Evidence from systematic reviews of randomized trials on enteral lactoferrin supplementation in preterm neonates

In this commentary, we summarize the current evidence from randomized controlled trials on enteral lactoferrin supplementation in preterm neonates. Our recently completed systematic review includes 12 randomized controlled trials performed all over the world. Our meta-analysis suggests clinical benefit in decreasing late-onset sepsis, late-onset fungal sepsis, length of stay in the hospital and urinary tract infections. There were no adverse effects. There was no statistically significant decrease in necrotizing enterocolitis, mortality or neurodevelopmental impairment in lactoferrin supplemented preterm infants. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis between larger and smaller studies, which may reflect either small study biases, differences in the effectiveness, dose or duration of supplemental lactoferrin products, or differences in underlying population risk, or any or all of these.

Automated summary

A meta-analysis of 12 randomized controlled trials on enteral lactoferrin supplementation in preterm neonates showed clinical benefits in decreasing late-onset sepsis and other infections, but no significant effects on necrotizing enterocolitis, mortality, or neurodevelopmental impairment. There was significant statistical heterogeneity in the effects of lactoferrin on late-onset sepsis, with potential factors including study biases, differences in product effectiveness, dose or duration, and population risk profiles.