Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Feb 29;9(2):e013691.
doi: 10.1136/bmjgh-2023-013691.

Impact of topical applications of sunflower seed oil on neonatal mortality and morbidity in southern Nepal: a community-based, cluster-randomised trial

Joanne Katz  1 , Subarna K Khatry  2 , Laxman Shrestha  3 , Aimee Summers  4 , Marty O Visscher  5 , Jeevan B Sherchand  6 , James M Tielsch  7 , Seema Subedi  4 , Steven C LeClerq  4   2 , Luke C Mullany  4
Affiliations
Randomized Controlled Trial

Impact of topical applications of sunflower seed oil on neonatal mortality and morbidity in southern Nepal: a community-based, cluster-randomised trial

Joanne Katz et al. BMJ Glob Health. .

Abstract

Introduction: Hospital-based studies have demonstrated topical applications of sunflower seed oil (SSO) to skin of preterm infants can reduce nosocomial infections and improve survival. In South Asia, replacing traditional mustard with SSO might have similar benefits.

Methods: 340 communities in Sarlahi, Nepal were randomised to use mustard oil (MO) or SSO for community practice of daily newborn massage. Women were provided oil in late pregnancy and the first month post partum, and visited daily through the first week of life to encourage massage practice. A separate data collection team visited on days 1, 3, 7, 10, 14, 21 and 28 to record vital status and assess serious bacterial infection.

Results: Between November 2010 and January 2017, we enrolled 39 479 pregnancies. 32 114 live births were analysed. Neonatal mortality rates (NMRs) were 31.8/1000 (520 deaths, 16 327 births) and 30.5/1000 (478 deaths, 15 676 births) in control and intervention, respectively (relative risk (RR)=0.95, 95% CI: 0.84, 1.08). Among preterm births, NMR was 90.4/1000 (229 deaths, 2533 births) and 79.2/1000 (188 deaths, 2373 births) in control and intervention, respectively (RR=0.88; 95% CI: 0.74, 1.05). Among preterm births <34 weeks, the RR was 0.83 (95% CI: 0.67, 1.02). No statistically significant differences were observed in incidence of serious bacterial infection.

Conclusions: We did not find any neonatal mortality or morbidity benefit of using SSO instead of MO as emollient therapy in the early neonatal period. Further studies examining whether very preterm babies may benefit are warranted.

Trial registration number: ClinicalTrials.gov Registry (NCT01177111).

Keywords: Child health; Cluster randomized trial; Paediatrics.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Consort Diagram for the Nepal Oil Massage Study (NOMS) trial. FU, follow-up.
Figure 2
Figure 2
Fatty acid content of mustard and sunflower seed oil over the trial time period.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Perin J, Mulick A, Yeung D, et al. . Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the sustainable development goals. Lancet Child Adolesc Health 2022;6:106–15. 10.1016/S2352-4642(21)00311-4 - DOI - PMC - PubMed
    1. Blencowe H, Cousens S, Chou D, et al. . Born too soon: the global epidemiology of 15 million preterm births. Reprod Health 2013;10:S2. 10.1186/1742-4755-10-S1-S2 - DOI - PMC - PubMed
    1. Fitzgerald FC, Zingg W, Chimhini G, et al. . The impact of interventions to prevent neonatal healthcare-associated infections in low- and middle-income countries: a systematic review. Pediatr Infect Dis J 2022;41:S26–35. 10.1097/INF.0000000000003320 - DOI - PMC - PubMed
    1. Cleminson J, McGuire W. Topical emollient for prevention of infection in preterm infants: a systematic review. Lancet 2015;385:S31. 10.1016/S0140-6736(15)60346-4 - DOI - PubMed
    1. Darmstadt GL, Saha SK, Ahmed ASMNU, et al. . Effect of topical treatment with skin barrier-enhancing emollients on nosocomial infections in preterm infants in Bangladesh: a randomised controlled trial. Lancet 2005;365:1039–45. 10.1016/S0140-6736(05)71140-5 - DOI - PubMed

Publication types

Associated data