Patient Presentation
An 8-year-old male came to clinic with pharyngitis, rhinorrhea and cough for 2 days. He had a mild fever and was drinking. The past medical history showed that he had atretic nasolacrimal ducts that easily caused build up of mucoid discharge when he had upper respiratory illness. The pertinent physical exam showed a mildly ill male with normal temperature and vital signs. His eyes had clear/mucoid discharge that was somewhat matted on his eyelashes, but did not appear purulent. He had clear nasal discharge and his throat showed erythematous tonsils with two small white patches. His ears and lungs were clear. The laboratory evaluation was negative for a rapid strep test and a throat culture was sent to the laboratory.
The diagnosis of of an upper respiratory tract infection with pharyngitis was made. The physician said, “This looks like a viral infection but we will continue to monitor the throat culture. I don’t think your eyes have a bacterial infection but are just real watery.” The mother said, “Yeah, this is how his eyes look when he has a cold. They may look a little worse because we have been using coconut oil on his eyelids. It seems to help protect his skin from all the tears and goop he gets. Plus it’s easier to wipe it off. I’ve also read that it acts kind of like an antibiotic. Anyways it seems to help when he has a cold.” The pediatrician noted that the coconut oil didn’t seem to be hurting anything, and noted to herself that another parent said that she was using coconut oil for her daughter’s atopic dermatitis.
Discussion
Coconut oil along with many other plant oils are used by humans for many reasons. It is often used as a food ingredient either as an ingredient or in food preparation such as frying. It is also used topically and applied to skin, hair or nails to provide protection or help improve their condition. Some people use it for hygiene such as rinsing their mouths while others ingest it like a medication as they feel it improves various acute or chronic diseases.
There are relatively few scientific studies of coconut oil use in children or even adults. A PubMed search on 11/23/15 of coconut oil in human children with ages birth to 18 years found only 57 articles from 1973-2015. On the same day the American Academy of Pediatrics website (aap.org) was searched and found coconut oil being used as part of a healthy diet. Similarly, the Cochrane Collaboration (cochrane.org) and the National Guideline Clearinghouse (http://www.guidelines.gov) returned no results about coconut oil when searched. The National Institutes of Health National Center for Complementary and Integrative Medicine (https://nccih.nih.gov) also does not list coconut oil as one of its health topics. The Federal Drug Administration (fda.org) regards coconut oil as GRAS or generally recognized as safe and specifically states that “[n]one of the available biological information indicates that these substances are hazardous to man or animals even when consumed at levels that are orders of magnitude greater than could result form their use….”
Learning Point
There’s little research that supports the use of coconut oil specifically as an antibacterial agent. Those studies that are available recently have small numbers. A 2007 study found that coconut oil had in-vitro activity against Candida species. A 2008 study found that coconut oil did have improved antibacterial effects for Staphylococcus aureus compared to olive oil in adult atopic dermatitis patients (N=52 for total study patients). A 2013 study found that two coconut oils did not have antibacterial effects for Staphylococcus aureus in rodents.
Preterm infant massage therapy studies have found some benefits to using coconut oil in addition to the massage itself. Infants had greater weight gain possibly because of transdermal absorption of the oil which then potentially could be used as a nutritional source by the infant. Another study also found better thermoregulation.
Questions for Further Discussion
1. What resources do you use for information about nutritional supplements or complementary and integrative medicine?
2. What plant, petroleum or synthetic oils do you prescribe and for what uses?
Related Cases
Disease: Coconut Oil | Herbal Medicine | Alternative Medicine
Symptom/Presentation: Sore Throat
Specialty: General Pediatrics | Pharmacology / Toxicology | Dermatology | Nutrition / Dietetics
Age: School Ager
To Learn More
To view pediatric review articles on this topic from the past year check PubMed.
Evidence-based medicine information on this topic can be found at SearchingPediatrics.com, the National Guideline Clearinghouse and the Cochrane Database of Systematic Reviews.
Information prescriptions for patients can be found at MedlinePlus for this topic: Herbal Medicine
Information prescriptions for patients can be found at MedlinePlus for these topics: Topics and Complementary and Integrative Medicine.
To view current news articles on this topic check Google News.
To view images related to this topic check Google Images.
To view videos related to this topic check YouTube Videos.
Ogbolu DO, Oni AA, Daini OA, Oloko AP. In vitro antimicrobial properties of coconut oil on Candida species in Ibadan, Nigeria. J Med Food. 2007 Jun;10(2):384-7.
Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BS. Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis. Dermatitis. 2008 Nov-Dec;19(6):308-15.
Field T, Diego M, Hernandez-Reif M. Preterm infant massage therapy research: a review. Infant Behav Dev. 2010 Apr;33(2):115-24.
Manohar V, Echard B, Perricone N, Ingram C, Enig M, Bagchi D, Preuss HG. In vitro and in vivo effects of two coconut oils in comparison to monolaurin on Staphylococcus aureus: rodent studies. J Med Food. 2013 Jun;16(6):499-503.
Federal Drug Administration. Select Committee on GRAS Substances (SCOGS) Opinion: Coconut oil, peanut oil, oleic acid (packaging), and linoleic aid.
Available from the Internet at http://www.fda.gov/Food/IngredientsPackagingLabeling/GRAS/SCOGS/ucm261259.htm (rev. 9/29/2015, cited 11/23/15).
Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa Children’s Hospital
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