Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C


Objective: The objective of this selective evidence-based medicine (EBM) review is to determine whether bovine lactoferrin is effective in preventing diarrhea in infants and toddlers.

Study design: Review of three English-language primary randomized controlled trials published between 2007 and 2016.

Data sources: Three double-blind controlled trials comparing bovine lactoferrin to placebo were found using PubMed.

Outcomes measured: Incidence and incidence rate of diarrhea in episodes/child/year were measured using the information provided by the caregivers and the healthcare records obtained from a hospital or clinic.

Results: King et al. found that there was no statistically significant difference in incidence of diarrhea between the infants taking bovine lactoferrin (1.31 episodes/infant/year) versus placebo (1.35 episodes/infant/year) in a 0- to 12-months-old age group. Similarly, Ochoa et al. determined no statistically significant difference in diarrhea occurrence between children who received a bovine lactoferrin supplement (5.43 episodes/child/year) and the children who received placebo (5.15 episodes/child/year) in a 12- to 18-months-old age group (p = 0.375). In contrast, Chen et al. found a significantly lower incidence rate of diarrhea in infants after exposure to bovine lactoferrin as compared to placebo (rate ratio of 0.32 with p < 0.05) in a 4- to 6-months-old age group.

Conclusion: The evidence regarding whether bovine lactoferrin is effective in preventing diarrhea in infants and toddlers is conflicting. It appeared to be clinically effective in 4- to 6- months-old infants who were followed over a 3-months period, but had shown no effect in 0- to 12- and 12- to 18-months-old infants and toddlers who were followed for 12 and 6 months, respectively. Therefore, it is possible that the effectiveness of bovine lactoferrin demonstrated by Chen et al. could have been influenced in some way by the short duration of the study and by the especially narrow age group.

Included in

Pediatrics Commons