Cerebral oxygenation, staffing economics, delivery room scoring, neurodevelopmental prognostication, and public health — a full week on the Incubator Journal Club.

Ben walks through the NIRTURE trial, a single-device RCT testing cerebral oximetry-guided care in infants born under 29 weeks. The intervention dramatically reduced the burden of cerebral hypoxia and hyperoxia compared to standard care. Secondary clinical outcomes were neutral and neurodevelopmental follow-up is still pending. The question of whether stabilizing cerebral oxygenation actually moves the needle for these babies remains unanswered.

Daphna covers a brief communication from the Journal of Perinatology on what happens to billing and productivity when NICUs shift to 24-hour in-house attending coverage. Clinical FTE went up, work RVUs went down — and the reason is counterintuitive. Attendings present overnight were weaning babies faster. Better care, less revenue. The coding system was not built to capture that.

Ben then pairs the 5-minute Apgar with umbilical artery pH in very preterm infants using EPICE cohort data. When both are low, risk is highest. When they compete, the Apgar wins.

Daphna rounds out Journal Club with a systematic review showing that combining EEG and brain MRI outperforms either tool alone for neurodevelopmental prognostication in preterm infants.

The week closes with Ben and Eli on the sweeping domestic and international public health funding cuts — and what they mean for the vulnerable populations in your NICU.

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In this episode of Neo News, Ben and Eli tackle the recent, quiet—but massive—public health funding cuts implemented by the Department of Health and Human Services. With $600 million pulled back from four targeted states and additional CDC block grants eliminated, they discuss the severe domestic implications for local health departments, HIV/STI surveillance, and lead poisoning prevention. They also zoom out to examine the global health consequences of the US withdrawing from the WHO. Tune in as the hosts break down why these macro-level policy shifts directly impact the frontlines of neonatal care, from the need to scrutinize prenatal labs more closely to adapting clinical protocols for vulnerable populations and new arrivals.

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https://www.nytimes.com/2026/02/11/health/hhs-california-public-health-lawsuit.html

https://www.washingtonpost.com/health/2026/02/19/alternative-world-health-organization-proposal/

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In this episode of Journal Club, we wrap up a marathon recording session with a deep dive into the world of neonatal neuroprognostication. Daphna reviews a systematic review and meta-analysis from Pediatric Neurology that evaluates whether combining EEG and MRI provides better answers for families of preterm infants. While MRI remains a powerful tool for structural assessment, the data suggests that adding the functional insights of EEG significantly boosts specificity, particularly when predicting severe neurodevelopmental outcomes. We discuss the importance of timing these studies and the clinical value of sleep-wake cycling as a developmental milestone at the bedside.

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Combined Use of Electroencephalography and Magnetic Resonance Imaging in the Prognostication of Neurodevelopmental Outcomes in Preterm Infants - A Systematic Review and Meta-Analysis. Forrest CD, Biagioni T, Liley HG, Lai MM, Colditz PB, Ware RS, Boyd RN, Roberts JA.Pediatr Neurol. 2026 Feb;175:116-129. doi: 10.1016/j.pediatrneurol.2025.11.005. Epub 2025 Nov 13.PMID: 41337899 

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Ben kicks things off with a major career update before we dive into a critical study from JAMA Network Open. We explore the predictive value of the five minute Apgar score when combined with umbilical artery pH in very preterm infants. While the Apgar score was originally designed for term babies, this analysis of the EPICE cohort reveals its enduring utility even in the smallest patients. We discuss how these two measures interact, which one "wins" when they conflict, and why the clinician assessment remains a powerful predictor of mortality and severe morbidity in the NICU.

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Apgar Score Plus Umbilical Artery pH and Adverse Neonatal Outcomes in Very Preterm Infants. Ehrhardt H, Behboodi S, Maier RF, Aubert AM, Ådén U, Staude B, Draper ES, Gudmundsdottir A, Siljehav V, Varendi H, Weber T, Zemlin M, Zeitlin J; EPICE/SHIPS Research Group.JAMA Netw Open. 2026 Feb 2;9(2):e2557913.

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Is your NICU considering the shift to 24 hour in house attending coverage? In this episode of Journal Club, we explore a provocative brief communication from the Journal of Perinatology. Ben and Daphna discuss the impact of moving from home call to on site presence at UC Davis. While the change was intended to improve patient care, the data reveals a surprising 15 percent decrease in work RVUs. We examine how proactive weaning and bedside presence might actually lower billing levels under current CPT codes. Are we being penalized for doing the right thing for our patients?

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From on-call to on-site: the impact of 24-hour in-house neonatology on billing patterns and physician productivity. Donohue L, Lakshminrusimha S.J Perinatol. 2026 Feb;46(2):289-292. doi: 10.1038/s41372-025-02530-8. Epub 2026 Jan 5.PMID: 41490931 Free PMC article. No abstract available.

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In this episode of Journal Club, Ben and Daphna dive into the results of the NIRTURE trial, recently published in JAMA Network Open. Building on the lessons of SafeBoosC 3 , the NIRTURE investigators aimed to reduce the burden of cerebral hypoxia and hyperoxia in extremely preterm infants using a standardized NIRS guided treatment protocol. While the study showed a dramatic improvement in maintaining cerebral normoxia, driven largely by a reduction in hyperoxia , the clinical outcomes before discharge remained neutral. Join us as we discuss whether regional oximetry is a must have bedside tool or just another data point in search of a clear clinical benefit.  

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Cerebral Oximetry-Guided Treatment and Cerebral Oxygenation in Extremely Preterm Infants: A Randomized Clinical Trial. Jani PR, Goyen TA, Balegar KK, Maheshwari R, Saito-Benz M, Schindler T, Moore J, Merhi M, Cruz M, Song Y, McDonagh H, Luig M, Tracy M, D'Cruz D, Perdomo A, Morakeas S, Dasireddy V, Culcer M, Shingde V, Bennington K, Michalowski J, Fucek A, Querim J, Stevens S, Santanelli J, Elhindi J, Gloss B, Halliday R, Shah D, Popat H.JAMA Netw Open. 2026 Feb 2;9(2):e2557620. 

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The American Board of Pediatrics (ABP) recently announced a move toward competency-based subspecialty training that would shorten fellowships — including neonatology — from three years to two. The proposal has sent shockwaves through the training community. In this episode, Daphna sits down with three leaders from the Organization of Neonatal Perinatal Training Program Directors (ONTPD): Dr. Patrick Myers from Northwestern, Dr. Heather French from the Children's Hospital of Philadelphia, and Dr. Melissa Scala from Stanford. Together, they break down what competency-based medical education actually means in practice, why the math simply doesn't add up when applied to neonatology, and what this could mean for procedural training, scholarly activity, fellow well-being, and ultimately patient care. They also address the workforce concerns driving the ABP's proposal, share survey data from program directors across the country, and offer concrete alternative pathways forward. The message from the field is clear: the community wants to innovate — but they want a seat at the table first.

