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Published on: October 1, 2015
Efficacy of lactoferrin supplementation in pediatric infections: a systematic review and meta-analysis
Valerie S Mayorga1, Rafaella Navarro1, Victor D Torres Roldan2
1Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
Insights
Lactoferrin (LF) supplementation may reduce serious infections in children. Studies show LF significantly decreased neonatal sepsis and diarrhea, but not upper respiratory infections, suggesting potential benefits for child health.
Area of Science:
- Pediatric Infectious Diseases
- Nutritional Immunology
- Evidence Synthesis
Background:
- Pediatric infections cause a substantial global mortality burden in children under five.
- Lactoferrin (LF) possesses antimicrobial, anti-inflammatory, and immunomodulatory properties beneficial for infection prevention.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) of oral lactoferrin supplementation in individuals under 18.
- To evaluate the efficacy of LF in reducing key pediatric infection-associated outcomes: late-onset sepsis (LOS), diarrhea, and upper respiratory infections (URIs).
Main Methods:
- Systematic literature search and meta-analysis of RCTs involving oral LF supplementation in pediatric populations.
- Primary outcome assessment included culture-proven or probable neonatal LOS, diarrhea incidence, and URI incidence.
- Mortality data from LOS studies were also analyzed.
Main Results:
- LF supplementation significantly reduced the incidence of neonatal LOS compared to placebo (OR: 0.60; 95% CI: 0.42-0.86).
- LF also demonstrated a significant reduction in diarrhea incidence in children (OR: 0.56; 95% CI: 0.41-0.75).
- No significant effect was observed for URI reduction (OR: 0.61; 95% CI: 0.27-1.40).
Conclusions:
- Oral lactoferrin supplementation shows promise in reducing neonatal late-onset sepsis and childhood diarrhea.
- Further refinement of trial designs is needed before LF can be considered a public health intervention.
- Future RCTs should prioritize high-burden infection settings to maximize potential impact.
Abstract:
Pediatric infections account for approximately one-third of all deaths in children under 5 years globally. Lactoferrin (LF) supplementation has the potential to reduce infection-related morbidity due to its antimicrobial, anti-inflammatory, and immunoregulatory properties. We conducted a systematic review and meta-analysis of oral LF supplementation randomized controlled trials in population under 18 years old. The primary outcomes were infection-associated outcomes: late onset sepsis (LOS), diarrhea, and upper respiratory infections (URIs). We also analyzed mortality among LOS studies. Of 1594 citations identified, 25 studies met eligibility criteria, including 10 studies of LOS, 14 of diarrhea, and 8 of URI. LF supplementation was associated with fewer patients with culture-proven or probable neonatal LOS compared to placebo (odds ratio (OR): 0.60; 95% confidence interval (CI): 0.42-0.86), with fewer patients with diarrhea compared to placebo in children (OR: 0.56; 95% CI: 0.41-0.75), and no significant fewer patients with URI (OR: 0.61; 95% CI: 0.27-1.40). Before LF can be used as a public health intervention, it is necessary to refine some aspects of the design of future trials. Ideally these trials should be conducted in countries with the highest burden of infections, where the potential benefit is expected to have the largest impact.
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