Caffeine for apnea episodes

jlh123

My daughter was put on caffeine early on in the NICU due to her episodes.  About 4 days ago she was taken off of it because of her bad reflux.  The doctor felt that her episodes were due to her reflux since they primarily happened around feedings.  He said that caffeine makes the reflux worse too.  Sure enough, the episodes decreased and so did the reflux when taken off the caffeine.  However, today they are back.  Not the reflux but the episodes.

So the nurse calls the on call doctor who puts her back on the caffeine.  The way this NICU works is there's a group of doctors that switch off their primary care weekly.  So the doctor on last week had the philosophy I mentioned above.  The guy this weeks has the same.  They are a bit younger.  The on call doctor tonight is much older and has a different philosophy to use the caffeine.  I don't know who the heck to trust here!  The younger doctors did warn me that their colleagues have a different philosophy but I felt fine with the main doctors being on the same page.  This nightly on call doctor though isn't.  Maybe his way is better, I have no idea.  I don't know what to think.

Any experience with this sort of thing?  I don't want my baby to be put on and off things based on the doctor on call.  I need to be her advocate but I need more knowledge on this.  I will voice my concern tomorrow how I feel about this going back and forth.  I keep wondering if our main doctor this week will discontinue what the doctor tonight did.

TriciaJoy

unfortunately there aren't magic answers, which is, of course, why the doctors disagree. A lot of it is trial and error. Robbie was on caffeine forever, and finally taken off of it... gosh, I think he was nearly 38w gestation by then. When he was taken off of it, there wasn't really any affect to his episodes- he still had them. He had awful reflux which we very shortly later found out was caused (or at least, very severely aggravated) by a rare stomach defect (not preemie related)

I would say give her a little time to see how she responds to being back on the caffeine again. If the episodes decrease- you have your answer. If they stay the same or get worse, she probably doesn't need it and just needs to outgrow them.

 

 

southphilly

My little guy (33 weeks gestational) definitely suffers when  his caffeine dosage is too low-they are constantly upping to keep up with his weight gain.

RubyRed7

Ruby came home on caffeine. I think she was on it until 1 month after her due date. She also had reflux and was having all kinds of bradys. There was never any discussion about taking her off to help her reflux. Her bradys were too severe to consider that and they were the primary concern...

I hope you figure out what's best for you, good luck!

albertabride06

Dylan has been on caffeine since he was about 34 weeks, he continued to have a & b's until just before 37 weeks. He is still on the caffiene at home as well, he will probably be on it until close to the end of Sept. He started spitting up more being on it but there has never been talk about stopping the caffeine because of the reflux, in fact his Pediatrician perscribed Zantac last week to help with the reflux while he is on the caffeine.

Also, why would the Doctor just stop the caffeine cold turkey like that? All of the Dr.'s and nurses we've talked to said that they have to be weaned off of it they can't just stop it.