Administered to premature babies from their first days of life, caffeine allows better neurological development, in addition to helping the maturity of the lungs.
Born before 37 weeks of amenorrhea, ie 8 and a half months of pregnancy, children are considered premature. Since their organs have not all reached maturity, they are not yet ready to face extra-uterine life. Among these are the brain and the lungs. This is all the more true for very premature infants, born before 29 weeks of amenorrhea (SA).
Among the treatments given to them in neonatal intensive care units (NICUs) is now caffeine, administered in daily doses. A new study by researchers at the University of Calgary, Canada, shows that not only is caffeine effective in developing the brains of newborns, but the earlier the dose is given, the better.
Positive effects on the respiratory capacities of premature babies
“Caffeine is the most common drug used in the NICU after antibiotics,” says Dr. Abhay Lodha, MD, associate professor in the departments of pediatrics and community health sciences at the Cumming School of Medicine and neonatologist on staff at the Alberta Health Services (AHS). “It’s important that we understand the long-term effects of caffeine as a treatment and ensure that these babies not only survive, but have an optimal quality of life.”
Among the babies followed by the research team was Anna. Born at 27 SA at Foothills Medical Center and considered extremely premature, she was given caffeine to help her breathe and improve her lung function.
“Doctors told us that with premature babies, their brains hadn’t developed enough to allow them to do everything their body should do on its own, like breathe,” says Anna’s mother, April Stratchan. “During the first few weeks, when Anna was feeding, her breathing slowed down and she sometimes even forgot to breathe. This slowed down her heart and prevented her from getting enough oxygen. To help her breathe better, Anna needed a continuous positive airway pressure (CPAP) machine to provide constant airflow to his lungs.
In his case, but also in that of other babies born prematurely, the administration of caffeine was decisive. In 2014, a study by Dr. Abhay Lodha, a researcher at the Alberta Children’s Hospital Research Institute, showed that starting caffeine treatment within two days of childbirth reduced the duration of respiratory support as well as the risk of bronchopulmonary dysplasia (BPD), a chronic lung disease due to damage to the lungs caused by the use of a ventilator.
Better cognitive development
But we did not know until now what were the effects of caffeine on the brain of premature babies. Dr. Lodha therefore collaborated with researchers from the Universities of British Columbia, Montreal, Toronto and Mount Sinai Hospital in Toronto to analyze data from 26 neonatal intensive care units across Canada. In the review Pediatricsthey explain that they found that early caffeine treatment had no long-term negative effect on neurodevelopment and was in fact associated with better cognitive scores and a reduced likelihood of cerebral palsy and of hearing impairment.
The team looked at follow-up assessment data performed between 18 and 24 months on babies born prematurely. During these follow-ups, the children were assessed for their cognitive, language and motor development. “We look at how children construct their understanding, for example to solve simple problems or to understand three-dimensional objects and toys,” says Dr. Dianne Creighton, assistant research professor in the Department of Pediatrics and a retired psychologist. “We also assess the little ones’ ability to understand simple words or recognize the name of a picture, as well as their motor skills such as climbing, crawling, balance and coordination.”
How to explain the effects of caffeine on the brain? According to Dr. Lodha, it could increase the growth of dendrites, the small branches of a neuron that receive signals from other neurons. “Caffeine may also improve lung stretch and expansion, cardiac output, and blood pressure in premature infants, which improves oxygen delivery to the body and brain, reducing the duration of mechanical ventilation and the risk of chronic lung disease and damage to the developing brain.”
Now two, Anna has had several follow-up assessments and is taking lessons in dance, gymnastics and “swimming like a fish”, her mother says. “She’s very mechanical. She likes to build, take apart and figure out how it works,” she says. “It’s wonderful to know that the caffeine treatment has no adverse effects and that if the researchers obtain positive results, it should remain the reference treatment for premature babies.”
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