Lactoferrin
A Cochrane review found lactoferrin lowered late-onset sepsis in preterm infants, but the largest trial, of 2,203 infants, found no difference. Deaths and bowel inflammation did not change. Pooled trials found fewer children with diarrhea. Two reviews differed on respiratory infections in children. Compared with ferrous sulfate, lactoferrin raised iron and hemoglobin more. Trials reported few adverse events.
Add to Bio HackChecked 2026-11-09
- Status
- Sold as a dietary supplement and added to some infant formulas in the US.
- Also called
- bovine lactoferrin, bLF, Lf, lactotransferrin, apolactoferrin, milk iron-binding protein, lactoferrin formula
- Taken for
- immunity, colds, respiratory infections, iron deficiency, anemia, gut health, infections in preterm babies, diarrhea, inflammation
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help2
Reported risks1
What people take it for, and what was found
Shown to help2
Iron deficiency anemia
Shown to raise serum iron, ferritin and hemoglobin more than ferrous sulfate in people with iron deficiency anemia.
The numbers and sources
- Effect
- Compared with ferrous sulfate, lactoferrin raised serum iron by 41.44 µg/dL and ferritin by 13.60 ng/mL more, and raised hemoglobin more. Fractional iron absorption was 2.08 percentage points lower and IL-6 was 45.59 pg/mL lower [5]. In 8 controlled trials in children with or without anemia, adding bovine lactoferrin to iron raised serum ferritin by 3.52 µg/L more than iron alone (95% CI 0.66 to 6.38), with no difference in hemoglobin, serum iron or transferrin receptor [6].
- Population
- Intervention studies in people with iron deficiency anemia [5]. Children in 8 trials [6].
- Sources
- [5], [6]
- Caveats
- The first abstract does not give the number of trials or participants [5]. The second compared lactoferrin plus iron with iron alone, not lactoferrin with iron [6].
Colorectal polyps
One trial found polyp growth slowed over 12 months only in adults aged 63 or younger with small colorectal polyps.
Mixed results3
Sepsis in preterm infants
Mixed results: pooled trials found less late-onset sepsis in preterm infants, while the largest trial, of 2,203 infants, found no difference.
The numbers and sources
- Effect
- In 12 trials (5,425 infants), lactoferrin added to feeds lowered late-onset sepsis (RR 0.82, 95% CI 0.74 to 0.91, number needed to treat 25, low certainty) and shortened hospital stay by 2.38 days [1]. A 2025 meta-analysis of 10 trials found fewer infants with culture-proven or probable late-onset sepsis (OR 0.60, 95% CI 0.42 to 0.86) [2]. In the largest trial, 2,203 very preterm infants in 37 UK hospitals, late-onset infection occurred in 29% on lactoferrin and 31% on sucrose (adjusted RR 0.95, 95% CI 0.86 to 1.04) [3].
- Population
- Preterm infants in hospital [1][2]. Infants born before 32 weeks, given 150 mg/kg a day [3].
- Sources
- [1], [2], [3]
- Caveats
- The pooled analyses and the largest trial disagree. The Cochrane authors note publication bias and small studies of poor method that may inflate the effect [1]. Both were funded by the UK National Institute for Health Research [1][3].
Respiratory infections
Mixed results: one review found fewer respiratory infections in children but not adults, and another found no difference in children.
The numbers and sources
- Effect
- Across 25 studies, respiratory infection incidence fell in infants and children (OR 0.78, 95% CI 0.61 to 0.98) but not in adults (OR 1.00, 95% CI 0.76 to 1.32). In adults, IL-6 fell by 24.9 pg/mL, while CRP and NK cell activity did not change [4]. A 2025 meta-analysis of 8 trials in people under 18 found no significant difference in upper respiratory infections (OR 0.61, 95% CI 0.27 to 1.40) [2].
- Population
- 20 studies in adults and 5 in children [4]. 8 trials in children [2].
- Sources
- [4], [2]
- Caveats
- The two reviews differ on children [4][2]. The authors of the first describe the clinical studies as limited. The review was supported by an Australian government grant in partnership with Freedom Foods Group Nutritionals [4].
Diarrhea in young children
Mixed results: a meta-analysis found fewer children with diarrhea, while a 555-child trial found no change in how often it occurred, only shorter episodes.
The numbers and sources
- Effect
- A 2025 meta-analysis of 14 trials found fewer children with diarrhea on oral lactoferrin than on placebo (OR 0.56, 95% CI 0.41 to 0.75) [2]. In 555 children aged 12 to 18 months followed for 6 months, diarrhea incidence did not differ (5.4 against 5.2 episodes a year). Episodes were shorter (4.8 against 5.3 days), and moderate or severe dehydration was less common (1.0% against 2.6%) [7].
