The 2020 Pammi meta-analysis [73], which incorporated the large ELFIN trial (n = 2203) [38], reversed the 2017 conclusion that lactoferrin reduced late-onset sepsis (RR 0.80 vs. prior 0.59) and eliminated the apparent benefit for NEC (RR 1.10 vs. prior 0.40), demonstrating how definitive trials can correct overoptimistic estimates from smaller studies. The gene discussed is LTF; the disease is necrotizing enterocolitis.