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Dr. Daniel Rauch, PAS 2026 program chair, joins Ben for a behind-the-scenes look at what it takes to pull off a conference of this scale — and what he's learned from this year's record-breaking attendance in Boston. He reflects on the sessions that packed rooms beyond capacity, from the Tiny Baby Collaborative to AI in pediatrics, and shares what's on the horizon for PAS 2027 in Minneapolis and PAS 2028 in Vancouver. He also makes the case for why PAS remains uniquely valuable for trainees and early career clinicians — not just for the science, but for the cross-disciplinary hallway conversations that become next year's publications — and highlights the steps the conference is taking to be more inclusive, from closed captioning and a first-ever Spanish language session to on-site daycare and mobility devices for attendees with ambulatory difficulties.

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Dr. Benny Rossner, PGY-2 pediatrics resident and veteran physician recruiter with 15 years of experience building clinical teams across the country, joins Ben and Rupa for a candid look at the neonatology workforce from a side of the conversation trainees rarely hear. He breaks down why demand for neonatologists is rising — sicker and younger patients, a shrinking APP pipeline into high-acuity specialties, and hospitals stretching budgets on locums before finally raising permanent salaries — and why fellows coming out of training have more negotiating power than they typically realize. He also shares practical advice on contract negotiations, non-competes, and why knowing the right people still matters enormously when it comes to landing the most competitive academic or metropolitan positions.

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Dr. Gabriel Altit and Daniela Villegas from the NeoCardioLab at Montreal join Ben and Rupa to reflect on a packed PAS filled with hemodynamics science — from pulmonary hypertension phenotyping to heart-brain interactions in the golden hour. Dr. Altit makes the case that just as neonatology learned to embrace gentle ventilation, it is time to think about gentle hemodynamics — intervening thoughtfully, recognizing different clinical phenotypes, and knowing when to remove interventions before they carry a price. He also previews early 3D echo data suggesting that a single clip at day 7 to 10 of life may already carry a signature predicting which babies will develop adverse cardiopulmonary outcomes by 36 weeks. Daniela shares her approach to family consent and research recruitment — sitting down, leaving papers behind, connecting families to the history of research that made current NICU care possible, and always giving them space to process before returning for an answer.

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Dr. Kristen Leeman and Dr. Jonathan Levin join Ben to debrief a packed interactive session on tracheostomy timing and counseling for babies with severe bronchopulmonary dysplasia (BPD). Using iterative cases and live audience polling, they mapped the wide variability in practice across the country — finding rough consensus that tracheostomy conversations become likely around 44 to 48 weeks post-menstrual age for intubated infants and 48 to 52 weeks for those on non-invasive ventilation, with key comorbidities like pulmonary hypertension, poor growth, and neurological injury shifting the calculus significantly. Families who participated in the session delivered a powerful message: the conversation should start early, be repeated often, and be framed not as a failure but as a transition — and continuity of care, having a familiar face who knows the baby and the family, made all the difference.

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Dr. Rangasamy Ramanathan, division chief at Cedars-Sinai Guerin Children's Hospital and one of neonatology's most prolific investigators, joins Ben to share what's keeping him busy — 14 active clinical trials including studies on IGF-1 for lung injury prevention, oral insulin for weight gain, and the upcoming phase three trial of aerosolized surfactant. He reflects on what has sustained his passion through decades of work, from training a third of California's neonatologists to launching Southern California's first NeuroNICU with 24-7 neurology coverage and in-house whole genome sequencing. He also previews his next innovation — the ROM Smith ventilator, designed to be manufactured and distributed at cost to resource-limited settings around the world where babies are dying for lack of a $30,000 machine he believes he can build for under $2,000.

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Dr. Thais Queliz, neonatologist at Winnie Palmer Hospital in Orlando, presents ten years of data from one of the country's highest-volume programs caring exclusively for babies born at 22 to 24 weeks. She shares how survival rates for 22 and 23-weekers climbed from 40% before the Tiny Baby program launched to 67% overall — and 72% over the last two years — driven by institutional alignment, standardized protocols, and a dedicated multidisciplinary team. She also presents Golden Hour data showing a jump from 8% to 75% completion rate after implementing strict checklists and role-defined workflows that cut average admission time from nearly two hours to 54 minutes. And she previews work on prolonged empiric antibiotics in this population — extending courses based on placental pathology — which has been associated with decreased mortality in 22 and 23-weekers, echoing findings presented earlier in the conference by her fellow Dr. Gesca Borchardt.

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Dr. Indrani Bhattacharjee, neonatologist and POCUS program director at Tufts Medical Center in Boston, joins Ben to discuss a fascinating and largely unexplored frontier — intestinal ultrasound in healthy preterm infants. Rather than waiting for NEC to appear, her team has been systematically scanning babies born under 32 weeks every week from one week of age until eight weeks or discharge, building what may be the first normative dataset for bowel wall thickness in this population. Early findings are already challenging the standard radiological definitions, showing that extremely preterm babies have thinner bowel walls than current benchmarks would classify as normal — raising the question of whether definitions derived from term or older patients have ever been appropriate for our tiniest babies. The publication is forthcoming in the European Journal of Pediatrics.

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Dr. Surabhi Aggarwal, neonatologist at Stony Brook University, joins Ben and Rupa to share five years of experience building a LISA — Less Invasive Surfactant Administration — program from the ground up at her institution. She walks through the obstacles of getting IRB approval, gaining clinical buy-in from colleagues comfortable with intubation, and how the introduction of video laryngoscopy was the turning point that finally got the practice off the ground. She shares early results showing that 30% of eligible babies received surfactant via LISA rather than intubation, discusses the technical nuances of catheter placement and confirmation, and weighs in on the emerging SALSA technique using an LMA — with a candid admission that she may be a little biased. She also highlights her work with MidCan, the AAP mid-career neonatologist group supporting clinicians between seven and seventeen years post-training.

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Dr. Arpitha Chiruvolu, neonatologist and infant nutrition researcher, joins Ben to share three posters from this year's PAS covering two of her core research interests. She presents pilot data on using Prolacta human milk cream as an alternative to dextrose gel for treating asymptomatic neonatal hypoglycemia — highlighting the well-known limitations of dextrose gel including inconsistent dosing, poor tolerance, and the way it interferes with breastfeeding immediately after administration. In 25 babies treated with cream, blood glucose rose from a median of 36 to 56 mg/dL, only one baby required NICU admission, and nurses and families loved it. She also shares her center's experience with probiotics in extremely low birth weight infants — where NEC rates dropped significantly with no cases of probiotic sepsis — and raises the urgent question of what is happening to NEC rates now that probiotics have been pulled from use in the US.

