcomes. Cureus, v. 16, n. 4, p. e57440, April 2, 2024. DOI: 10.7759/cureus.57440. Available at: https://www.cureus.com/articles/274598. Accessed on: September 10, 2025.
LEMES, M. A. et al. Evaluation strategies in active learning in higher education in health: integrative review. Revista Brasileira de Enfermagem, v. 47, n. 2, 2021. Available at: https://www.scielo.br/j/reben/a/KG8VgQhpKf9ySfCwjkyNY6w/?format=pdf&lang=en. Accessed on: September 6, 2025.
LOCKWOOD, C. et al. Systematic reviews of qualitative evidence. In: AROMATARIS, E.; MUNN, Z. (Editors). JBI Manual for Evidence Synthesis. JBI, 2020. Available at: https://jbi-global-wiki.refined.site/space/MANUAL/355860482. Accessed on: September 4, 2025.
MOHER, D. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine, v. 6, n. 7, p. 1000097, 2009. Available at: https://pubmed.ncbi.nlm.nih.gov/19621072/. Accessed on: September 6, 2025.
SCHÖNKNECHT, Y. B. et al. Clinical studies on the supplementation of manufactured human milk oligosaccharides: a systematic review. Nutrients, v. 15, n. 16, p. 3622, August 17, 2023. DOI: 10.3390/nu15163622. Available at: https://www.mdpi.com/2072-6643/15/16/3622. Accessed on: September 10, 2025.
STERN, C.; JORDAN, Z.; MCARTHUR, A. Developing the review question and inclusion criteria. The American Journal of Nursing, v. 14, n. 4, p. 53–56, 2014. Available at: https://pubmed.ncbi.nlm.nih.gov/24681476/. Accessed on: September 6, 2025.
STROBEL, K. M. et al. Human milk as therapy: neurodevelopment and neonatal brain injury. Seminars in Perinatology, In Press, Corrected Proof, 2025. DOI: 10.1016/j.semperi.2025.152140. Available at: https://www.sciencedirect.com/science/article/pii/S0146000525001170. Accessed on: September 10, 2025.
SURDACKA, L. M. et al. Epigenetic and immune mechanisms linking breastfeeding to lower breast cancer rates. Medical Science Monitor, v. 30, e945451, November 5, 2024. DOI: 10.12659/MSM.945451. PMID: 39497379; PMCID: PMC11549897. Accessed on: September 5, 2025.
VERHASSELT, V. et al. Antibodies in breast milk: pro-bodies designed for healthy newborn development. Immunological Reviews, v. 328, n. 1, p. 192–204, November 2024. DOI: 10.1111/imr.13411. PMID: 39435770; PMCID: PMC11659933. Accessed on: September 4, 2025.
VICTORA, C. G. et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, v. 387, n. 10017, p. 475–490, 2016. DOI: 10.1016/S0140-6736(15)01024-7. Accessed on: September 4, 2025.
WHITTEMORE, R.; KNAFL, K. The integrative review: updated methodology. Journal of Advanced Nursing, v. 52, n. 5, p. 546–553, 2005. DOI: 10.1111/j.1365-2648.2005.03621.x. Available at: https://www.ics.org/Wasabi/Documents/DocumentsDownload.aspx?DocumentID=1832. Accessed on: September 7, 2025.
YAO, T. et al. Effect of maternal miRNAs and milk oligosaccharides on regulating the growth behavior of Bifidobacterium longum subsp. infantis. Journal of Functional Foods, v. 128, p. 106800, May 2025. DOI: 10.1016/j.jff.2025.106800. Available at: https://www.sciencedirect.com/science/article/pii/S1756464625000935. Accessed on: October 7, 2025.
YOUNG, L.; MCGUIRE, W. Immunologic properties of human milk and clinical implications in the neonatal population. Neoreviews, v. 21, n. 12, p. e809–e816, December 2020. DOI: 10.1542/neo.21-12-e809. PMID: 33262207. Accessed on: September 4, 2025.
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Copyright (c) 2025 Cynthia de Paula Costa Borba, Rodolfo de Oliveira Medeiros, Aline Maria Noli Mascarin, Juliana Pascon dos Santos, Cristiano Machado Galhardi, Roberto Giovanetti Mendes Neto, Lívia de Oliveira Alves, Fábio Augusto Freiria Barbosa, Wilson Bernardo Silva, Percyleine Pelegrine Herculiani, Maria Beatriz Correa Aneli, Camila Cristina Andrade Sava, Alexandre Goes Borba, Jaddy Costa Rodrigues, Angélica Mercia Pascon Barbosa
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