Topical Emollient Oil Application in Neonatal Care: A Scoping Review of Types, Application Protocols, Effectiveness, and Safety

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This scoping review aims to systematically map the existing evidence on the application of topical emollient oils in neonatal care, with a particular focus on types of oils used, application protocols (dose, frequency, and duration), effectiveness on neonatal health outcomes, and safety profiles. Neonatal morbidity and mortality, especially among preterm and low birth weight infants, remain significant global health challenges, particularly in low-resource settings. The immature skin barrier in these infants increases susceptibility to infection, transepidermal water loss, and poor growth outcomes. Topical emollient oil application has emerged as a low-cost, feasible, and culturally acceptable intervention with potential benefits in improving neonatal health outcomes. However, global practices vary widely, and there is limited synthesis of evidence regarding optimal application protocols and safety. This review follows the methodological framework proposed by Levac et al. (2010), based on the original Arksey and O’Malley framework, and adheres to the Joanna Briggs Institute (JBI) guidance for scoping reviews. Reporting is guided by the PRISMA-ScR checklist to ensure transparency and rigor. A comprehensive literature search was conducted across PubMed, Scopus, Cochrane Library, and Embase databases for studies published between January 2000 and April 2025. Additional sources included Google Scholar and reference list screening. Eligible studies included randomized controlled trials, quasi-experimental, and observational studies focusing on topical emollient oil application in neonates. Studies were screened in three stages (title, abstract, and full text), and data were extracted using a standardized tool. The review included 58 studies involving 45,067 neonates from multiple geographic regions. The most commonly studied oils were sunflower and coconut oil. Evidence suggests that these oils improve skin integrity, promote weight gain, reduce infection rates, and support neurodevelopment, with generally minimal and mild adverse effects. However, variability in oil types, dosing, frequency, and duration highlights the absence of standardized clinical guidelines. Some safety concerns were identified for specific oils (e.g., Aquaphor and mustard oil). The findings of this review aim to: 1. Map the breadth of current evidence on emollient oil use in neonatal care 2. Identify gaps in knowledge and inconsistencies in practice 3. Inform future research, including clinical trials 4. Support the development of standardized, evidence-based guidelines This scoping review also serves as a foundational step for designing a future large-scale trial and implementation research in low-resource settings.

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