Topical Oil Application and Trans-Epidermal Water Loss in Preterm Very Low Birth Weight Infants-A Randomized Trial.
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.


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).


CONCLUSIONS
Coconut oil application reduced TEWL without increasing skin colonization in VLBW neonates.


BACKGROUND
NCT01758068.
Department of Neonatology, Lady Hardinge Medical College & Kalawati Saran Children's Hospital, New Delhi 110001, India drsnangia@gmail.com.
Sushma
S
Nangia
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Vinod Kumar
VK
Paul
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Ashok Kumar
AK
Deorari
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi 110029, India.
V
V
Sreenivas
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Ramesh
R
Agarwal
Department of Pediatrics, Government Medical College, Chandigarh 160030, India.
Deepak
D
Chawla
D000279:Administration, Cutaneous; D000074263:Coconut Oil; D003428:Cross Infection / Q000517:prevention & control; D004643:Emollients / Q000008:administration & dosage / Q000627:therapeutic use*; D004817:Epidermis / Q000187:drug effects / Q000378:metabolism*; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development*; D007363:Intensive Care Units, Neonatal; D008297:Male; D010938:Plant Oils / Q000008:administration & dosage / Q000627:therapeutic use*; D017592:Skin Care; D016896:Treatment Outcome; D014867:Water
D004643:Emollients; D010938:Plant Oils; D014867:Water; D000074263:Coconut Oil
coconut oil; neonate; prematurity; skin conditioning score; trans-epidermal water loss; very low birth weight