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Recombinant Lactoferrin

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Lactoferrin is one of the miraculous substances found in breastmilk which helps the infant kill bacteria and fight infection.  It is the major whey protein in human milk and has its highest concentrations in colostrum.  While it is important for all infants, it is especially important in the prevention of necrotizing enterocolitis (NEC) in preterm infants.   Lactoferrin has an anti-inflammatory action that may mitigate the pro-inflammatory states present in the gut before the onset of NEC.  This highlights the importance of mothers providing early feedings of colostrum and fresh mature milk to prevent necrotizing enterocolitis in their premature infant.

Researchers are experimenting with recombinant lactoferrin use in preterm infants and showing a benefit in reducing NEC.  In recombinant DNA, molecules of DNA are recombined into sequences that would not otherwise be found in the genome.   Recombining DNA is possible because DNA molecules from all organisms share the same chemical structure. They differ only in the nucleotides, the subunits of DNA and RNA, in the gene sequence.

Lactoferrin is present in cow’s milk in lower levels than found in human milk.  And the process of creating formula lowers those levels even further.  So, exogenous sources of lactoferrin must be added to formula if it is to match human levels.  Recombinant human lactoferrin can now be obtained from yeast, transgenic cows, and rice which have structural similarity to endogenous lactoferrin. 

There is already an infant formula manufacturer which is marketing Enspire™ containing lactoferrin in the range found in mature breastmilk.  This formula uses bovine sourced lactoferrin and is being marketed for use in any baby, not necessarily NICU infants.

Why are research dollars being spent on developing a protein that mothers can provide to their own infants?  Why don’t we spend the research dollars refining our techniques on how to best help mothers of premature infants provide their own lactoferrin, provide the best breast pumps, a place to pump, “rooming in” in the NICU and facilitate lots of skin-to-skin holding? In addition, when the mother is supplying her own lactoferrin, she is also colonizing the newborn's GI tract with beneficial bacteria and lowering stress levels in both herself and her infant. 

Liao Y, Jiang R, Lönnerdal B.  Biochemical and molecular impacts of lactoferrin on small intestinal growth and development during early life. Biochem Cell Biol 2012   90: 476–484.

Lönnerdal B, Jiang R, Du X  Bovine lactoferrin can be taken up by the human intestinal lactoferrin receptor and exert bioactivities. J Pediatr Gastroenterol Nutr 2011 53: 606–614.

Satué-Gracia MT, Frankel E, Rangavajhyala N , German JB.  Lactoferrin in Infant Formulas:  Effect on Oxidation.  J. Agric. Food Chem., 2000, 48:10:4984–4990

Sherman MP, Adamkin DH, Niklas V, Radmacher P, Sherman J, Wertheimer F, Petrak K Randomized Controlled Trial of Talactoferrin Oral Solution in Preterm Infants.  J Pediatr. 2016 Aug; 175:68-73.e3

Sherman MP, Sherman J, Arcinue R, Niklas V.  Randomized Control Trial of Human Recombinant Lactoferrin: A Substudy Reveals Effects on the Fecal Microbiome of Very Low Birth Weight Infants.  J Pediatr. 2016 Jun;173 Suppl:S37-42.

Sherman MP, Pritzl CJ, Xia C, Miller MM, Zaghouani H, Hahm B.  Lactoferrin acts as an adjuvant during influenza vaccination of neonatal mice.  Biochem Biophys Res Commun. 2015 Nov 27;467(4):766-70.

Sherman MP, Miller MM, Sherman J, Niklas V.  Lactoferrin and necrotizing enterocolitis.   Curr Opin Pediatr. 2014 Apr;26(2):146-50.

Sherman MP.  Lactoferrin and necrotizing enterocolitis.  Clin Perinatol. 2013 Mar;40(1):79-91.

Sherman MP, Petrak K. .  Lactoferrin-enhanced anoikis: a defense against neonatal necrotizing enterocolitis.  Med Hypotheses. 2005;65(3):478-82.

Sherman MP, Bennett SH, Hwang FF, Yu C.  Neonatal small bowel epithelia: enhancing anti-bacterial defense with lactoferrin and Lactobacillus GG.  Biometals. 2004 Jun;17(3):285-9.b, c

Vergie Hughes has a long history of experience in Maternal Child Health including labor and delivery, post-partum and pediatrics, and for the past 25 years she has been involved in lactation management. Ms. Hughes has a BSN from Pacific Lutheran University and a MS from Georgetown University. She has been a board certified lactation consultant since 1985. At Georgetown University Hospital, she was the director of the Human Milk Bank. She created and developed the National Capitol Lactation Center and the one week Lactation Consultant Training Program. This course has trained more than 4,000 Lactation Consultants since its inception in 1990.


She has been a private practice lactation consultant and business owner, and operated her own lactation center, Washington’s Families First. Lactation Education Resources On-Line is her website, offering training to professionals and information to parents as well. Ms. Hughes has served on the International Board of Lactation Consultant Examiners and has served on the IBLCE exam writing committee. Her first love is teaching and that is exemplified by the creativity of the courses she has developed. A series of courses “The In-patient Breastfeeding Specialist,” "The Out-patient Breastfeeding Specialist” and “The NICU Breastfeeding Specialist” are all designed to advance the lactation management skills of nurses at the bedside. She regularly teaches skills to labor and delivery nurses and just recently developed the course “Towards Exclusive Breastfeeding.”


Ms. Hughes is the program director and content manager for all of the on-line Lactation Education Resources courses. Ms. Hughes was recently honored with a “lifetime achievement award” as Fellow of the International Lactation Consultant Association (FILCA).