Topical emollient application improves skin integrity and topical oil reduces sepsis risk in preterm neonatesTopical Oil May Reduce Sepsis Risk in Preterm Infants

European journal of pediatrics Published June 15, 2026 Study authors: Basu Saurodeep, Singh Poonam, Priyadarshi Mayank, Chaurasia Suman, Basu Sriparna PubMed ↗ DOI ↗ Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

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Key Takeaway

Consider topical oil for preterm neonates to improve skin integrity and potentially reduce sepsis risk.

This meta-analysis evaluated the impact of topical emollient application, including oils, ointments, and creams, compared to routine skin care in preterm neonates. The study pooled data from 5,586 infants to assess skin integrity and related clinical outcomes like sepsis and mortality.

The analysis found a significant improvement in skin integrity for those receiving topical emollients (SMD -1.11; 95% CI [-1.57, -0.65]). Regarding infection, the overall difference in culture-positive neonatal sepsis between emollient groups and routine care was not significant (RR 0.82; 95% CI [0.61, 1.09]). However, a specific comparison of topical oil versus routine care showed a significant reduction in sepsis (RR 0.66; 95% CI [0.47, 0.92]). No difference was observed for mortality or when comparing topical ointments/creams to routine care.

The authors note that high heterogeneity limits the generalizability of these results. Furthermore, the certainty of evidence is low for both skin integrity and sepsis outcomes due to a high risk of bias. Clinicians should note that the reduction in sepsis is specifically associated with topical oil rather than all emollient types.

How this fits prior evidence

This meta-analysis addresses gaps in neonatal skin care by providing data on topical emollients. It complements existing evidence regarding preterm infant outcomes, such as the finding that early kangaroo care reduces mortality in very preterm infants and that preterm children aged 0 to 2 years show lower growth rates and IGF-1 levels compared to full-term peers.

A large review of data from over 5,000 preterm babies looked at how different skin treatments affect infant health. The study compared the use of topical emollients, such as oils, ointments, and creams, against routine skin care. Researchers found that using any type of topical emollient significantly improved the overall condition of the infants' skin.

While all emollients helped skin integrity, the results for infection were more specific. The study found a significant reduction in culture-positive neonatal sepsis specifically when topical oil was used compared to routine care. However, using ointments or creams did not show a similar benefit for preventing infections. No differences were found regarding mortality rates.

It is important to note that the evidence for these findings is currently considered low certainty due to variations in how different studies were conducted. Because of this, these results should be viewed as an early indication rather than a definitive rule. Parents and doctors should discuss specific skin care plans based on individual needs.

What this means for you:

Topical oils may improve skin health and reduce sepsis risk in preterm infants, but evidence remains uncertain.

Common questions

Does every type of skin cream help prevent infection?

No, the study found a specific benefit for infections only when topical oil was used. While all emollients (oils, ointments, and creams) improved skin integrity scores, ointments and creams did not show a significant reduction in culture-positive neonatal sepsis compared to routine care.

Is it safe to use these products on preterm infants?

The study reported no major adverse events when using topical emollients. However, because the evidence for skin integrity and sepsis outcomes is currently rated as low certainty, you should always consult a medical professional before starting any new treatment for an infant.

How much did the skin condition improve with emollients?

The study found a significant improvement in skin integrity scores when using topical emollients. This was measured as a standard mean difference of -1.11, showing that these products were more effective for skin health than routine care alone.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

PMID42268439

View Original Abstract ↓

UNLABELLED: This systematic review and meta-analysis compared the efficacy and safety of topical emollient application in preterm neonates for maintaining skin integrity. The available evidence related to the effects of topical emollients vs. routine skin care was identified, appraised, and synthesized. The outcome measures were assessment of skin integrity, objectively defined by a skin condition score (SCS), incidence of culture-positive neonatal sepsis, mortality, trans-epidermal water loss, skin colonization, and adverse events. Data were pooled using RevMan Web. Certainty of evidence (CoE) was analyzed by GRADE. Nineteen trials comprising 5586 neonates were included for meta-analysis. A significant decrease in SCS was observed, favoring topical emollients [SMD (95% CI), - 1.11 (- 1.57, - 0.65), I = 85%, 6 studies, n = 2807, high RoB, low CoE]. Although there was no overall difference in the incidence of culture-positive neonatal sepsis with topical emollients [RR (95% CI), 0.82 (0.61, 1.09), I = 56%, 15 studies, n = 5297, high RoB, low CoE], a sensitivity analysis including studies comparing topical oil vs. routine care showed significant benefits favoring topical oil [RR (95% CI) 0.66 (0.47, 0.92), I = 30%, 8 studies, n = 3392], whereas pooled data from studies including topical ointment/cream vs. routine care did not show any benefit [RR (95% CI) 1.03 (0.72, 1.48), I = 26%, 8 studies, n = 2046]. There was no difference in mortality, and no major adverse events were reported. Data for other outcomes could not be pooled. CONCLUSION: Low-CoE evidence suggested better skin integrity with topical emollients, and a lower incidence of culture-positive neonatal sepsis with topical oil application. High heterogeneity limits the generalizability of results. WHAT IS KNOWN: • Compared to routine skin care, application of topical oils may reduce the incidence of sepsis in preterm infants. • There is no difference in mortality with the use of topical emollients. WHAT IS NEW: • Low-certainty evidence documented an improvement in skin integrity with the use of topical emollients and a reduction in the incidence of culture-positive neonatal sepsis with topical oil application. • No major adverse effects of topical emollients were observed.

Topical emollient application improves skin integrity and topical oil reduces sepsis risk in preterm neonatesTopical Oil May Reduce Sepsis Risk in Preterm Infants

How this fits prior evidence

Common questions

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Topical emollient application improves skin integrity and topical oil reduces sepsis risk in preterm neonatesTopical Oil May Reduce Sepsis Risk in Preterm Infants

How this fits prior evidence

Common questions

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