Many people rely on a caffeine kick from their morning coffee to boost their critical thinking. But for premature infants, a dose of caffeine may help with more vital functions, such as breathing.
For decades doctors have prescribed caffeine to premature babies because it appears to protect against apnoea, a condition in which breathing stops for more than 15 seconds. But physicians have wondered about the other effects of the caffeine.For this reason, Arne Ohlsson at the University of Toronto, Canada, and his colleagues set out to study more than 2000 premature babies. Most of the infants in the trial were born at around 27 weeks, as opposed to the normal full term of 40 weeks. Half of the babies in the trial received caffeine, first intravenously and then through their feeding tubes. Medical information on the babies was collected until their first discharge home.The group did not study the rate of apnoea in the babies to confirm the findings of previous trials – a missed opportunity according to some experts. But the researchers did monitor how long the babies required assistance from ventilators and the health of the infants’ lungs.Scarred lungsBabies who received no caffeine had a 47% risk of bronchopulmonary dysplasia, an illness characterised by inflammation and scarring in the lungs. Premature babies are at greater risk of this condition because of the air pressure placed on their lungs from medical ventilators. But the premature infants given caffeine were found to have just a 36% risk of brochopulmonary dysplasia. Ohlsson says this may be partly because babies receiving caffeine were taken off ventilator systems about a week earlier than those that did not receive the stimulant, on average. Rates of death and brain injury did not differ between the groups. Long-term effects Experts are not sure exactly how caffeine helps the infants breathe better. But they do know that the stimulant activates a respiratory control centre at the base of the brain, which in turn communicates with the diaphragm.Ohlsson and his team mates will continue collecting data from this group of infants for several years to assess whether administering caffeine to infants has any long-term developmental drawbacks. He notes that caffeine may inhibit certain important receptors on the outside of cells that might eventually cause some brain damage. Physicians are also keen to find out if caffeine increases a premature infants’ risk of disorders such as cerebral palsy and visual impairment.(Source: New Scientist: New England Journal of Medicine (vol 354, p 2112): Roxanne Khamsi: May 2006.)