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Dietary gangliosides [9], sialic acid [10], and sphingomyelin [11] have been shown to be important for optimal brain development and function in different animal models. However, it should be noted that some of these models are disease models or models with inhibited de novo synthesis, which is far from supplementing a healthy infant or child. In a small study on premature infants with a birth weight <1,500 g, infants receiving formula with high sphingomyelin content (20 vs. 13% of all phospholipids in milk) to cover shortages of breast milk performed better than those fed the lower content at neurobehavioral follow-up between 6 and 18 months corrected age [12]. Further, oral sphingomyelin [13], as well as a bovine MFGM concentrate [14], increased maturation of the intestine in rats. Gangliosides have also been suggested to play an important role in the development of intestinal microbiota composition, gut immunity, and, consequently, in the defense against infections [15]. Other components of MFGM are also involved in the defense against infections, e.g., the glycoproteins butyrophilin, lactadherin, and mucins [16], which all have antimicrobial effects, and the lipid fraction of bovine MFGM has antiviral effects in vitro [17]. Both lipid and protein components of MFGM have anticancer effects in vitro [18], and intake of MFGM in early life has also been suggested to protect against obesity later in life [19].

Fig. 1. Schematic drawing of the release of the milk fat globule and composition of the milk fat globule membrane (MFGM). Illustration by Erik Domellöf. Reproduced from Hernell et al. [1] with permission.