As a soon-to-be or brand-new parent of newborn twins, you're going to be completely and utterly exhausted. And while you might feel like you need several cups of coffee to survive on the miniscule amounts of sleep you'll be stealing, you might also be concerned about consuming caffeine and passing it into your milk supply if you're planning on breastfeeding your babies.
But did you know that caffeine—when administered properly by trained professionals in a healthcare setting—can actually be beneficial to your babies if they were premature?
The key word, here, is "premature."
Caffeine isn't recommended for full-term babies; if they don't need it, they can experience side-effects, like sleep disruption or an increased heart rate.
But for babies who were born prematurely, caffeine therapy can be beneficial.
No, the nurses in the neonatal intensive care unit (NICU) aren't going to give your newborn preemies a piping cup of coffee through their feeding tube. In the NICU, caffeine is routinely administered to premature babies as part of their feed to improve their pulmonary function and neurodevelopment.
After antibiotics, caffeine is the most commonly used drug in the NICU. Caffeine stimulates the brain, helping premature babies remember to breathe, and it also stimulates their diaphragm and lungs.
According to the Journal of Perinatology, "infants born preterm are physiologically and metabolically immature and have higher rates of morbidity and mortality, and poorer long-term neurodevelopmental outcomes than those born at term…they are at risk of apnea of prematurity and intermittent hypoxemia (low blood oxygen), which result in a decrease in oxygen saturation and bradycardia and have been associated with increased risk of neurodevelopmental impairment."
The article goes on to say that the instances of apnea are correlated with how premature a baby is, occurring most often in extremely preterm infants (though, late preterm infants are also affected). Late preterm infants also experience frequent episodes of intermittent hypoxemia and poorer neurodevelopmental outcomes than full-term babies.
When babies are born prematurely, their brains haven't developed enough to allow them to do everything their bodies need to be able to do on their own.
When babies are born prematurely, their brains haven't developed enough to allow them to do everything their bodies need to be able to do on their own. A prime example of one of these things we take for granted is breathing.
In their first few weeks of life, when preemies are feeding, they expend so much energy, they tend to slow down and get sleepy and can even forget to breathe, which, in turn, causes their hearts to slow down and results in them not getting enough oxygen, which is why you tend to see very premature babies wearing so many leads to monitor their vitals, like their blood oxygen levels, heart rate, etc.
Eventually, premature babies graduate from the NICU and get to go home once they're strong enough and have gone a certain length of time without any blood oxygen dips or other incidents, but, even then, they can still randomly forget to breathe in those early days, while their brains continue to develop to where they "should have been" if the babies had been born full-term.
Our twins were born 6.5 weeks early, so their respiratory system was still developing and shifting from the fluid-filled environment they were used to in the womb to one of breathing air.
We didn't run into any breathing issues with our twins overnight, but there was one instance where one of our babies stopped breathing the first day he was at home.
It happened during the day, and my husband was holding and watching him, so, fortunately, he saw it right away. He had to poke our baby's tummy after a second to remind him to take his next breath, and he took it right away and was fine after that.
Luckily, the NICU team had warned us this might happen, and because they'd given us a heads-up to watch for this, my husband knew what to do, and everything worked out fine.
The earlier, the better the outcome
A study conducted by researchers from the University of Calgary shows the sooner a dose of caffeine is given, the better the benefits are for the premature baby.
Administered by healthcare professionals as caffeine citrate within the first few days of life, this routinely used drug can have long-lasting benefits for both cognitive and pulmonary outcomes in babies who are born early.
Widely used in NICUs to treat apnea of prematurity, caffeine helps neonates to breathe and mature their lungs and brains.
Widely used in NICUs to treat apnea of prematurity, caffeine helps neonates to breathe and mature their lungs and brains.
Acting as a respiratory stimulant, caffeine works in this capacity for babies who were born early because it acts as a catalyst for the respiratory center in the brain, helping preemies to regulate their breathing.
Caffeine therapy has been used in this way for decades, and studies have shown it's both safe and effective, with no negative long-term effects.
In fact, a study on neurobehavioral outcomes 11 years after neonatal caffeine therapy for apnea of prematurity that was published by the American Academy of Pediatrics found that "neonatal caffeine therapy for apnea of prematurity improved visuomotor, visuoperceptual, and visuospatial abilities at 11 years" and that general intelligence, attention, and behavior weren't adversely affected by caffeine, highlighting the long-term safety of caffeine therapy for apnea of prematurity in very low birthweight neonates.
Studies also show that caffeine doses administered to premature infants actually reduces the risk of bronchopulmonary dysplasia, a chronic lung disease that's common in premature, very low birthweight infants.
Caffeine citrate also helps with the stretch and expansion of lungs, allowing them to function better and, therefore, reducing the need for mechanical ventilation.
With improved lung function comes better cardiac output and an increased oxygen supply to your babies' entire bodies, including their brains, resulting in improved long-term cognitive and pulmonary outcomes, all thanks to the correct dose of caffeine given at the right times.
The power of caffeine
While caffeine is something we're trained to think should never be anywhere near a baby (and, granted, this is generally true), it can actually have positive impacts when used in a calculated way by healthcare professionals.
When given at the right time to the right premature patients, caffeine therapy can bring about long-term benefits to your babies, helping them with lung function, regulating their breathing and leading to better blood oxygen levels and improved cognitive and pulmonary outcomes for your babies.
Did your twins undergo caffeine therapy while they were in the NICU? What do you think about the use of caffeine citrate in premature babies? Let us know in the Comments section below or connect with us on Instagram to share your thoughts!
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