Topical application of coconut oil to the skin of preterm infants: a systematic review
Preterm infants are at risk of increased trans-epidermal water loss and infections due to epidermal immaturity. The emollient and anti-infective properties of coconut oil make it a potentially beneficial topical agent for this population. We aimed to systematically review randomised trials assessing the effects of topical coconut oil in preterm infants. Medline, EMBASE, Cochrane Central Register of Controlled Trials and CINAHL were searched. Seven trials (n = 727 infants) were included. The majority of trials included relatively mature infants (gestation > 32 weeks, birth weight > 1200 g). The duration of intervention (5–31 days) and outcomes of interest varied among included studies. Meta-analysis using random effects model found significantly lower incidence of hospital-acquired blood stream infections (HABSI) in the coconut oil group (11/164 vs 32/166; relative risk 0.35, 95% confidence interval 0.18, 0.67, p = 0.001; I2 = 0%, two RCTs). Overall, infants in the coconut oil group had decreased water loss, decreased infection rates, better growth and skin condition. There were no significant adverse effects associated with coconut oil application. The overall quality of evidence was considered moderate for the outcome of HABSI and low for the outcome of physical growth based on GRADE guidelines.
What is Known:
• Coconut oil has been used traditionally for topical application in terms of infants in Asian countries
What is New:
• This systematic review found that topical application of coconut oil may reduce the risk of infection and improve weight gain and skin condition in preterm infants. However, the quality of evidence was considered to be moderate to low based on GRADE guidelines.
KeywordsCoconut oil Topical Preterm infant Sepsis Trans-epidermal water loss Skin
Inter quartile range
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Randomised controlled trial
Trans-epidermal water loss
Sameer Pupala: Concept, design, independent literature search selection of studies for inclusion, extraction and interpretation of the data, assessing the risk of bias of included studies, GRADE evidence, writing the first and final drafts of the manuscript; Shripada Rao: Independent literature search, selection of studies for inclusion, data extraction, meta-analysis to generate forest plots, GRADE evidence, helping with the first and final draft of the manuscript; Tobias Strunk: Concept, design, interpretation of the data, GRADE evidence, critical review of the first and the final draft of the manuscript. Sanjay Patole: Concept, design, interpretation of the data, GRADE evidence, critical review of the first and the final draft of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Not applicable since it was a systematic review.
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