Caffeine Therapy May Benefit Development of Premature Babies

For most adults, caffeine is something that kickstarts their day. Research has found that caffeine therapy may benefit premature babies.

What are the problems with premature babies?

Any baby born before 37 weeks of gestation is classified as premature. Babies that are born very prematurely, i.e., at less than 32 weeks of gestational age or have a very low birth weight (less than 1500 grams), have been found to have a number of medical problems such as jaundice. Some problems may last until childhood and adulthood. One of the major problems with premature birth is the baby’s lungs are not fully developed and functional. Preterm infants have been noted to have poor expiratory air flow compared to babies who were born at full term and had a normal birth weight.

What does research show about caffeine therapy for premature babies?

In 2017, the American Thoracic Society reported the effects of caffeine on neonatal lung health. The Caffeine for Apnea of Prematurity (CAP) study enrolled more than 2000 infants at 35 hospitals. The study found that caffeine treatment in newborn preterm infants reduced apnea (suspended breathing), shortened the period for which the baby required assisted ventilation, and improved expiratory flow rates up to the age of 11 years. The beneficial effects of caffeine have been observed in the short-term, but the long-term effects on the respiratory health of the premature babies are unknown. Interestingly, the study did not reveal any harmful effects from the therapy.

Is caffeine therapy right for my baby?

Parents may feel concerned, even overwhelmed, when healthcare providers suggest caffeine therapy for a tiny infant. Studies have looked at the benefits and risks of caffeine therapy for preterm babies. It will be reassuring to parents to learn that:

• Caffeine therapy has been used in NICUs (neonatal intensive care units) for years
• Caffeine is a respiratory stimulant and helps the baby’s lungs mature
• Caffeine helps the baby’s brain send the proper signals to breathe
• Caffeine therapy is weaned off gradually when the baby’s lungs have developed sufficiently

How does caffeine therapy benefit a preterm baby?

Some of the therapeutic effects of caffeine include:

• Reduction in apnea of prematurity
• Prevention of failure of extubation
• Reduction in postoperative apnea and bradycardia in infants who require general anesthesia for surgical procedures
• Treatment of bronchiolitis-related apnea, bronchopulmonary dysplasia, and intermittent hypoxemia (common complications in premature infants)
• Reduced requirement for drug treatment in infants with PDA (patent ductus arteriosus – a heart defect)
• Higher survival rate
• Lower likelihood of neurodevelopmental disabilities such as cerebral palsy, cognitive delay, blindness, and hearing loss
• Reduced chance of severe ROP (retinopathy of prematurity – a problem in the eyes)

Some of the noted disadvantages of caffeine therapy in preterm infants include:

• Reduction in blood flow to the brain
• Less weight gain compared to babies who do not receive caffeine
• Accidental administration of large doses associated with agitation, tremor, irritability, tachypnea, tachycardia, and seizure activity