Human breast milk as an irreplaceable source of nutrition for infants is not a new concept. Furthermore, it has also been known that human breast milk is rich in exosomes and its elements among other nutrients. With a recent explosion in research that scrutinizes the physiologic and pathologic functions of exosomes, it has brought to surface the undeniable therapeutic effects of milk-derived exosomes in treating and/or monitoring several pediatric diseases such as necrotizing enterocolitis, childhood obesity, cancer, type 1 diabetes mellitus, etc. The purpose of this review is to understand the current knowledge regarding the presence and composition of milk-derived exosomes, their functions, and potential clinical applications. The focus of this review will be on human milk–derived exosomes and its potential therapeutic effects. Studies have shown the sources and physiologic functions of exosomes are not limited and need to be well understood and isolated to further improve treatment of diseases that involve the function of exosomes. The overall literature is understanding of the effect of milk-derived exosomes on infant growth and development and is encouraging to increase the depth of knowledge of milk-derived exosomes for further therapeutic management.