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

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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/m2/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.Clinical Trials Registration: NCT01758068

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