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Dr. David Sas, pediatric nephrologist at Mayo Clinic, joins Ben to discuss primary hyperoxaluria type 1 — a rare but devastating genetic disease where the liver overproduces oxalate, flooding the kidneys with crystals and leading to end-stage kidney failure in roughly 60% of patients, historically requiring both a liver and kidney transplant. He presents 60-month long-term extension data on Lumasiran, an siRNA-based therapy that suppresses oxalate production at its source — showing that urinary oxalate drops rapidly within the first three months and stays down with quarterly injections, potentially changing the trajectory of this disease forever. He also issues a direct call to urologists and nephrologists everywhere: if your patient has recurrent calcium oxalate stones, check a 24-hour urine — because primary hyperoxaluria is almost certainly being missed.

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Dr. Kyle Willsey, pediatric critical care transport director at Cedars-Sinai, joins Daphna to discuss one of the least standardized corners of pediatric and neonatal medicine — critical care transport. With children's hospitals closing across the country and tertiary centers absorbing more of the patient load, the demand for safe, well-trained transport teams is growing at the same time that national standards remain nearly nonexistent. He shares the challenges of building a transport program from the ground up, presents early pilot data using the NASA Task Load Index to measure the subjective cognitive burden on transport nurses and respiratory therapists, and makes an open call for collaboration with anyone else navigating the same uncharted territory — because the transport leg of a critically ill child's journey should never be an afterthought.

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Dr. Emily Wassmer, researcher at Children's Hospital of Philadelphia, presents findings from one of the first studies to examine gaming addiction in young children ages 5 to 12 with ADHD diagnoses. Using a newly developed caregiver-report screening tool based on DSM-5 criteria for internet gaming disorder, she found that inattention — more than hyperactivity, anxiety, depression, or autism symptoms — was the factor most strongly associated with meeting criteria for gaming addiction, mirroring patterns seen in adolescent research. Perhaps most striking was the parenting finding: each additional negative parenting behavior, such as yelling or losing one's temper, tripled the child's risk of gaming addiction — suggesting that evidence-based parent training programs already used in ADHD populations may be one of the most promising avenues for intervention.

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Dr. Lily Lou joins Daphna and Rupa to reflect on this year's Silverman Lecture at PAS — the annual honorary lecture of the AAP Section on Neonatal Perinatal Medicine — delivered by Dr. John Ioannidis of Boston, who turned the lens of research methodology back on the research community itself. Drawing on meta-analyses of meta-analyses, he offered ten provocations about how neonatology studies its own practice: are we studying the right populations, asking about race and ethnicity appropriately, and publishing the right amount? Dr. Lou also makes a heartfelt call for trainees to prioritize these foundational lectures alongside the practical career-building sessions, arguing that understanding the history and philosophy of how neonatology does science is just as important as learning how to get published.

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Dr. Satyan Lakshminrusimha, pediatric chair and neonatologist, joins Ben hot off the ONTPD meeting to share his perspective on the ABP fellowship reform debate — and it's more nuanced than a simple yes or no to a two-year fellowship. He argues that the real problem is a six-year training pipeline that is driving medical students away from pediatric subspecialties under crushing debt, and that the solution for procedure-heavy specialties like neonatology is not to shorten fellowship but to truncate the pediatric residency to two years — following the precedent already set by pediatric neurology. He also makes the case that the workforce crisis is ultimately an entry ticket problem: before debating fellowship length, we need to convince more medical students to choose pediatrics in the first place, and more pediatric residents to choose subspecialty training before it's too late.

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Dr. Nathan Sundgren, neonatologist and NRP educator at Texas Children's Hospital, joins Ben to discuss one of the most deceptively difficult skills in neonatal resuscitation — effective bag mask ventilation. He shares findings from a fellowship training study showing that respiratory function monitor feedback improves ventilation technique equally well across all three device types, and tackles the harder question of why that same technology has yet to show clinical benefit in the delivery room — pointing to human factors, cognitive overload, and the need for a dedicated respiratory coach role rather than a better device alone. He also reflects on the evolution of team leadership in neonatal resuscitation, why doing a procedure and leading a team simultaneously is impossible, and where people can find his free educational content on YouTube at Texan Neo-Ed.

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Dr. Matthew Saxonhouse, neonatologist at Atrium Health, joins Ben to discuss two initiatives designed to fill the gaps that traditional conferences often leave behind. The first is Neonatal Insights, a biennial meeting returning January 29-31, 2027 in Houston — both in person and virtual — where controversial topics like the new hypoglycemia guidelines, cord blood transfusions, optimal caloric targets for growing infants, and wasteful NICU practices are presented from all sides with the explicit goal of reaching a working consensus. The second is Neonatal Insider, a monthly virtual series combining physiology and current evidence on hot topics, now opening its five-year archive to subscribers. He also reflects on why education that presents competing perspectives honestly is one of the most valuable things neonatology can offer its community.

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Dr. Mitchell Goldstein, neonatologist at Loma Linda University and editor-in-chief of Neonatology Today, joins Ben to share the story behind one of neonatology's most accessible and wide-reaching publications — a peer-reviewed, open-access journal with 25,000 monthly readers worldwide, no publication fees, no page limits, and no color charges. He explains the philosophy behind the Academic True Open Model that guides the journal, why author development and rapid peer review turnaround of as little as 72 hours set it apart, and how the journal has used platforms like LinkedIn to find voices that traditional publishing would never have reached. He also highlights the 39th International Gravens Conference on the Physical and Developmental Environment of the High-Risk Infant, taking place June 16-18 in South Bend, Indiana — use code Special10 for 10% off registration.

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Dr. Jayasree Nair, neonatal resuscitation expert, joins Ben to reflect on one of the most humbling realities in neonatology — nearly everything we know about epinephrine use in extensive neonatal resuscitation comes from animal studies, adult data, or pediatric populations, not neonates. She explains why the pyramid of resuscitation research narrows dramatically as you move toward chest compressions and epinephrine, why randomized controlled trials in this space may never be fully achievable, and why collaborative registries like the DRIVE network offer one of the most promising paths forward. She also shares her experience piloting the new NRP NICU resuscitation module and reflects on how the two-year fellowship debate ultimately circles back to the same root problem: the financial sustainability of a career in academic pediatrics.

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Christie Lawrence, clinical nurse specialist at Rush University Medical Center, joins Ben to discuss sudden unexpected infant death (SUID) — the updated term that encompasses all sleep-related infant deaths, including what was formerly called SIDS. In Cook County alone, an infant dies every week from SUID, with Black infants dying at 14 times the rate of white infants — a disparity far exceeding the already alarming national figure of three times. She explains why shifting the language from the mysterious "SIDS" to the more concrete word "suffocation" is not about being harsh but about giving families something they can actually understand and act on — and why meeting families where they are, involving the whole family unit, and addressing real barriers to safe sleep is the only way to move the needle on a problem that has been hiding in plain sight.

