What is the primary therapeutic purpose of caffeine citrate in preterm infants?

• A. Prevent apnea of prematurity.
• B. Treat neonatal sepsis.
• C. Reduce phototherapy need.
• D. Stimulate milk production.

Answer: (B)

Caffeine citrate works as a central nervous system stimulant to boost the infant’s respiratory drive. In preterm babies, it increases the sensitivity of the brain’s respiratory center to CO2 and enhances diaphragmatic contractility, which together reduce episodes of pauses in breathing (apnea) and related bradycardia and hypoxemia. By preventing apnea of prematurity, it helps stabilize respiration and often reduces the need for ventilatory support.

It’s not used to treat infection, so it isn’t aimed at neonatal sepsis. It also doesn’t directly affect bilirubin levels or phototherapy needs, since phototherapy targets hyperbilirubinemia, not breathing effort. And it isn’t a means to stimulate milk production.

Typical use involves a loading dose around 20 mg/kg followed by a maintenance dose of about 5–10 mg/kg daily, with careful monitoring for side effects such as tachycardia, jitteriness, or feeding intolerance.