Not too long ago, a participant in one of my research
studies asked me if I had heard of using breast milk as a treatment for ear or
eye infections and skin rashes. A friend had recommended treating a recent episode
of conjunctivitis on the baby with human milk. About a year earlier, another
participate had informed me that she was putting milk in her baby’s ear to
treat an infection. So here’s the
question . . .does it actually work?
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| Figure 1: Much like Gus Portokalos found that Windex cured everything, is it possible that human milk can treat topical infections? |
Ear Infections
First off, there is good evidence that the act of
breastfeeding reduces the risk of ear infections in infants. It is unclear if
this benefit is related to the milk itself or to the actual act of suckling at
the breast, as no studies have been conducted on infants receiving only pumped
milk. Abraham and Labbock do hypothesize that the mechanical act of suckling,
with its distinct pattern of suck, swallow, breathe and the may increase aeration
of the eustachian tube, while the differences in pressure associated with
bottle feeding may instead increase the risk of eustachian tube dysfunction
from the negative pressure transmitted from the bottle (Brown and Magnuson
2000). Importantly, these pressure differences are only found in unventilated
or partially ventilated bottles – fully ventilated bottles showed no such
pressure changes. Human milk also contains numerous antibodies and immune
factors that will serve to protect the infant from infection.
However, the use of breast milk as a topical treatment for
ear infections has not been similarly studies. No one has ever published the
results of a randomized control trial – or even an observational study – on the
topical application of human milk as a treatment for ear infections. And there
is a pretty good reason why:
Most ear infections clear up on their own without the need
for further treatment.
In fact, the American Academy of Pediatrics recommends
against using routine antibiotics in the case of milk to moderate ear
infections, instead reserving them for severe or chronic infections. Further,
the majority of ear infections are middle ear infections, on the inside of the
ear drum. In this instance, the ear drum will block the milk from entering the
ear and maintain a barrier between the milk and the infection. The majority of personal accounts reporting
breast milk as curing the ear infection? The mostly likely explanation is that
the ear infections resolved from a combination of immunological support from
the mother’s milk during normal breastfeeding practices and the infant’s immune
system, not from the external application of the milk.
Skin conditions:
rashes, eczema
Okay, so what about breast milk as a treatment for other,
topical conditions, such as skin rashes, eczema, or diaper rash? In these
instances, the milk will be in direct contact with the infection, possibly allowing
the immunological agents in the milk to work directly on the infection. And
certainly, we know from studies exposing different pathogens to human milk that
exposure is associated with increased pathogen death.
A recent study by Farahani, Ghobadzadeh, and Yousefi
actually conducted a randomized clinical trial or hydrocortisone 1% ointment
compared to freshly expressed human milk in study of 141 breastfeeding infants.
All infants in the study were breastfeeding, and they were randomly assigned to
one of the two treatment groups: freshly expressed human milk or topical
application of the 1% hydrocortisone ointment. Treatment lasted for 7 days,
with clinical assessment of the diaper rash at baseline, 3 and 7 days. There were
no differences between the two groups with regards to severity scoring of the
rash at recruitment and no difference in severity between the two groups at day
7. Most importantly, both groups had shown significant declines in severity
from the baseline assessment. So, for
mild diaper rash, human milk applied a minimum of three times a day has been
shown to reduce severity of diaper rash.
Eye infections
The history of using human milk as a treatment for eye infections
is a very old one, going back to some of the earliest known medical texts.
However, not much is known about the effectiveness. A recent study by Baynham
and colleagues (2013) looked at the effectiveness of fresh human milk against
several species of bacteria that commonly cause eye infections in infants. The
researchers tested milk against Escherichia coli,
Haemophilus influenzae, Neisseria gonorrhoeae, Pseudomonas aeruginosa, Streptococcus pneumonia, Staphylococcus aureus, Moraxella catarrhalis,
coagulase-negative Staphylococcus
and viridans group Streptococcus. Of
these bacteria, three were inhibited following exposure to human milk: three
were significantly inhibited by human milk relative to the negative control: N. gonorrhoeae, M. catarrhalis and viridans group Streptococcus. Human
milk was as effective as polymyxin B sulfate/trimethoprim
ophthalmic solutions against N. gonorrhoeae; less so but still effective against
M. catarrhalis and Streptococcus. In the typical American infant, the common
causes of conjunctivitis are H influenzae, Streptococcus pneumonia and M catarrhalis. However,
this pattern is unique to developed countries – in developing countries the
most common pathogen causing eye infections is N. gonorrhoeae.
So how does human milk stack up as a topical treatment? Pretty well
based on the limited clinical evidence and there is certainly no data to
suggest that using milk as a first line intervention will have any negative
consequences.
Abrahams,
Sheryl W., and Miriam H. Labbok. “Breastfeeding and Otitis Media: A Review of
Recent Evidence.” Current Allergy and Asthma Reports 11, no. 6 (August
11, 2011): 508. doi:10.1007/s11882-011-0218-3.
Baynham, Justin T. L., M. Allison Moorman, Catherine Donnellan, Vicky
Cevallos, and Jeremy D. Keenan. “Antibacterial Effect of Human Milk for Common
Causes of Paediatric Conjunctivitis.” The British Journal of Ophthalmology
97, no. 3 (March 2013): 377–79. doi:10.1136/bjophthalmol-2012-302833.
Brown, C. E., and B. Magnuson. “On the Physics of the Infant Feeding
Bottle and Middle Ear Sequela: Ear Disease in Infants Can Be Associated with
Bottle Feeding.” International Journal of Pediatric Otorhinolaryngology 54,
no. 1 (August 11, 2000): 13–20.
Farahani, Leila Amiri, Maryam Ghobadzadeh, and Parsa Yousefi.
“Comparison of the Effect of Human Milk and Topical Hydrocortisone 1% on Diaper
Dermatitis.” Pediatric Dermatology 30, no. 6 (December 2013): 725–29.
doi:10.1111/pde.12118.