- Population
- Children under 18 [2]. Weaned children in Peru [7].
- Sources
- [2], [7]
- Caveats
- One meta-analysis. Its abstract does not report heterogeneity or certainty of evidence [2]. The 555-child trial was funded by NIH's NICHD, and its first author is the senior author of the review [7][2].
Not shown to help1
Bowel inflammation and death in preterm infants
Not shown to change necrotizing enterocolitis or deaths in preterm infants.
The numbers and sources
- Effect
- Lactoferrin did not change necrotizing enterocolitis stage II or III (RR 1.10, 95% CI 0.86 to 1.41, 7 studies, 4,874 infants) or all-cause mortality (RR 0.90, 95% CI 0.69 to 1.17, 11 studies, moderate certainty). With probiotics, sepsis fell (RR 0.25) and necrotizing enterocolitis fell in one study (RR 0.04, very low certainty) [1].
- Population
- Preterm infants [1].
- Sources
- [1]
- Caveats
- The combination studies were few and of poor methodological quality [1].
Doses studied
Preterm trials used doses such as 150 mg/kg a day, up to 300 mg a day, until 34 weeks of postmenstrual age [3]. Adult inflammation studies used about 200 mg a day, and infant and child formulas 35 to 833 mg a day [4]. The polyp trial tested 1.5 and 3.0 g a day [8].
Risks
Reported risks1
Serious adverse events in preterm infants
One trial found 16 serious adverse events on lactoferrin against 10 on sucrose in very preterm infants, 2 judged possibly related.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- In the 2,203-infant trial, 16 serious adverse events occurred on lactoferrin and 10 on sucrose. Two on lactoferrin, one case of blood in stool and one death after intestinal perforation, were judged possibly related [3].
- Population
- Very preterm infants in UK hospitals [3].
- Sources
- [3]
- Caveats
- Serious events in very preterm infants have many causes. The numbers are small.
Checked, no increase found1
Adverse effects across trials
No adverse effects were reported in preterm infant trials, and none related to lactoferrin in a trial of young children.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- The Cochrane review found no adverse effects reported in its included studies [1]. In the 555-child diarrhea trial, no adverse events were related to lactoferrin [7].
- Population
- Preterm infants [1] and young children [7].
- Sources
- [1], [7]
- Caveats
- Harms were not always defined or actively collected in small trials.
Claims tested and not found
Sources
- Pammi M, Gautham KS. Enteral lactoferrin supplementation for prevention of sepsis and necrotizing enterocolitis in preterm infants. Cochrane Database of Systematic Reviews. 2020. https://doi.org/10.1002/14651858.CD007137.pub6
- Mayorga V, Navarro R, Roldan V, et al. Efficacy of lactoferrin supplementation in pediatric infections: a systematic review and meta-analysis. Biochemistry and Cell Biology. 2025. https://doi.org/10.1139/bcb-2024-0181
- Griffiths J, Jenkins P, Vargova M, et al. Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial. The Lancet. 2019. https://doi.org/10.1016/s0140-6736(18)32221-9
- Berthon BS, Williams LM, Williams EJ, et al. Effect of Lactoferrin Supplementation on Inflammation, Immune Function, and Prevention of Respiratory Tract Infections in Humans: A Systematic Review and Meta-analysis. Advances in Nutrition. 2022. https://doi.org/10.1093/advances/nmac047
- Zhao X, Zhang X, Xu T, et al. Comparative Effects between Oral Lactoferrin and Ferrous Sulfate Supplementation on Iron-Deficiency Anemia: A Comprehensive Review and Meta-Analysis of Clinical Trials. Nutrients. 2022. https://doi.org/10.3390/nu14030543
- Zhong J, Chen K, Liu C. Is Iron Combined With Lactoferrin More Effective Than Iron Alone in Improving Iron Metabolism in Children With or Without Anemia? A Systematic Review and Meta-analysis of Controlled Clinical Trials. Nutrition Reviews. 2026. https://doi.org/10.1093/nutrit/nuaf296
- Ochoa TJ, Chea-Woo E, Baiocchi N, et al. Randomized Double-Blind Controlled Trial of Bovine Lactoferrin for Prevention of Diarrhea in Children. The Journal of Pediatrics. 2013. https://doi.org/10.1016/j.jpeds.2012.07.043
- Kozu T, Iinuma G, Ohashi Y, et al. Effect of Orally Administered Bovine Lactoferrin on the Growth of Adenomatous Colorectal Polyps in a Randomized, Placebo-Controlled Clinical Trial. Cancer Prevention Research. 2009. https://doi.org/10.1158/1940-6207.capr-08-0208