Why Are Doctors Giving Caffeine To Premature Babies?

Many of us need a caffeine kick to get us going in the morning and probably had our first encounter by means of a fizzy drink when we were a few years old, but what if your first encounter with caffeine is when you are just a few hours old?



Although this may sound strange, it's actually fairly common for babies born early to be given caffeine to help give their development a boost after an earlier-than-intended entrance to the world, however, it is normally given to babies who are at least a few days old.

A new study from researchers at the University of Calgary suggests that giving them a boost with caffeine "as early as possible within the first few hours of life" comes with increased benefits and no negative long-term effects compared to giving them the caffeine a few days later.

"In babies who are premature, their lungs are quite immature. They often breathe for a while and then they stop, requiring artificial lung support for anywhere between days to months afterwards, depending on how under-developed their lungs are," said Abhay Lodha, M.D., neonatologist and associate professor at the University of Calgary Cumming School of Medicine and leader of the new research.

Ventilators to breathe for babies who are premature undoubtedly save lives, but they can cause damage and injury to the delicate lung tissue, leaving babies with chronic scarring and diseased lungs. Perhaps surprisingly, that's where caffeine comes in.

"Caffeine is the most commonly used drug in the neonatal intensive care unit after antibiotics," said Lodha.

Lodha published work in 2014 showing that starting caffeine therapy within two days of birth shortened the amount of time that the babies needed ventilators to assist with their breathing and hence the negative long-term effects on lung health from using a ventilator that early in life. Lodha says that amongst other effects, caffeine is thought to increase the growth of dendrites, the small branches of a neuron which help it to communicate with other brain cells.

"Caffeine may also improve better lung stretch and expansion, cardiac output and blood pressure in premature infants, which improves oxygen supply throughout the body and brain," said Lodha.

Dosing with caffeine early on definitely appears to be good for premature babies in the short term, but less was known about the long-term effects, with researchers particularly worried that this early exposure to caffeine might have negative effects on brain development in such young babies.

"We don't just want to see survival of these babies. It's important that we understand the long-term effects of caffeine as a treatment and ensure these babies are not only surviving but have quality of life down the road," said Lodha.

The new study published in the journal Pediatrics looked at data collected from thousands of toddlers who had been treated with caffeine as babies. The children, from several different centers all over Canada, were assessed for their language, cognitive and motor development skills. The researchers found no negative effects on brain development, the children treated with caffeine in the first few days of life did better cognitively than premature babies who were a few days old by the time they had the caffeine.

But this does not mean that healthy babies should be given caffeine.

"Caffeine should be used in premature babies prone to have breathing issues. In this situation caffeine is ideal, but we can't recommend giving this to full-term babies. They don't need it and there are side-effects such as disruption of sleep and increased heart rate," said Lodha.

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Ofcoz it is a good survey actually, caffeine citrate in premature baby act as a respiratory stimulant, helping their immature lungs and brains remember to breathe and reducing episodes of intermittent hypoxia (IH)—short, repetitive drops in blood oxygen levels.

Though caffeine should be given premature baby, not all premature baby need caffeine , forexample premature bayby who derived by SVD with GA of above 35weeks most of them don't need caffeine because their brain at that age is well developed and exposure to Labour facilitate them production and maturation of surfactant ..so baby will have a good respiratory pattern .
In my hospital I always don't give caffeine to premature baby above 35week derived by SVD . unless baby was derived by cessarian section, I do give caffeine to those derived by cessarian section because they have risk of getting respiratory distress secondary to transient tachypnoic attact