Background The skin of the preterm infant is immature at birth and unable to serve as an effective epidermal barrier whose major functions and prevention of transepidermal water loss (TEWL).

The Aim of the study is to determine the effect of topical ointment therapy (Aquaphor) in newborn preterm infants on their TEWL measured using total body water (TBW), fluid intake and metabolic balance in the first week of life. Secondary outcomes were all so noted (sepsis, CLD, PDA and IVH).

Methods This is a prospective randomised controlled trial in a single tertiary centre. Twenty six newborn preterm infants <30 weeks gestation were randomised into 2 groups; treatment with Aquaphor or a control group. The infants TBW was measured using the Body Stat method as described for neonates by Tang that measured total body water content using bioelectric impedance.

Results There was no statistically significant difference in TBW between the 2 groups from day 4–7 of life. However, the treated group showed an improved trend in their base deficts from day 1 to 7 when compared to controls. This finding supports the hypothesis that metabolic balance in extreme preterm babies may improve with Aquaphor treatment in the first week of life.

Conclusions There was no increase in sepsis or metabolic derangement. Rather, the trend was for better metabolic balance in the treated group from day 1–7 when compared to controls. Larger studies are needed to elucidate the role of Aquaphor in preterm fluid control.