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Dr. Elisabeth Kuhn, researcher focused on hospital operations, presents findings from a mixed-methods study examining how US children's hospitals measure and respond to capacity strain — the point at which demand for care outpaces the ability to deliver it safely. In a survey of 45 tertiary children's hospitals, 43 reported experiencing capacity strain in the past year, underscoring just how widespread and persistent the problem has become since the triple-demic brought it into sharp focus. She argues that current metrics like occupancy rates and boarding times fail to capture the real clinical experience of strain — which is driven by acuity and complexity, not just bed counts — and calls for better measurement tools tied directly to patient outcomes, alongside broader policy change to address what no amount of internal reshuffling can fully solve.

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Kimberly Novod, community health advocate, founder of Sol's Light, and fierce voice for health equity, joins Ben for a conversation about what it actually means to build trust between hospitals and the communities they serve. Drawing on her experience in New Orleans — where the prematurity rate sits at 14% and environmental factors like air, water, and soil quality in areas like Cancer Alley drive devastating birth outcomes — she makes the case that health equity cannot be achieved within hospital walls alone. She calls on institutions to stop designing solutions without asking the people they're meant to serve, to share research findings back with the communities that participated in them, and to invest meaningfully in family partners who reflect the full spectrum of lived experience — not just the ones with the rosiest stories to tell.

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Dr. Brandon Hadfield and Dr. Debora Abimana join Ben for a conversation that brings the incubator's global neonatology work full circle — from the founding of Rwanda's first neonatology fellowship program to seeing its first trainee present scholarly work at PAS. Dr. Abimana shares findings from her research on healthcare provider attitudes toward donor human milk in Rwandan NICUs, where the concept is largely welcomed but faces cultural concerns around infants adopting the characteristics of their donor — a barrier the team hopes to address through targeted community education. She also paints a vivid picture of the need: NICUs without TPN, near-universal breastfeeding rates driven by necessity rather than choice, and critically ill mothers who simply cannot produce enough milk for their premature babies in those first crucial hours.

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Dr. Zubair Aghai, neonatologist at Thomas Jefferson University in Philadelphia, presents results from one of the largest neonatal trials ever conducted — enrolling 3,448 late preterm and term infants across India to test whether umbilical cord milking in non-vigorous newborns reduces death or moderate-to-severe HIE. With over 100,000 deliveries screened and real-time data collected by research staff present at every delivery around the clock, the primary outcome showed no short-term harm from cord milking — and a secondary signal of reduced infection risk, possibly driven by the immunoglobulins transferred with the extra blood. He also explains why non-vigorous babies stand to gain the most from this simple ten-second intervention, and previews two-year neurodevelopmental follow-up data still to come.

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Dr. Ryan McAdams guest hosts alongside the NeoMind AI team — Dr. Ameena Husain, Dr. Kristyn Beam, Dr. Brynne Sullivan, and Dr. Zach Vesoulis — to recap their third annual pre-conference AI workshop at PAS, including a live predictive modeling bake-off using the Epic Cosmos database to predict late-onset sepsis in nearly 100,000 preterm infants. The group discusses where AI stands today in neonatology — from using large language models to reduce administrative burden and improve family communication, to Epic's growing investment in neonatal-specific tools — and makes an honest case for what clinicians should start doing now and what still requires caution. They close with an open invitation to join NeoMind AI, a growing community of neonatologists, data scientists, and researchers working to ensure the NICU is not left behind as this technology reshapes medicine.

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Dr. Melissa Zhou, researcher at the Developing Brain Institute at Children's National, joins Daphna to discuss functional MRI and what it reveals about how preterm brains are building connections during the NICU stay. Using functional connectivity — measuring how different brain regions communicate with each other over time — her team compares preterm infants to healthy in utero fetuses scanned as early as 20 weeks, finding that the ex utero preterm brain actually looks more mature in terms of connectivity, suggesting the NICU environment itself accelerates certain aspects of brain development. She shares why extremely and very preterm infants show a distinctly different pattern of connectivity compared to moderately preterm babies who seem to bounce back more quickly, and why the team's next goal is to use these early functional findings to predict which babies will struggle with neurodevelopmental outcomes at 36 months — and which ones will be just fine.

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Dr. Kevin Cook, researcher at the Developing Brain Institute at Children's National, joins Daphna to discuss functional MRI and what it reveals about how preterm brains are building connections during the NICU stay. Using functional connectivity — measuring how different brain regions communicate with each other over time — his team compares preterm infants to healthy in utero fetuses scanned as early as 20 weeks, finding that the ex utero preterm brain actually looks more mature in terms of connectivity, suggesting the NICU environment itself accelerates certain aspects of brain development. He shares why extremely and very preterm infants show a distinctly different pattern of connectivity compared to moderately preterm babies who seem to bounce back more quickly, and why the team's next goal is to use these early functional findings to predict which babies will struggle with neurodevelopmental outcomes at 36 months — and which ones will be just fine.

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Dr. Gesca Borchardt, third-year neonatology fellow at Winnie Palmer Hospital, presents findings from a retrospective study of 296 infants born under 25 weeks examining whether extending empiric antibiotic use beyond 72 hours reduces mortality in this vulnerable population. She shares why her unit moved to a seven-day antibiotic course for babies with placental pathology positive for chorioamnionitis — and what they found when they looked at the data. At 22 and 23 weeks, longer antibiotic courses were associated with a statistically significant decrease in mortality. At 24 weeks, no difference was seen. One puzzling finding clouds the picture however: an increased incidence of spontaneous intestinal perforation in the prolonged antibiotic group — a signal the team is still trying to understand and that the wider community will want to watch closely.

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Dr. Katie Ottolini, researcher at the Developing Brain Institute at Children's National in Washington DC, presents findings from a longitudinal MRI study comparing brain growth trajectories in preterm infants to healthy fetuses — scanning as early as 25 weeks and through term corrected age. Even in preterm babies with no significant brain injury and appropriate growth at birth, brain volumes were already smaller by the first MRI at around two weeks of life. She shares which regions are most vulnerable, why the amygdala-hippocampus shows a distinct window of impaired growth beginning after 32 weeks that may represent an opportunity for intervention, and why the goal for neonatology must now shift from neuroprotection alone to what she calls neuropromotion — actively supporting optimal brain development through nutrition, sleep, and other targeted interventions.

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Dr. Lori Devlin, neonatologist and principal investigator of the Optimize Now trial, shares results from the first multicenter randomized trial comparing symptom-based opioid dosing to scheduled opioid tapers in babies with neonatal opioid withdrawal syndrome (NOWS). Published in JAMA on the day of this recording, the trial found that symptom-based dosing reduced medical readiness for discharge by an additional 2.1 days — and that 65% of babies who would traditionally have been placed on a scheduled opioid taper never needed one at all. She also previews the next trial in this series, TREAT Now, which will compare buprenorphine versus morphine for babies who do require pharmacologic treatment, and reflects on how far the field has come since Eat Sleep Console first changed the way we think about caring for this population and their families.

