3. Discussion
We investigated the effect of topical coconut oil emollient on the skin microbiome in preterm infants born <30 weeks of gestational age. Microbiome data were collected longitudinally from three body sites up to 21 days after birth. Overall, within-sample diversity was highest on day 1 after birth, with a subsequent decline and emergence of the The reduction in diversity with age is likely due to a combination of host and environmental factors [Alpha diversity of the skin microbiome was significantly lower in the intervention arm than in the control arm, perhaps related to the higher absolute abundance of CoNS observed in children receiving coconut oil. In contrast, coconut oil application had no effect on the prevalence and absolute quantity of We have previously reported that the implementation of topical coconut oil skin care in our NICU was associated with a lower frequency of LOS, without a change in the pattern of causative organisms [Antibiotics decrease skin-microbiome alpha diversity in preterm infants [Strengths of this study include its prospective integration into a randomized clinical trial comparing preterm infants’ skin care with and without topical coconut oil, including serial sampling of three body sites. However, this study was underpowered to make conclusive findings about associations between the microbiome and antibiotic administration and clinical outcomes such as LOS. This study highlights the rapid succession of the skin microbiome, especially during the first week of life, and the potential modifying effects of topical coconut oil therapy.