Human milk sphingomyelins and metabolomics: an enigma to be discovered.

Sphingomyelins, the most abundant sphingolipids in most mammalian cells, appear to be among the most represented polar lipids in breast milk. Despite the variability of the data reported in the literature, human milk sphingomyelins are qualitatively unique and their quantities are five times higher than in most formula milk. The structural and functional role within the milk fat globule membranes, the involvement in neonatal neurological maturation both in neuro-typical development and in some pathological circumstances, together with the possible contribution in the intestinal development of newborns, are certainly among the main characteristics that have fueled the curiosity of the scientific world. Metabolomics studies, providing a unique metabolic fingerprint, allow an in-depth analysis of the role of these molecules in the extreme variability and uniqueness of breast milk. In the perspective of preventive medicine, at the base of which there is certainly personalized nutrition, it is possible, in the presence of particular conditions, such as neonatal growth retardation or in preterm infants, to consider supplementation of some target nutrients, such as certain sphingomyelins. Nevertheless, further studies are needed to more accurately assess whether and how the type and quantity of sphingomyelins present in breast milk could affect the metabolic health of newborns.HIGHLIGHTSBreast milk is the golden standard for infants' nutritionSphingomyelins are the most represented polar lipids in breast milkThese molecules are involved in both intestinal and neural developments of newbornsMetabolomics is a very useful tool to investigate their precise roleFurther studies are needed to provide eventual nutritional treatment.