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Influence of bovine lactoferrin on feeding intolerance and intestinal permeability in preterm infants: a randomized
Nermeen Ellakkany1,2, Hesham Abdel-Hady3, Ahmed Mahfouz Eita3
1Faculty of Medicine, Horus University - Egypt, Damietta, Egypt. Nermeen.ellakany@gmail.com.
Insights
Oral bovine lactoferrin (LF) supplementation improved feeding intolerance in preterm infants. This intervention also reduced intestinal permeability, as indicated by lower serum zonulin levels in the LF group.
Area of Science:
- Neonatalogy
- Gastroenterology
- Immunology
Background:
- Preterm infants (26-34 weeks gestational age) face feeding intolerance due to immature gastrointestinal function.
- Bovine lactoferrin (LF) shows promise in managing feeding intolerance and sepsis.
- This study investigates LF's impact on feeding intolerance and gut permeability in preterm neonates.
Purpose of the Study:
- To assess the efficacy of oral bovine LF supplementation in preterm infants with feeding intolerance.
- To evaluate the effect of LF on intestinal permeability using serum zonulin concentrations.
Main Methods:
- A randomized controlled double-blind pilot study.
- Sixty preterm neonates (26-34 weeks gestational age) with feeding intolerance were enrolled.
- Participants were randomized to receive either bovine LF (100 mg/day) or a placebo for 4 weeks or until discharge.
Main Results:
- The lactoferrin group achieved full enteral feeding significantly faster (9 vs. 15 days, P=0.001).
- Serum zonulin concentrations were significantly lower in the lactoferrin group at study completion (3.38 vs. 5.49 ng/ml, P=0.04).
Conclusions:
- Oral bovine lactoferrin improves feeding intolerance in preterm infants.
- Bovine LF supplementation is associated with decreased intestinal permeability in this population.
Objects:
Preterm infants are at an increased risk of developing feeding intolerance (FI) due to the functional immaturity of their gastrointestinal tract. Recent studies and meta-analyses have shown a significant role of bovine lactoferrin (LF) in the management of feeding intolerance and sepsis. This study aimed to assess the effects of oral bovine LF supplementation on FI in preterm infants (26-34 weeks gestational age) and its effect on intestinal permeability measured by serum zonulin concentrations.
Methods:
A randomized controlled double-blind interventional pilot study was conducted in the Neonatal Intensive Care Unit (NICU) of Mansoura University. Sixty preterm neonates with FI were included in the study and were randomly assigned into two groups: lactoferrin group (100 mg/day bovine LF for 4 weeks or until discharge) and control group.
Results:
The time needed to achieve full enteral feeding of sixty preterm infants (26-34 weeks gestational age) (9 vs. 15 days, P = 0.001) was significantly shorter and serum zonulin concentrations at end of the trial or discharge (3.38 vs. 5.49 ng/ml, P = 0.04) were significantly lower in the lactoferrin group compared with the control group.
Conclusion:
Oral bovine lactoferrin given to preterm infants (26-34 weeks gestational age) is associated with improvement of feeding intolerance and decreased intestinal permeability.
Trial Registration:
This study was registered at clinical trials.gov with ID (NCT04738058) at 2 March 2021.
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