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July 25, 2016

Infant with Feeding Tube

Protein in Breast Milk Reduces Infection Risk in Premature Infants

Study shows need for large-scale trial of lactoferrin’s role in immune system development.

Full-term babies receive natural protection from their mothers that helps them fight off dangerous infections. However, babies born prematurely lack protective intestinal bacteria and often are unable to be nursed, causing their infection-fighting capabilities to be underdeveloped. Now, researchers at the University of Missouri School of Medicine and the MU Sinclair School of Nursing have found that a manufactured form of lactoferrin, a naturally occurring protein in breast milk, can help protect premature infants from a type of staph infection.

“Babies born with low levels of protective intestinal bacteria are at an increased risk of devastating and sometimes deadly infections,” said Michael Sherman, MD, professor emeritus in the Department of Child Health at the MU School of Medicine and lead author of the study. “Our study found that giving very-low-birth-weight premature infants a manufactured form of lactoferrin can virtually eliminate the germ that causes a staph infection known as staphylococcus epidermidis.”

The researchers studied the immune systems of 120 premature infants in the neonatal intensive care units at MU Women’s and Children’s Hospital and the University of Southern California Children’s Hospital Los Angeles between July 2009 and January 2012. Infants in the trial weighed between 1 pound, 10 ounces, and 3 pounds, 4 ounces, at birth. Sixty of the infants received lactoferrin via a feeding tube twice a day for 28 days to simulate receiving mother’s milk while nursing.

To understand the protein’s role in the development of protective intestinal bacteria, the researchers examined fecal matter of the infants. The researchers found that germs responsible for the colonization of staph infection were virtually eliminated in the newborns who received lactoferrin.

“These germs are the most common cause of in-hospital bloodstream infections in premature babies, causing up to 50 percent of infections,” Sherman said. “As physicians, we’ve had limited knowledge of how lactoferrin affects the development of protective intestinal bacteria. Our study shows that it can modify germs in the bowel of infants, and those germs can protect premature babies from staph infections.”

As part of the study, lactoferrin was provided to the patients at no cost. According to Sherman, lactoferrin can cost an estimated $25 to $500 per dose, though an infection can extend an infant’s hospital stay by 10 to 14 days at a cost of $40,000 to $56,000.

Though it is too early to recommend lactoferrin as a standard treatment protocol in NICUs across the country, the researchers say more research could shed light on its role in preventing infections.

“These vulnerable babies need all the support they can get to fight off infections,” Sherman said. “Our results justify the need for a large-scale trial of lactoferrin, as well as its counterpart derived from cow milk, bovine lactoferrin.”

The study, “Randomized Control Trial of Human Recombinant Lactoferrin: A Substudy Reveals Effects on the Fecal Microbiome of Very Low Birth Weight Infants,” recently was published by The Journal of Pediatrics. Research reported in this publication was supported by the National Institutes of Health (HD05774) and the Gerber Foundation (PN002-1214-2708). The authors received an honorarium to serve as members of the Mead Johnson Pediatric Institute Bioactive Expert Panel to write the manuscript. The sponsor had no involvement in preparing the manuscript, and the authors are entirely and exclusively responsible for its content.

In addition to Michael Sherman, the research team included Jan Sherman, PhD, RN, a teaching professor at the MU Sinclair School of Nursing; Roxanne Arcinue, MD, a neonatologist at Kapiolani Medical Center for Women and Children in Honolulu, Hawaii; and Victoria Niklas, MD, a scientist at Prolacta in Los Angeles and a clinical professor at the University of California, Los Angeles.

Download a high-resolution photo of Michael Sherman, MD.


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