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Dr. John Feister, neonatologist and health equity researcher at Cincinnati Children's Hospital, presents two studies that challenge us to look beyond the bedside. The first reveals that NICU babies whose families prefer a language other than English have nearly double the in-hospital mortality rate of English-speaking families — a difference that persisted even after adjusting for medical and sociodemographic risk factors, and one he suspects is driven in part by barriers to family advocacy and end-of-life communication. The second introduces the concept of medical-financial partnerships, and specifically a hospital-based free tax preparation clinic that helped NICU and hospital families claim thousands of dollars in refundable tax credits — with 90% of participants reporting that the service improved their trust in their medical team.

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Dr. Ravi Jhaveri, infectious disease physician at Lurie Children's Hospital in Chicago, joins Daphna for a conversation spanning two underappreciated threats in pediatrics. On hepatitis C, he shares that up to 90% of perinatally exposed infants never get tested despite clear guidance — and makes the case for point-of-care, heel-stick based testing that meets families where they are rather than relying on follow-up that often never happens. On long COVID, he reframes the vaccine conversation away from acute illness and toward something families actually care about: protecting their child's ability to show up for the things that matter most to them — sports, dance, school — since even mild or repeat COVID infections can double the risk of debilitating long COVID symptoms.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Sharon Levy, director of the Division of Addiction Medicine at Boston Children's Hospital, joins Daphna for a wide-ranging conversation on adolescent substance use. She shares data showing a sudden spike in nicotine exposure among teens in treatment for substance use disorders — likely driven by larger vape devices and cooling agents that eliminate the burn sensation — and introduces one of the most novel concepts in addiction medicine: a vaccine that would create antibodies against fentanyl, blocking its effect at the meningeal level before it reaches the brain. She also presents findings on why current surveillance questions fail to capture how teens actually talk about drug use, and why kids who need treatment most are paradoxically the ones most likely to answer screening questions honestly.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Jonathan Flyer, pediatric and fetal cardiologist at the University of Vermont, presents findings from a Vermont Oxford Network analysis of over 11,000 extremely low birth weight infants examining whether the method of patent ductus arteriosus (PDA) closure — transcatheter device versus surgical ligation — makes a difference for neurodevelopmental outcomes at 18 to 24 months. The answer: no difference between the two techniques on Bayley-4 cognitive, language, and motor scores. The more sobering finding is that both groups scored well below the normative mean of 100, sitting in the high 70s to low 80s — a reminder of just how much ground this population has to cover. He also makes a case for centering the counseling conversation not on technique but on what each center does best, and what families actually care about most: their child's brain.

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Dr. Brandon Tucker and Dr. Jenelle Ferry share two studies tackling some of the most pressing challenges in the care of extremely low birth weight infants. Dr. Tucker presents a quality improvement initiative examining whether switching from PRN glycerin suppositories to scheduled glycerin enemas every 12 hours reduces feeding intolerance and spontaneous intestinal perforation in babies under 1,000 grams — with early results trending in the right direction. Dr. Ferry then shares findings from a meta-analysis of 14 studies and nearly 4,700 babies showing that an exclusive human milk diet is associated with a roughly 20% reduction in the odds of death — a finding that reached statistical significance when RCTs and observational cohorts were pooled together, and one that carries real weight for units still weighing the evidence on human milk-based nutrition.

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Dr. John James Parker, internist, pediatrician, and researcher at Northwestern University and Lurie Children's Hospital, joins Daphna and Rupa for a conversation about one of the most overlooked players in family-centered care — fathers. He shares why paternal stress in the NICU and postpartum period often peaks later than maternal stress, why discharge instructions routinely go home with only one parent, and how a few small changes — making eye contact with dad, asking him a question, giving him a specific task — can fundamentally shift how engaged fathers feel in their child's care. He also reflects on the inaugural Fathers in Pediatrics special interest group at PAS, and makes the case that thinking about the whole family unit, including the mental and physical health of every caregiver, is not a nice-to-have but a core part of caring for the child.

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Dr. Christina Rojas, from Lurie Children's Hospital, presents findings from a multi-center study across eight hospitals examining how often hospitalized patients and families receive communication touchpoints from their care team — and whether that differs based on preferred language. Across more than 30 languages represented in the study, families who preferred a language other than English experienced significantly fewer room visits, less direct communication when staff did enter the room, and a 55% gap in language-concordant interactions. She discusses what this means for patient safety — since missed touchpoints are missed opportunities to catch medication errors and address family concerns — and makes the case that interpreter access needs to stop being an extra step and start being the cultural default built into every care process.

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Dr. Ayesha Khalid, resident at Marshall University, presents findings from a large meta-analysis pooling data from eight national registries across Europe — covering 2.5 million pregnancies — to examine whether prenatal acetaminophen exposure is truly linked to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children. She shares why the association with ASD largely disappears when accounting for heterogeneity and confounders, why the previously reported link with ADHD appears significantly smaller than what has been published, and why publication bias may have inflated the estimates we have been working from. She also addresses the critical limitation that no patient-level dose or timing data was available, why the risk-benefit calculation around fever control in pregnancy complicates any simple recommendation, and what kind of studies — ideally sibling-controlled designs like those done in Sweden — would be needed to actually settle this question.

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Dr. Lyubina Yankova, hospitalist at Yale, presents findings from a large retrospective multi-center analysis across 106 sites examining whether the combination of procalcitonin and C-reactive protein (CRP) can match or outperform the inflammatory marker combinations currently recommended by the 2021 AAP guidelines for risk-stratifying febrile infants between 8 and 60 days of age. She shares why this combination showed similar sensitivity but higher specificity for detecting invasive bacterial infections — meaning fewer false positives, fewer unnecessary lumbar punctures, and fewer unnecessary antibiotics. She also addresses the limitations of retrospective data, why preterm infants were excluded from this analysis and what future research in that population might look like, and what it would take for guideline committees to feel confident enough to incorporate this combination into routine practice.

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Dr. Ofer Levy, director of the Precision Vaccines Program at Boston Children's Hospital and member of the FDA's Vaccines and Related Biologic Products Advisory Committee, makes the case that vaccines must be tailored to the immune system of the person receiving them — and that immune system changes dramatically from the moment of birth through old age. He explains why preterm infants, who represent 11% of births worldwide, carry an increased risk of infection-related hospitalization all the way through age 18, and why almost no investment has been made in understanding how to optimally immunize them. He also discusses the FDA Modernization Act 2.0, which is shifting vaccine development away from animal models toward human in vitro modeling and systems biology, and reflects on what precision vaccinology could mean for rebuilding public trust in a deeply polarized conversation — not by dismissing concerns, but by taking vaccine safety science more seriously than ever before.

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Dr. Anup Katheria, one of the world's leading researchers in umbilical cord management, joins Daphna to share the latest data on deferred cord clamping and cord milking across gestational ages. He presents new two-year follow-up findings showing that while cord milking remains a reasonable alternative to immediate cord clamping, delayed cord clamping still carries a measurable advantage in Bayley scores for motor and language — even in babies between 28 and 32 weeks where short-term outcomes looked identical. He also breaks down the practical decision tree for vigorous versus non-vigorous babies at different gestational ages, shares his vision for involving obstetricians more actively in that critical first minute of life, and previews an upcoming large-scale Neonatal Research Network trial testing 100% oxygen delivery during the cord clamping window. He closes with a call to move away from traditional composite outcomes in neonatal trials toward ranked ordinal outcomes that better reflect what actually matters to families.

