Topical oil application and trans-epidermal water loss in preterm very low birth weight infants-a randomized trial

Abstract

Objective: Topical emollient application reduces trans-epidermal water loss (TEWL) in preterm neonates. Coconut oil used traditionally for infant massage in India has not been evaluated for the same. Patients and Methods: Very low birth weight (VLBW) neonates were randomized at 12 h of age to Oil (n=37) or Control (n=37) groups. Oil group neonates received twice-daily coconut oil application without massage, and Control group received standard care. TEWL was measured every 12 h using an evaporimeter till Day 7 when skin swabs were obtained for bacterial growth and skin condition was assessed using a validated score. Results: Birth weight (g; mean± SD: 1213+214 vs. 1164+208, p=0.31), gestation [week; median (interquartile range): 32 (31-33) vs. 32 (29-33), p=0.10] and other baseline variables were comparable. TEWL was significantly reduced (g/m2h, mean difference: 6.80, 95% confidence interval: 3.48, 10.15; p<0.01) with better skin condition and lower bacterial growth in the Oil group (20% vs. 60%, p<0.01). Conclusion: Coconut oil application reduced TEWL without increasing skin colonization in VLBW neonates. Clinical Trials Registration: NCT01758068.