Table 1.

Articles included in this review, with study details.

References	Intervention/Study Type	Sample Size	The Dropout Rate	Study Design	Outcomes	Main Findings
Berents et al. (2015) [5]	Atopic eczema/Randomized clinical trial	18 participants	33%	HBM or emollient was applied on the spot, three times a day for four weeks. The severity and area of the eczema spots was calculated weekly by SCORAD.	Both control and intervention areas of the eczema spots were increased during the intervention. At inclusion mean SCORAD (SCORing Atopic Dermatitis) was 35 and at the end of study 34.	No effect with topical application of HBM was found.
Kasrae et al. (2015) [6]	Atopic eczema/Randomized clinical trial	116 participants	10%	HBM or hydrocortisone 1% was applied twice a day for 21 days on the affected area. Efficiency of the treatment was defined by SCORAD index.	The frequency of healed infants was 81.5% and 76% in HBM and 1% hydrocortisone groups on day 21, respectively (p < 0.24).	HBM was as effective as 1% hydrocortisone.
Farahani et al. (2013) [7]	Diaper dermatitis/Randomized clinical trial	152 participants	4.6%	HBM or hydrocortisone 1% was applied for 7 days on the affected area. The efficiency of the treatment was evaluated at 3 and 7 days by a 6-point scale.	The severity score was not different between the topical HBM and hydrocortisone 1% groups at 3 and 7 days (p < 0.95).	HBM was as effective as 1% hydrocortisone.
Gozen et al. (2014) [8]	Diaper dermatitis/Randomized clinical trial	70 participants	10%	HBM and barrier cream containing 40% zinc oxide and cod liver oil was applied on diaper dermatitis change for 5 days and the postlesion score was establish by a 4-point scale.	The condition of dermatitis was improved in 60% of infant from HBM group and 93.6% treated with barrier cream. The postlesion score of barrier cream group was lower than HBM group (p = 0.002).	Barrier cream was more effective than HBM.
Seifi et al. (2017) [9]	Diaper dermatitis/Randomized clinical trial	30 participants	0	Infants suffering from diaper dermatitis assigned to HBM group and the control group were followed up for 5 days and the efficiency of the treatment was evaluated by a 5-point scale rash severity.	In the control group 26.1% infants showed improvement, in HBM group—80%. HBM has decreased the incidence of anal dermatitis rash (p = 0.009).	A positive effect with topical application of HBM was found.
Abou-Dakn et al. (2011) [10]	Painful and damaged nipples/No full randomized clinical trial	84 participants	14%	The efficacy of HBM and lanolin on pain and damage nipples was assessed on the 10-range Visual Analog Scale (VAS) and the Nipple Trauma Score (NTS) over 14 days after delivery.	Lanolin was more effective than HBM, including faster healing of nipple trauma and reducing nipple pain (p = 0.043).	No positive effect with topical application of HBM was found.
Golshan and Hossein (2013) [11]	Umbilical cord care/Randomized clinical trial	316 participants	5%	The neonates were divided into three groups: Topical ethanol or HBM application twice a day, the control group kept the stump dry. Umbilical separation time and local infection frequency were considered.	Umbilical separation time in human milk group was significantly shorter (6.5 days) than in ethanol (8.94 days) (p < 0.0001) and drying groups (7.54 days) (p < 0.003).	A positive effect with topical application of HBM was found.
Aghamohammadi et al. (2012) [12]	Umbilical cord care/Randomized clinical trial	152 participants	14.5%	The umbilical separation time was compared in the group of topical HBM application (three times a day) and dry cord care for 10 days.	Median time of cord separation in human milk application group (150.95 ± 28.68 h) was significantly shorter than dry cord care group (180.93 ± 37.42 h) (p < 0.001).	A positive effect with topical application of HBM was found.
Abbaszadeh et al. (2016) [13]	Umbilical cord care/Randomized clinical trial	174 participants	6.9%	The infant from HBM group received topical application of milk and group 2 chlorhexidine solution 4% to the umbilical stump 2 times a day. Follow-up and visit at home were done.	The mean cordseparation time in the human milk group (7.14 ± 2.15 days) was shorter than the chlorhexidine group (13.28 ± 6.79 days) (p < 0.001).	A positive effect with topical application of HBM was found.
Ghaemi et al. (2014) [14]	Neonatal conjunctivitis/Randomized clinical trial	300 preterm neonates	10.6%	The intervention group with culture-negative eye swab received two drops of HBM in each eye or erythromycin ointment (0.5%), control group—no treatment. All neonates were followed for the occurrence of clinical conjunctivitis for 28 days.	The beneficial preventive effects of colostrum against neonatal conjunctivitis (p = 0.036).	A positive effect with application of HBM was found.
Asena et al. (2017) [15]	Corneal epithelial wound/Randomized trial on mice model	24 female experimental corneal epithelial defect mice model	0	A central corneal epithelial defect was created in mice and HBM, autologous serum, artificial tears four times a day was applied for 3 days. Histopathological and electron microscopy examination was performed.	Topical human breast milk drops causedfaster and better healing of central corneal epithelial defect than serum drops, artificial tears and in the control group (p < 0.001).	A positive effect with application of HBM was found.
Beynham et al. (2013) [16]	Antimicrobial effect on pediatric conjunctivitis/in vitro study	milk from 23 women/9 bacterial species tested	not applicable	The inhibitory effects of HBM against three common ocular pathogens were assessed. Zones of inhibition by milk samples, sterile saline, and trimethoprim ophthalmic solution were measured	Growth of N gonorrhoeae, M catarrhalis, M viridans was significantly inhibited (p ≤ 0.01) by human milk samples.	A positive effect with application of HBM was found.
Diego et al. (2016) [17]	Dry eye syndrome/Animal in vivo study	91 BALB/c mice	0	The animals with dry eye syndrome were treated with HBM, nopal, nopal extract derivatives, or cyclosporine four times daily for 7 days. Punctate staining and preservation of corneal epithelial thickness were used as indices of therapeutic efficacy.	Reduction in corneal epithelial thickness was largely prevented by administration of HBM (33.2 ± 2.5 μm).	HBM decreased epithelial damage.
Mossberg et al. (2010) [18]	Bladder cancer treatment/animal model and in vitro studies	6 C57BL mice bladder cancer model	0	Bladder tumors cells and bladder mice cancel models were instilled by HAMLET. Effects of HAMLET on tumor size and apoptosis were analyzed.	HAMLET caused a dose dependent decrease in MB49 cell viability in vitro. Five intravesical HAMLET instillations significantly decreased tumor size anddelayed development in vivo compared to controls.	HAMLET from HBM delays bladder cancer development.
Puthia et al. (2014) [19]	Colon cancer prevention and treatment/animal model and in vitro studies	ApcMin/+ mice colorectal tumors model	0	HAMLET was given in therapeutic and prophylactic regimens. Tumor burden and animal survival were compared, and biochemistry and molecular methods were used to determine effects on colon cancer cells.	Peroral HAMLET administration reduced tumor progression and mortality in ApcMin/+ mice.	HAMLET from HBM delays colon cancer development.

HBM: Human breast milk; HAMLET: human alpha-lactalbumin made lethal to tumor cells.