Topical emollients for preterm infants

Posted on 2 February 2016

A new Cochrane review on the use of topical emollients for preventing infection in preterm infants has just been published. The systematic review was conducted by CRD staff members Bill McGuire, Professor of Paediatrics and Child Health and Jess Morgan, Clinical Research Fellow.

Preterm infants (born before 37 weeks' gestation) are susceptible to bloodstream and other serious infections partly because their immature skin is not a fully effective barrier to micro-organisms. Applying emollient (ointment, cream, or oil) may protect against skin breakdown and thereby prevent micro-organisms from spreading into the bloodstream and causing serious infection.

We conducted a Cochrane systematic review to assess the evidence that topical application of emollients reduces the incidence of invasive infection in preterm infants. We identified eight trials (2086 infants) that examined the effect of topical ointments or creams. Most participants were very preterm infants cared for in health-care facilities in high-income countries. We identified eleven trials (1184 infants) that assessed the effect of sunflower, sunflower seed, and other vegetable oils. Nine of these trials were undertaken in low- or middle-income countries and all were based in health-care facilities rather than home or community settings. Analyses of these trial data did not provide evidence that the use of emollient therapy prevents invasive infection or death in preterm infants in high-, middle- or low-income countries. Since these interventions are low cost, readily accessible and generally acceptable, further randomised controlled trials, particularly in both community- and health care facility-based settings in low-income countries, may be justified.

Cleminson J, McGuire W. Topical emollient for preventing infection in preterm infants. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD001150. DOI: 10.1002/14651858.CD001150.pub3.