Caffeine therapy for the first few days of life helps resolve breathing difficulties in babies born prematurely, according to a report in this week’s New England Journal of Medicine.

Caffeine belongs to a class of compounds called methylxanthines, which are known to improve respiration. However, it was unclear if such therapy would help very preterm infants, whose lungs are too immature to work properly.

Dr. Barbara Schmidt, from McMaster University in Hamilton, Ontario, Canada, and colleagues assessed the outcomes of 2006 very low birth weight infants who were randomly assigned to get intravenous infusions of caffeine or inactive placebo for the first 10 days of life, until breathing difficulties improved.

Caffeine therapy was associated with a 37 percent reduction in the need for supplemental oxygen. In addition, caffeine infusions allowed positive airway pressure ventilation to be discontinued one week earlier.

While encouraging, the results represent only short-term outcomes, which are inadequate to assess the overall risks and benefits of neonatal intervention, the researchers warn.

“Follow-up of our study cohort to the corrected ages of 18 to 21 months and 5 years, currently in progress, is needed before one can confidently recommend the standard use of methylxanthine therapy,” they say.

SOURCE: New England Journal of Medicine, May 18, 2006.