Topical Use of Human Milk in the Neonatal Intensive Care Unit: An Integrative Review

Background: Research has shown that the bioactive components in human milk could demonstrate efficacy when applied topically. One common neonatal skin issue is diaper dermatitis (DD). DD treatment and prevention guidelines often lack the inclusion of topical human milk as a viable option. Purpose: To analyze the safety and efficacy of topical human milk application as a means to support future research of human milk as a topical treatment for DD. Data sources: Google Scholar, CINAHL, PubMed, and Cochrane. Study selection: The search was limited to articles published between 2011 and 2023 in the English language. Disqualifying characteristics included nonhuman subjects, literature reviews, inability to obtain articles, and non-peer-reviewed articles. Data extraction: For Google Scholar, the search terms "human milk OR breast milk" and "topical" were used. For CINAHL, PubMed, and Cochrane, the search terms "human milk OR chest milk OR breast milk OR donor milk" and "topical" were used. Quantitative significance was defined by a P value of less than .05. Results: The search yielded 20 articles. The results of the review demonstrate that topical human milk application is a safe and effective topical treatment to skin integrity/inflammatory issues such as DD. It also identified that caregivers will likely show positive regard to the treatment, promoting its acceptance. Implications for practice and research: The results provide evidence to support methodologic development for human milk application for the prevention and treatment of DD. Further studies can use the results to develop protocols that investigate the effects of human milk application.