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Please explain to me WHY caffine is prescribed to a ppremie with apnea? What do we know of the long term if any affects and what a mom can do naturally that will not endanger the premie
 

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Don't know the science behind it but I worked L&D for 20 years and it's been used at least that long. I guess the stimulant is better than having to be hooked to a ventilator for longer periods of time.
 

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From the New England Journal of Medicine: <a href="http://content.nejm.org/cgi/content/extract/354/20/2179" target="_blank">Caffeine Therapy for Apnea of Prematurity</a><br><br>
We randomly assigned 2006 infants with birth weights of 500 to 1250 g during the first 10 days of life to receive either caffeine or placebo, until drug therapy for apnea of prematurity was no longer needed. We evaluated the short-term outcomes before the first discharge home....Caffeine therapy for apnea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight.<br><br>
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From The Cochrane Library: <a href="http://www.nichd.nih.gov/COCHRANE/Steer/Steer.HTM" target="_blank">Caffeine versus theophylline for apnea in preterm infants</a><br><br>
While there are no data from these studies on the long term effectiveness and safety, caffeine appears to have similar short term effects on apnea/bradycardia to theophylline. In view of the other therapeutic advantages of caffeine (a higher therapeutic ratio, more reliable enteral absorption and a longer half life) this is the preferred treatment for apnea in preterm infants.<br><br>
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From Medscape Medical News: <a href="http://doctor.medscape.com/viewarticle/411989" target="_blank">Caffeine Citrate Safe and Effective for Treatment of Premature Infants</a><br><br>
A new study, conducted in 9 US neonatal intensive care units to evaluate caffeine citrate (Cafcit, Roxane Laboratories) in the treatment of premature infants suffering from apnea of prematurity, revealed that the treatment is both safe and effective in reducing apnea of prematurity attacks. The study results were published in the July issue of Pharmacotherapy.<br><br>
This first-ever placebo-controlled study concluded that caffeine citrate proved significantly better than placebo in reducing apnea of prematurity episodes in infants between 28 to 32 weeks' postconception. Caffeine citrate treatment, which was studied for a maximum of 10 to 12 days, significantly eliminated apnea of prematurity events on day 2 of treatment.<br><br>
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From the European Journal of Clincical Pharmacology: <a href="http://www.springerlink.com/content/2882560356436354/" target="_blank">Pharmacokinetic aspects of caffeine in premature infants with apnoea</a><br><br>
The pharmacokinetics of caffeine was examined in 13 premature infants (gestational age 25–34 weeks, birth weight 920–2060 g, postnatal age 1–42 days) who received the drug for treatment of opnoea....Single doses of 15 mg/kg i.v. or p.o. prevented apnoea in most cases, if necessary followed by additional doses. Monitoring the blood level of caffeine in infants receiving frequent repeated doses is necessary to prevent toxicity.<br><br>
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From eMedicine: <a href="http://www.emedicine.com/ped/topic1157.htm" target="_blank">Apnea of Prematurity</a><br><br>
Caffeine citrate (Cafcit) -- Increases respiratory center output, chemoreceptor sensitivity to CO2, and cardiac output
 
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