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Daphna is back for day two of PAS 2026 in Boston, joined in the booth by Christa and Rupa. More episodes coming all day — and if you're at the conference, stop by and say hi.

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Dr. Bridget Young, researcher at the University of Rochester, shares early but promising work on using freeze-dried mother's own breast milk — including a skim milk fraction — as a fortifier for human milk feeds in the NICU. She explains why milk variability makes accuracy the central challenge in this approach, how her team validated a method using macronutrient analysis to consistently hit a target caloric density of 28 kcal per ounce, and why the skim milk fraction in particular can deliver a protein content that rivals commercial bovine fortifiers. She also introduces the concept of mother's own breast milk cream — a centrifuge-derived calorie booster that families in her unit have found deeply empowering — and lays out honestly what it would take to bring lactoengineering from a research setting into routine clinical practice.

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From lumbar punctures to mitochondrial recycling, this booth interview from PAS 2026 covers a lot of ground. Ben and Daphna sit down with Dr. Ioanna Kotsopoulou from Mass General to discuss two distinct but equally compelling topics. First, a quality improvement project that took ultrasound-guided LP use from 12 to 73 percent and first attempt success from 32 to 68 percent. Then a pivot to basic science: impaired mitophagy in pulmonary hypertension, and whether dysfunctional mitochondrial recycling in cardiomyocytes may be contributing to the cardiac phenotype we see in these patients. A wide-ranging conversation with something for every neonatologist.

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Dr. Nathan Kupperman and Dr. Brett Bernstein, lead investigators on a landmark international pooled analysis published in JAMA, present the most comprehensive evidence to date on whether a lumbar puncture can be safely avoided in febrile infants under one month of age. Using a simple three-criteria rule — negative urinalysis, procalcitonin of 0.5 or below, and absolute neutrophil count of 4,000 or below — across more than 2,500 prospectively collected cases from multiple international cohorts, the rule did not miss a single case of bacterial meningitis. They explain what this means for shared decision-making with families, why the number needed to perform a lumbar puncture to identify one case of bacterial meningitis is now vanishingly close to infinity for low-risk infants, and why implementing this approach requires a multidisciplinary coalition across emergency medicine, infectious disease, and inpatient teams before any individual physician changes their practice.

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What does it actually feel like to be told your 22-week baby has no chance — before anyone asks what you want? In this booth interview recorded live at PAS 2026, Ben and Daphna sit down with two NICU parents, Christelle and Reem, both of whom delivered at the limits of viability. They share candid, at times difficult accounts of prenatal counseling experiences where they felt dismissed, pressured, and unheard — and what it would have taken to make those conversations feel human. This episode is a reminder that listening is not a soft skill. It is the clinical skill.

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Point-of-care biomarkers for predicting sepsis mortality, not from a resource-rich academic center, but from a tertiary referral hospital in Tanzania. In this booth interview from PAS 2026, Ben and Daphna sit down with Dr. Abigail Sorensen, a pediatrician now based in East Africa, to discuss how a lasso model combining malnutrition, altered mental status, respiratory distress, and procalcitonin can risk-stratify children with sepsis at the bedside. The lessons here are not just for low-resource settings. They are for anyone trying to identify the sickest kids before it is too late, with the tools already in front of them.

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Dr. Jennifer Harling, pediatrician and neonatologist who spent six years practicing in Burundi, one of the poorest countries in the world, shares what it took to introduce breast milk fortification, bubble CPAP, and revised sepsis protocols in a setting with nurse-to-patient ratios as high as one to forty and near-zero access to medical supplies. She reflects on the extraordinary obstacles of implementing quality improvement in resource-limited environments — from procurement failures to language barriers to training nurses with limited formal education — and explains why sustainability ultimately came down to the same thing it does everywhere: culture. She also turns the lens around and offers what may be the most universally applicable lesson she brought back from Burundi: slow down, and ask the parent what their number one concern is today.

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Dr. Ward Rice, neonatologist and researcher within the Neonatal Research Network, presents two-year follow-up data from the landmark ACT NOW Eat Sleep Console trial — one of the largest multi-center randomized trials ever conducted on neonatal opioid withdrawal syndrome. He shares findings on neurodevelopmental and behavioral outcomes at two years of age in babies exposed to buprenorphine versus methadone in utero, explaining why the short-term advantages of buprenorphine did not translate into measurable differences at this time point — but why both groups still scored below population norms on Bayley testing, underscoring the ongoing developmental risk in this population. He also discusses why longer follow-up is planned, what a smaller four-year study suggests may still emerge, and why this research ultimately informs prenatal decision-making by obstetric colleagues just as much as neonatal care at the bedside.

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Dr. Christa Matrone, neonatologist and program director at Winnie Palmer Hospital in Orlando, Florida, joins Ben and Daphna for a candid conversation about one of the most consequential announcements to hit neonatology training in years. She breaks down the American Board of Pediatrics proposal to create an optional two-year clinical training pathway for all pediatric subspecialties — including neonatology — starting as early as 2028, and explains why the neonatology community was largely caught off guard. She shares her nuanced perspective as a program director at one of the highest-volume units in the country, acknowledging both the potential benefits of a shorter clinical pathway and the serious concerns around clinical readiness, trainee wellbeing, and the future pipeline of physician scientists. She also calls on trainees and practicing neonatologists alike to make their voices heard before this conversation moves any further without them.

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Dr. Allison Lure, neonatologist and clinical informatics fellow, presents findings from a large primary care network spanning over 80 practices in Massachusetts on how term and preterm infants grow longitudinally after discharge. She shares why the standard practice of correcting for gestational age until two years may be sufficient for moderate and late preterm infants but falls short for babies born below 32 weeks — who may need correction extended to three years or beyond to avoid being misclassified as failing to thrive. She also sheds light on the often-overlooked growth trajectories of moderate and late preterm babies, a population rarely captured in NICU follow-up clinics, and explains what her work in clinical informatics is teaching her about how to store, structure, and extract meaningful data from the electronic health record.

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Dr. Parvesh Garg, neonatologist and researcher specializing in necrotizing enterocolitis (NEC) and acute kidney injury (AKI) in preterm infants, shares more than a decade of work on two of the most understudied organ systems in the NICU. He explains why surgical NEC is an independent risk factor for long-term neurodevelopmental impairment, how aggressively managing hypotension at the time of diagnosis may protect both the brain and the kidneys, and why the severity of NEC-associated AKI should be used as a prognostic tool in counseling families. He also presents early but fascinating laboratory findings suggesting that low-dose dexamethasone — unlike high doses — may help limit intestinal epithelial loss once NEC has set in, drawing a parallel to what therapeutic hypothermia does for HIE: the event has happened, but the inflammatory cascade may still be containable.

