Nutritional supplementation for the prevention and treatment of neonatal brain injury: Breast milk and beyond

Neonatal brain injury can occur in both term and preterm infants and leads to lifelong cognitive, motor, and behavioral impairments. Breast milk is generally considered the preferred source of nutrition, due to the many unique components supporting brain development for both healthy neonates and populations at risk. Macronutrients in breast milk (lipids, carbohydrates, and proteins) are needed as a source of energy and as building blocks for the development of new tissue. Specific forms of lipids, proteins, fibers, and micronutrients are also complexly involved in modulating the immune system and supporting brain development. Next to these nutrients, breast milk contains other bioactive compounds such as stem cells, exosomes, and growth factors that are important contributors to brain development and dampening neuroinflammation. Although beneficial, the large variation in breast milk composition and availability underline the need for personalized breast milk-inspired nutritional supplements for vulnerable populations.