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Randomized Controlled Trial
. 2019 Dec 23;19(1):512.
doi: 10.1186/s12887-019-1871-2.

Impact of sunflower seed oil versus mustard seed oil on skin barrier function in newborns: a community-based, cluster-randomized trial

Aimee Summers  1 , Marty O Visscher  2 , Subarna K Khatry  1   3 , Jeevan B Sherchand  4 , Steven C LeClerq  1 , Joanne Katz  1 , James M Tielsch  5 , Luke C Mullany  6
Affiliations
Randomized Controlled Trial

Impact of sunflower seed oil versus mustard seed oil on skin barrier function in newborns: a community-based, cluster-randomized trial

Aimee Summers et al. BMC Pediatr. .

Abstract

Background: Natural vegetable oils are widely used for newborn massage in many low resource settings. Animal models indicated that sunflower seed oil (SSO) can accelerate skin barrier recovery following damage, while other oils, including mustard oil (MO), may cause further skin barrier damage. The objective was to compare the effects of two SSO and MO used for routine massage on skin integrity in premature and full-term neonates.

Methods: This community-based cluster randomized controlled trial included 995 neonates assigned to full body massage with sunflower seed oil (SSO, intervention) or mustard seed oil (MO, standard practice) from July 2012-May 2014 in Sarlahi, Nepal. Skin integrity measures were evaluated over 28 days, including skin condition (erythema, rash, dryness), skin surface pH, stratum corneum (SC) cohesion/protein concentration, and transepidermal water loss (TEWL). Overall means and rates of change in these skin measures were compared between oil groups using bivariate random-effects models.

Results: 500 and 495 live born neonates received repeated massage with MO and SSO, respectively. Skin pH decreased more quickly for SSO than MO in the first week of life, with a difference in mean daily reductions of 0.02 (95% CI: 0.002-0.040). Erythema, rash and dryness increased (worsened) over days 1-14 then decreased by day 28, with no significant oil group differences. TEWL increased over time, with no significant oil group differences. Gestational age did not modify the effect; the slightly faster decrease in skin pH among SSO infants was similar in magnitude between term and preterm infants.

Conclusions: Oil type may contribute to differences in skin integrity when neonates are massaged regularly. The more rapid acid mantle development observed for SSO may be protective for neonates in lower resource settings.

Trial registration: ClinicalTrials.gov (NCT01177111); registered August 6th, 2010.

Keywords: Emollient therapy; Massage; Mustard oil; Neonate; Skin; Skin barrier; Skin condition; Stratum corneum; Sunflower oil; TEWL; pH.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Participant Flowsheet. For SSO and MO, 11 (2.2%) and 10 (2.0%) infants died and 67 (13.5%) and 74 (14.8%) moved out of the study area prior to age 28 days, respectively
Fig. 2
Fig. 2
Lowess curves of change in chest skin condition throughout the neonatal period by oil group, Sarlahi, Nepal
Fig. 3
Fig. 3
Lowess curves of the changes in TEWL, Skin pH, and SC protein concentration throughout the neonatal period, Sarlahi, Nepal
See this image and copyright information in PMC

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