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Dr. Wanda Barfield, MD, MPH, neonatologist at Emory University, former director of the Division of Reproductive Health at the CDC, and former Assistant Surgeon General of the United States Public Health Service, joins Ben and Daphna for a conversation about the broader obligations of pediatricians in an era of growing maternal and infant health disparities. She reflects on what it means to truly know your community — not just your unit — and makes the case that engaging with local health departments, infant mortality review committees, and population health data can make you a better clinician at the bedside. She also offers practical advice on networking at large conferences and why showing up to learn, even without a poster or presentation, can be some of the most valuable time a physician spends at a meeting.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Ravi Patel, neonatologist and leading voice in neonatal hematology and transfusion medicine, joins Ben and Daphna to discuss the launch of NeoHeat — the first dedicated neonatal hematology and transfusion medicine group at PAS. He explains why transfusion medicine in neonatology is still full of unanswered questions, from how we manage iron supplementation to whether we are truly following the latest transfusion threshold guidelines at the bedside. He also introduces one of the most exciting emerging concepts in the field: using cord blood from healthy term newborns to transfuse premature infants, replacing adult hemoglobin with fetal hemoglobin — an innovation already being adopted in some European centers that could have wide-ranging implications beyond anemia alone.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Seetha Shankaran one of the pioneers of therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE) and longtime member of the NICHD Neonatal Research Network, reflects on a career devoted to preventing and treating neonatal brain injury. She discusses what neonatal MRI can and cannot tell us about long-term neurodevelopmental outcomes in infants with HIE, why a normal MRI does not equal a normal future, and how the pattern of brain injury on imaging should shape the counseling conversation with families. She closes with a message that no imaging study can replace: consistent, long-term follow-up remains the most important tool we have.

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Dr. Charles Roehr, neonatologist from Bristol, UK and faculty member of the Tiny Baby Collaborative, makes the case that caring for extremely preterm infants is as much about engaging families as it is about mastering the medicine. He discusses why parents of tiny babies are among the most vulnerable to enter a research conversation — often facing precipitous deliveries with little to no preparation — and what it takes for clinical teams to meet them where they are. He also addresses one of the hardest conversations in neonatology: how to counsel families around survival and neurodevelopmental outcomes when center-to-center variability is so wide, and why translating evidence from one unit to another remains one of the field's most stubborn unsolved problems.

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Jennifer Canvasser, founder of the NEC Society and mother of Micah, a 27-weeker who passed away from necrotizing enterocolitis (NEC) in 2014, shares what is new at the world's largest organization dedicated to NEC. She discusses the upcoming NEC Family Summit — the first of its kind globally — taking place in Davis, California this September, and explains why bringing families together as active research partners is not just about healing but about advancing the science. She also addresses how clinicians can better empower NICU families with information before a diagnosis is ever made, and highlights the free evidence-based resources the NEC Society has developed for units and families navigating this devastating disease.

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Dr. Atul Malhotra, neonatologist and researcher at Monash University in Melbourne, Australia, makes the case that cell therapy for neonatal brain injury is a slow burn that is finally gaining momentum. He shares why tempering expectations doesn't mean losing hope, how regulatory complexity sets stem cells apart from conventional therapies, and why cell therapy may look different for preterm infants with white matter injury versus term infants with HIE.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Breaking news from the American Board of Pediatrics: a proposal to move all 15 pediatric subspecialties to a two-year, competency-based training model by July 2028 just dropped, and Ben and Daphna are breaking it down in real time. What does shifting from time-based to EPA-grounded training mean for neonatology fellows? Is two years actually enough? What happens to scholarship, research exposure, and the physician-scientist pipeline? And should neonatology take this reshuffling of the cards as an opportunity to chart its own course entirely? This is essential listening for fellows, program directors, and anyone who cares about the future of our workforce.

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The transfusion threshold consensus is here — but practice hasn't fully caught up. In the second episode of On with VON, Ben and Daphna sit down with Dr. Roger Soll and Dr. Ravi Patel to extend the conversation from the Vermont Oxford Network Grand Rounds on evidence to practice for transfusion thresholds.

The core finding across trials is consistent: lower thresholds for both packed red blood cells and platelets appear safe. The guidelines are freely available in JAMA Network Open and actionable — 11, 10, 9 grams per deciliter across the first three weeks for infants on respiratory support. So why hasn't practice shifted uniformly?

The group works through the populations the trials didn't fully capture — hypoxic-ischemic encephalopathy, the most premature infants, and babies in the first week of life when intraventricular hemorrhage risk peaks. On NEC and feeding during transfusion: the data may surprise you. On transfusion volume and infusion duration: an underappreciated variable, particularly for platelets.

The episode closes with practical guidance on implementing transfusion guidelines at the unit level — who needs to be in the room, how informatics tools can support decision-making, and why understanding protocol deviations matters as much as the guidelines themselves.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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The AAP has weighed in on therapeutic hypothermia for HIE, and Daphna walks through the clinical report in full. The core eligibility criteria haven't moved — but the edges have gotten more nuanced. Late initiation, the 35-week zone, mild HIE, sentinel events, MRI timing, and feeding during cooling are all addressed.

Also this week: a prospective pilot from Australia tests whether adding bedside ultrasound to plain radiography improves surgical risk stratification in NEC. The X-ray-only model couldn't separate the clusters. The combined model produced a more than six-fold difference in odds of surgery — complex ascites, absent peristalsis, and abnormal bowel perfusion did the heavy lifting.

Daphna then covers F-NeoBright, a small but compelling feasibility study testing intranasal fresh breast milk in infants with moderate to severe HIE. Ten babies, high adherence, no safety signals, and parents administering doses at home.

Ben rounds out Journal Club with the two-year follow-up of the CALI trial examining outcomes after early caffeine plus LISA versus CPAP alone. Mortality trended toward LISA. The statistics didn't get there — but the direction held.

The week closes with Ben and Eli on the Guttmacher Institute study linking restrictive abortion laws to higher maternal mortality across two decades of US data.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of Neo News, Ben and Eli discuss a sobering Guttmacher Institute study recently featured in Bloomberg. Analyzing data from 2005 to 2023, the research reveals a troubling association between restrictive abortion laws and increased maternal mortality, specifically driven by cardiovascular complications and violent deaths. The hosts explore the clinical and social pathophysiology behind these findings, emphasizing how a lack of prenatal care and compounded social stressors disproportionately affect birthing people. Tune in for an important conversation on the "package" of restrictions driving these outcomes and practical ways neonatal professionals can advocate for maternal health equity!

