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Background Sepsis is defined as life-threatening multi organ failure caused by a dysregulated host response to infection leading to development of gut failure, D-lactate is produced by indigenous bacteria in the gastrointestinal tract lactoferrin is important constitute of human milk and other body fluid act to improve gut function. Aim of the Work To test effect of lactoferrin supplementation for improving gut barrier function, prognosis and the outcome of septic patients using D lactate as a marker of bacterial translocation in sepsis with gut failure. Patients and Methods After ethical committee approval and informed consent from the parents, this double armed single blinded therapeutic clinical trial study was conducted on 40 Egyptian children admitted to PICUs of Ain Shams University Hospitals, by diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented with it (group 2). D lactate level was measured in plasma using ELISA. Results The study show highly significant difference between Patient and control group in D lactate level, and we found no statistical difference before and after giving lactoferrin in our septic patient who weren’t in treatment of sepsis and gut failure. And we found plasma D lactate higher in non survivors with p value.048. and cut of point< 43.9 mmol\L Conclusion Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients, D lactate can be used as a predictor of intestinal failure severity and mortality. D lactate may be predictor of gut failure in sepsis and mortality