Coconut oil versus standard of care for the prevention of diaper dermatitis in the neonatal intensive care unit: A randomized clinical trial

Abstract

ObjectiveTo evaluate the effectiveness and safety of coconut oil (CO) for diaper dermatitis (DD) prevention. MethodsA prospective, 2-group, randomized trial compared organic CO applied at each diaper change to minimal standard of care (SOC) in 1 neonatal intensive care unit (NICU). DD characteristics were documented in diaper rash logs. Primary outcome was “time to rash” calculated using log-rank tests of Kaplan-Meier plots. Adverse events and parental satisfaction were secondary measures. ResultsInfants (N = 149, 40% female, median gestational age 35 weeks) were randomized to CO (n = 75) or SOC (n = 74). Time to rash plots showed no DD prevention for either group. Adverse events were documented in 29% of participants. Parental satisfaction scores were driven by rash outcome with favorable scores related to no DD. ConclusionCoconut oil and minimal SOC protocols did not prevent DD in NICU infants. Parents should be advised that coconut oil may not protect against DD.