Breast Milk: Proactive Immunomodulation and Mucosal Protection Against Viruses and Other Pathogens

Chiara Cerini; Grace M Aldrovandi


Future Virology. 2013;8(11):1127-1134. 

In This Article


Breast milk is a complex dynamic secretion that adapts to meet the infant's immune ontogeny. Its remarkable ability to protect against pathogens is evident even in industrial countries where hygiene and access to state-of-the-art medicine have markedly decreased infant morbidity and mortality. Immunologic immaturity often hinders newborns and young infants from responding to vaccines. During this vulnerable period, maternal immunity plays a critical role in ensuring the child's health. Maternal antibodies transmitted in utero or through breast milk are major elements in this protection. Maternal immunization aimed at increasing transplacental antibody transfer and persistence has proven to be of benefit against a variety of pathogens. However, this approach can be a double-edged sword, since maternal antibodies may be associated with inhibition of the infant's B-cell activation and antibody production. On the other hand, sIgA in breast milk has been shown to provide specific protection against many bacterial and viral infections, and appears to allow priming of the offspring's immune system. Strategies to optimize the protective effects of maternal immunization include novel vaccine formulations and mucosal routes of delivery. In breastfeeding mothers, stimulating mucosal immunity via oral or nasal vaccination may result in more robust protective responses and should be considered a strategy to protect the young infant. Further studies aimed at understanding the unique relationship in the mother–infant dyad and the mechanisms by which maternal immunity influences infant immune response are needed.