Effect of Enteral Lactoferrin Administration on Iron Status in Neonates
Authers: Mohammed EL Barbary; Nancy Abu Shady; Hebat Allah A. Shaaban and Ola Y. Ahmed
Background: Lactoferrin is an iron binding protein and one of the main component of breast milk that showed in the last decade very promising results in the prophylaxis against neonatal sepsis, NEC, fungal infections, iron deficiency anemia.
Objective: Our primary aim is: To evaluate the effect of enteral lactoferrin supplementation on levels of haemoglobin, haematocrit and serum levels of ferritin in infants admitted in the neonatal intensive care unit. Our secondary aim is: To study the effect of lactoferrin on the need and the frequency of blood transfusion in NICU, feeding intolerance, time to reach full enteral intake, weight gain, signs of sepsis, the length of hospital stay and the mortality as well as to study the relation between milk type and the serum ferritin.
Patients and methods: This study was conducted on 52 neonates in the NICUs of maternity and pediatrics hospitals, Faculty of Medicine, Ain Shams University in the period from March 2017 to May 2017.
Results: The lactoferrin group showed statistically significant higher S. ferritin level, HB, HCT and MCV than the placebo group (P-value <0.001),But lower RDW ( P-value 0.038), TLC ( P-value 0.004) and negative CRP (P-value <0.001) than the placebo group at Day 30 . For blood transfusion in the lactoferrin group no one needed blood transfusion 0% while 34.6% of the placebo group needed ( P-value 0.002) with a frequency of 1 transfusion for 2 neonates (7.7%) and 2 transfusions for 7 neonates (26.9%) for the placebo group ( P-value 0.001).As regards weight gain , LF group showed statistically significant more weight gain than placebo group (P-value 0.011) And about The Length of hospital stay it was significant for the lactoferrin group (p-value 0.029). the overall mortality was 0% in the lactoferrin group and 19.2% in the placebo group (P-value 0.051) .
Conclusion: Lactoferrin, being an iron binding protein and broad spectrum non pathogen-specific antimicrobial protective protein offers perspectives of beneficial effect in neonates. It proved to have an effective role in enhancing the serum ferritin level and the overall iron status in neonates and decreased the need for blood transfusion in NICU.