Microbiota, Breast Milk and Probiotics in Mastitis

Author: José María Paricio Talayero, Paediatrician, MD, PhD

Abstract

The study of the human microbiota has grown exponentially over the past two decades, extending to the analysis of breast milk (BM) as a complex biological ecosystem and to the exploration of the therapeutic potential of probiotics in a range of clinical conditions, including lactational or puerperal mastitis (hereafter, mastitis). The aim of this review is to critically analyse current knowledge on the microbiota of BM and to assess the quality of the available evidence regarding the use of probiotics for the prevention and treatment of mastitis.

Available evidence confirms that BM contains a diverse and dynamic microbial community, but important methodological and conceptual uncertainties remain regarding its origin, composition and functions. Clinical trials of probiotics in mastitis present significant methodological limitations, heterogeneous outcomes and limited independent replication. Some clinical guidelines have incorporated recommendations on probiotics, but the strength of the evidence supporting them is very limited. The conceptual and commercial development of this field has progressed more rapidly than the consolidation of a robust empirical basis. At present, there is insufficient high-quality evidence to establish with certainty the preventive or therapeutic efficacy of probiotics in mastitis.

Keywords: microbiota; microbiome; breast milk; human milk; probiotics; mastitis; lactational mastitis; breastfeeding; human lactation; evidence-based medicine.

How to cite: Paricio Talayero JM: Microbiota, Breast Milk and Probiotics in Mastitis: Current Evidence and Challenges for Clinical Practice. Lactation & Breastfeeding 2026;3:06.

Author Information and Disclosure of Conflicts of Interest

José María Paricio Talayero José María Paricio Talayero is a Paediatrician, MD, and holder of a Diploma in Statistics and Health Sciences. He is the former Head of the Paediatrics Department and specialist in hospital paediatrics and neonatal transport. He is the founder of the “Hospital Marina Alta Breastfeeding Photography Competition” and the websites e-lactancia.org and telasmos.org. He is a contributor to three national clinical guidelines, author of 61 scientific publications and 18 book chapters, and medical adviser to La Leche League International
The author declares that he has no conflict of interest, whether actual or perceived, direct or indirect, in relation to this article. He has no financial or professional relationship with companies that violate the WHO International Code of Marketing of Breast-milk Substitutes. He does not receive any remuneration from the pharmaceutical, food or probiotics industries.