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/m 2 /h, 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.