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Enteral lactoferrin supplementation did not reduce the risk of late-onset infection in very preterm infants
  1. Rachel Toone1,
  2. Catherine M Harrison2
  1. 1 Department of Neonatology, Leeds General Infirmary, Leeds, UK
  2. 2 Department of Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Rachel Toone, Leeds General Infirmary, Leeds LS1 3EX, UK; racheltoone{at}

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Study design

Design: randomised clinical trial.1

Allocation: concealed (web-based randomisation).

Blinding: parents, clinicians, investigators and outcome assessors were blinded.

Study question

Setting: 37 neonatal units in the UK.

Patients: infants born before 32 weeks gestation. Exclusion criteria were a severe congenital abnormality, an expected fast of over 14 days or no realistic chance of survival. A total of 2203 babies were enrolled for a target sample size of 2200.

Intervention: placebo versus supplementing enteral feeds with 150 mg/kg/day of bovine lactoferrin once the infant was feeding over 12 mL/kg/day. This was continued until 34 weeks corrected gestation.

Outcomes: the primary outcome was microbiologically confirmed or clinically suspected late-onset sepsis (LOS) (assessed locally initially, then by a central review committee) from trial entry to hospital discharge. Secondary outcomes were numerous but included necrotising enterocolitis (NEC), bronchopulmonary dysplasia (BPD), length of stay and mortality predischarge. Composite outcomes were also analysed.

Follow-up period: …

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  • Contributors RT: drafted the Picket section. RT and CMH: drafted the commentary; revised and approved the final version.

  • Funding Funding was provided by the UK National Institute for Health Research Health Technology Assessment Programme. The funder provided advice and support but no role in study design, data collection and analysis, and writing of the report.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.