Can topical coconut oil reduce late-onset sepsis in extremely preterm infants? A pragmatic cluster-randomised controlled trial protocol

Infants born before 28 weeks' gestation account for approximately 75% of neonatal morbidity and mortality. Late-onset sepsis (LOS) affects around 25% of these infants and is associated with an increased risk of adverse long-term outcomes. The topical application of coconut oil has been used for centuries in newborn care. Coconut oil is rich in saturated fatty acids, several of which have demonstrated antimicrobial properties. It is considered safe for extremely preterm infants, improves skin condition and may reduce the incidence of LOS.

Citation:
Strunk T, Mountain J, Gordon A, et al. Can topical coconut oil reduce late-onset sepsis in extremely preterm infants? A pragmatic cluster-randomised controlled trial protocol. BMJ Open. 2026;16(3):e108203.

Keywords:
Infant; Neonatal intensive & critical care; Sepsis

Abstract:
Infants born before 28 weeks' gestation account for approximately 75% of neonatal morbidity and mortality. Late-onset sepsis (LOS) affects around 25% of these infants and is associated with an increased risk of adverse long-term outcomes. The topical application of coconut oil has been used for centuries in newborn care. Coconut oil is rich in saturated fatty acids, several of which have demonstrated antimicrobial properties. It is considered safe for extremely preterm infants, improves skin condition and may reduce the incidence of LOS.