Background: Late-onset sepsis affects a large proportion of pre-term neonates in neonatal intensive care units worldwide, with high morbidity and mortality. Due to the frequency, severity and difficulties in early diagnosis and prompt therapy, prevention is crucial for decreasing the burden of infection-related complications in NICUs. The aim of this study was to evaluate the role of lactoferrin supplementation in prevention of late onset sepsis in preterm neonates.
Methods: A randomized controlled double-blind interventional pilot study was conducted in Neonatal Intensive Care Unit of Zagazig University and ElQenayate Central Hospital. Sixty Preterm neonates were included and randomly assigned into two groups; Lactoferrin group and Control group.

Results: Comparing to control group, the frequency of late onset sepsis was significantly lower in Lactoferrin group. There was statistically significant lower frequency of feeding intolerance .The lactoferrin group had significantly lower duration of mechanical ventilation, central line insertion, antibiotics use and oxygen supplementation with less NICU stay duration. Coagulase-negative staphylococci and Klebsiella were the most common organisms found among the septic neonates. Hemoglobin level was significantly higher in Lactoferrin group started from the first week also weight gain was significantly more started from the third week.
Conclusion: Preterm neonates supplemented with oral Lactoferrin had significantly lower incidence of late onset sepsis. Lactoferrin supplementation significantly improve feeding tolerance so allowing to reach full enteral intake in short period lead to decrease duration of hospitalization and improve weight gaining. lactoferrin decreased duration of O2 requirement, antibiotics treatment and hospital stay among preterm neonates.