Hypoxic-ischemic encephalopathy (brain injury caused by oxygen deprivation and impaired blood supply to the brain) is one of the most common causes of neonatal mortality and long-term neurological damage.
Currently, such cases are treated with therapeutic hypothermia, where newborns’ body temperature is reduced to 33–34°C. In the future, this treatment may be complemented by intranasal breast milk therapy. Fresh breast milk contains substances (such as stem cells and neurotrophic factors) that support the regeneration of the nervous system, and when administered through the nose rather than orally, these components may reach the central nervous system more effectively. In their study published in Pediatric Research, Dr. Ünőke Méder, assistant professor at the Department of Pediatrics of Semmelweis University, and Dr. Eszter Tarjányi, pediatric resident at the same clinic, investigated whether this type of breast milk therapy can be safely applied in both clinical and controlled home settings.
The study involved newborns with moderate to severe hypoxic-ischemic brain injury who received therapeutic hypothermia as standard treatment. Freshly expressed breast milk from their own mothers was administered into the nostrils under clinical supervision within 48 hours after birth. The therapy was continued for 28 days with the involvement of properly trained parents, while the infants’ condition was continuously monitored.
The research demonstrated that intranasal breast milk therapy is safe; it did not cause any respiratory, circulatory, or neurological complications in the newborns studied.
One of the biggest challenges of the research was not medical but logistical and psychological. “Transporting the breast milk and organizing care was one of the most difficult tasks. There were cases when I had to travel to a farm near Cegléd [a town that is situated 80 kilometers from Budapest] to collect the milk, to a place even taxi drivers refused to go because there was no proper road,” said Dr. Ünőke Méder. Supporting mothers who had experienced trauma was also crucial: initiating and maintaining milk expression required significant assistance.
According to Dr. Eszter Tarjányi, involving parents ultimately proved easier than expected: “For many parents, it was very important that they could do something for their child in such a difficult situation.” Learning how to administer the breast milk also did not present a major obstacle. “Once they understood how to administer the milk and that it does not cause pain to the baby, they were able to apply the procedure confidently,” added Dr. Méder.
The authors of the study emphasized that their research focused only on the safety of the administration method; the effectiveness of this form of breast milk therapy still needs to be confirmed by further studies. So far, the topic has been explored in animal experiments and in studies conducted in Germany and Canada on preterm infants who suffered brain hemorrhage. These studies suggested beneficial effects of intranasally administered breast milk on the nervous system. If further large-scale, controlled studies also yield positive results, this procedure could become an excellent therapy and even a simple, low-cost alternative in developing countries (where cooling therapy is not always available) for treating neonatal brain injury. Some countries have already shown interest in the method.
Photo: Boglárka Zellei – Semmelweis University
Cover image: elements.envato.com/yavdat