Diseases that affect premature infants in neonatal intensive care units are usually caused by hospital-acquired infections. Breast milk protects against infection by modifying the intestinal microbiome and boosting systemic immunity, but maternal colostrum is limited when infants are extremely preterm. According to a recent trial in The Journal of Pediatrics, feeding extremely low-weight preterm infants recombinant human lactoferrin talactoferrin (TLf), a human milk protein, was safe and resulted in fewer infections compared with placebo.
The phase 1 and 2 trial assigned 120 infants with a birth weight of 750 to 1500 g to receive either enteral TLf or placebo on days 1 through 28 of life; infants in the TLf group received 150 mg/kg every 12 hours. The rate of hospital-acquired infections—bacteremia, pneumonia, urinary tract infection, meningitis, and necrotizing enterocolitis—was 15% among infants fed lactoferrin compared with 36% among infants receiving placebo. There were 2 deaths in the TLf group, but neither was attributed to TLf. One death due to necrotizing enterocolitis occurred in the placebo group. All serious adverse events were associated with complications from very preterm birth and not to the use of TLf or placebo. There were no growth or neurodevelopmental differences in the 2 groups at 1 year.
The authors recommended that further studies should analyze the differences in the fecal microbiome and inflammatory biomarkers between TLf and placebo groups to elucidate the physiological changes that may account for TLf’s benefits.
read more at JAMA