Lactoferrin
Iron-binding glycoprotein with RCT signal for preterm infant sepsis prevention and modest immune/iron effects in adults.
Why
Lactoferrin is an iron-binding glycoprotein concentrated in mammalian milk and neutrophil granules. The strongest single RCT body is in preterm infants, the ELFIN multicentre trial and an earlier Italian study found bovine lactoferrin reduced late-onset sepsis (the Italian study was positive, ELFIN was null in a larger replication). Smaller bodies support modest benefit for iron-deficiency anaemia in pregnant women (Paesano RCTs) and antimicrobial effects in oral and gastric mucosa.
How it works
Sequesters iron from pathogens (bacteriostatic via iron deprivation) and directly damages bacterial membranes. Modulates innate immune signalling, supports gut barrier integrity in infants, and promotes iron absorption in iron-deficient adults via a distinct uptake pathway.
Expected onset · Iron-deficiency anaemia: 4–8 weeks. Immune/mucosal effects over 2–4 weeks.
How to take
Dosage
Adult iron-deficiency: 100–200 mg twice daily. Adult immune use: 100–250 mg/day. Preterm neonatology dosing: clinical-context only (typically 100 mg/day to weight).
Timing
On empty stomach or between meals for absorption
On the label
'Bovine lactoferrin' with stated mg/serving. Apolactoferrin (iron-free) for iron-binding effect; iron-saturated holo-lactoferrin for iron supplementation.
Ideal for
Preterm infants under neonatology supervision (institutional decision); pregnant women with iron-deficiency anaemia exploring tolerable alternatives to ferrous salts; adults with mild low-grade infections (oral, GI) under guidance.
Safety
Evidence
Cochrane 2020 SR on preterm infant lactoferrin: signal of reduced late-onset sepsis driven primarily by earlier Italian RCTs; the larger ELFIN 2019 Lancet replication (n=2,203) was null on the primary outcome. Paesano RCTs reported lactoferrin non-inferior to ferrous sulphate for pregnancy iron-deficiency anaemia with fewer GI side effects.
- Pammi & Suresh, Cochrane Database Syst Rev 2020, enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants
- ELFIN Trial Investigators, Lancet 2019, enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial
- Paesano et al., Biometals 2010, lactoferrin as iron supplement for treatment of iron deficiency and iron deficiency anaemia
Where to get it
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