Caffeine and Preemies

Caffeine is commonly used to treat idiopathic (no known source) apnea in preterm infants (like Frankie, especially neonates born before 30 weeks). Thean (Frankie's daddy) did not like to hear that he was recieving caffeine because he remembers my soap box on how too much caffeine is bad for the adrenal glands; so here he is thinking we may be doing damage to Frankie before he is even out of his artificial womb. I tried to come at Thean with the idea of costs versus benefits but then decided I needed to do some more research to learn about caffeine and preemies to see if there might be an alternative or at least no lasting effects from its use.

The subject is well researched and the research I found is encouraging. Here is some of what I found out:

• A look at caffeine and theophylline found that they have the same effect on apnea/bradycardia (low heart rate) but caffeine has more therapeutic effects (https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000273.pub2/abstract)
• Caffeine citrate (which is what Frankie is getting - 9.2mg/kg and he is just 1 kg) at doses of 20mg/kg does not result in adverse outcomes for development, temperament, or behavior; while effects on cognition need further study (https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1440-1754.2010.01943.x).
  
• Early caffeine therapy shows better outcomes in preterm infants (https://www.nature.com/articles/jp201252).
  
• A study on caffeine and brain development found that preterm infants who had caffeine had improved white matter microstructural development (https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.22098).
  
• Looking at the safety of caffeine for AOP (Apnea of Prematurity) it has repeatedly been found to be a safe treatment method (https://www.karger.com/Article/Abstract/442813).
  
• A particularly great study found that early administration improves neurodevelopment outcomes compared with later introduction (full pdf https://relaped.com/wp-content/uploads/2019/01/Early-Caffeine-Administration-and-Neurodevelopmental-outcomes-in-preterm-infants.pdf).
  

I could go on and on with all the great research but I think you get the point. I feel pretty good about Frankie being on Caffeine Citrate after I did the research to figure out why he would be on it; without just taking his doctors/nurses word for it.