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https://www.bloomberg.com/news/articles/2026-02-12/pregnant-women-die-at-higher-rates-when-states-restrict-abortion?srnd=phx-industries-health

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben reviews a secondary analysis of the CALI trial, published in JAMA Network Open, examining two-year neurodevelopmental and pulmonary outcomes in preterm infants who received early caffeine combined with LISA versus caffeine and CPAP alone. Building on the original CALI trial's finding that early caffeine prior to LISA reduced intubation rates and BPD, this follow-up asks the next logical question: does that early advantage translate into better long-term outcomes? Ben walks through the Bayley scores, gross motor function, ASQ-3, M-CHAT, and pulmonary outcomes — and delivers a reassuring if not statistically significant picture. Tune in for a deep dive into the evidence behind one of neonatology's most debated respiratory strategies!

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Two-Year Outcomes of Less Invasive Surfactant Administration Among Preterm Neonates: A Secondary Analysis of a Randomized Clinical Trial. Dorner RA, Morales A, Banerji A, Uy C, Ines F, Finer N, Vaucher Y, Katheria AC.JAMA Netw Open. 2026 Mar 2;9(3):e263852. doi: 10.1001/jamanetworkopen.2026.3852.PMID: 41915392

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Daphna presents the F-NeoBright trial — a pilot feasibility and safety study out of Hungary exploring intranasal fresh breast milk administration in neonates with moderate to severe HIE undergoing therapeutic hypothermia. With so few adjunct therapies available beyond cooling, the idea of harnessing breast milk's rich bioactive components — including neurotrophic growth factors, cytokines, and multipotent stem cells — to support the developing brain is both compelling and refreshingly low-risk. Daphna walks us through the protocol, the feasibility outcomes, and why 100% of approached families consented, including those who had never planned to breastfeed. Sometimes the simplest intervention really is the right one!

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F-NEO-BRIGHT: feasibility and safety of intranasal fresh breast milk in neonatal encephalopathy. Tarjanyi E, Jermendy A, Szabo M, Brandt FA, Szasz B, Nyilas N, Meder U.Pediatr Res. 2026 Mar 3. doi: 10.1038/s41390-026-04847-2. Online ahead of print.PMID: 41776367

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben takes the lead and reviews a prospective cohort pilot study from the Archives of Disease in Childhood examining whether combining abdominal ultrasound with plain radiography can improve surgical risk stratification in neonates with suspected NEC. With mortality remaining as high as 20–40% and diagnosis still heavily reliant on clinical judgment, the stakes couldn't be higher. Ben walks through the study's unsupervised clustering approach, explaining how adding ultrasound data to X-ray findings produced a more than six-fold difference in the odds of surgery between risk groups — something X-ray alone simply couldn't achieve. Tune in to hear why dynamic ultrasound features like peristalsis, ascites, and bowel perfusion may be the missing piece in your NEC diagnostic toolkit!

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Combining abdominal ultrasound and radiography for surgical risk stratification in necrotising enterocolitis: a prospective cohort pilot study. Priyadarshi A, Angiti R, Chabra S, McAdams R, Webb A, Badawi N, Hinder MK, Tracy MB.Arch Dis Child Fetal Neonatal Ed. 2026 Mar 5:fetalneonatal-2025-329960. doi: 10.1136/archdischild-2025-329960. Online ahead of print.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna dive into the American Academy of Pediatrics' February Clinical Report on Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy. Daphna, who presented this paper at the Florida Neonatal Neurologic Network, walks us through the key action statements — from the established 33.5°C target temperature to the more nuanced discussions around late cooling (6–24 hours), gestational age eligibility at 35 weeks, and the controversial question of cooling mild HIE. They also cover optimal MRI timing post-rewarming, continuous EEG monitoring, early enteral feeds during cooling, and the growing evidence supporting the "cool cuddle." A must-listen for anyone navigating the evolving landscape of HIE management!

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Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Clinical Report. Zanelli SA, Wusthoff CJ, Lucke AM, Kaufman DA; Committee on Fetus and Newborn; Section on Neurology.Pediatrics. 2026 Feb 1;157(2):e2025073627. doi: 10.1542/peds.2025-073627.PMID: 41581784 Review.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Tech Tuesday episode, Ben sits down with Dr. Itamar Nitzan and Alon Meritrikin-Gold, the co-founders of SkinCubator, a revolutionary wearable incubator designed to transform neonatal skin-to-skin care. They discuss how reframing kangaroo care from a rare procedure to a continuous necessity inspired this paradigm-shifting device. The hosts dive into the clinical logistics, from safely transferring intubated extremely preterm infants to alleviating parental anxiety and nursing resistance. Tune in to hear how this innovative "pocket incubator" maintains thermoregulation, secures critical lines, and promises to safely extend skin-to-skin duration for our most vulnerable NICU patients!

Learn more about the skincubator: https://www.skincubator-neocare.com/

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this interview episode, Ben and Daphna sit down with Professor Brett Manley to discuss a paradigm shift in neonatal research: adaptive platform trials. Frustrated by the inefficiencies and underpowered results of traditional RCTs, Dr. Manley outlines the ambitious Platypus Adaptive Platform Trial launching in Australia and New Zealand. They dive into how shared primary outcomes, novel consent models, and massive cross-center collaboration can answer pressing clinical questions—like optimal PPROM antibiotics and caffeine dosing—simultaneously. Tune in for a fascinating conversation on moving beyond medical dogma, embracing humility, and keeping families at the center of NICU research!

Learn more about the Platipus trial here: https://www.platipustrial.org/

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This week on The Incubator Podcast, Ben and Daphna cover five topics spanning clinical practice, emerging technology, and neonatal policy. They open with a large Swedish national cohort study from JAMA Network Open examining early prophylactic hydrocortisone in extremely preterm infants, debating whether a blanket approach to BPD prevention holds up across gestational ages and in the presence of chorioamnionitis.They then take a critical look at predischarge car seat tolerance screening, questioning whether this decades-old AAP recommendation still earns its place in routine NICU discharge planning given its failure to reduce mortality or readmissions.

The conversation shifts to BPD-associated pulmonary hypertension, reviewing a PPHNet study that challenges whether current grading criteria and assessment timepoints adequately capture pulmonary vascular disease severity. They then explore oculomics — a compelling new frontier in which deep learning applied to routine ROP screening images can predict BPD and pulmonary hypertension weeks ahead of clinical diagnosis.

The week closes with a Neo News policy discussion on the regulatory pressures threatening freestanding birth centers nationwide, and the downstream consequences for maternal health equity, newborn screening, and neonatal advocacy.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Neo News segment, Ben and Eli tackle a pressing Stateline report on the paradoxical struggle of freestanding birth centers. While hospital labor and delivery units are closing nationwide, alternative birth centers are facing aggressive regulatory hurdles and forced closures in states like Alabama. The hosts discuss the downstream effects on maternal health equity, the rise of unregulated crisis pregnancy centers, and the clinical realities of out-of-hospital births like hyperbilirubinemia and missed newborn screens. Plus, they dive into the EMTALA implications for hospital transfers and highlight key takeaways on neonatal advocacy and teleneonatology from the recent Delphi Conference. Tune in for a critical policy discussion!

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https://stateline.org/2026/01/05/freestanding-birth-centers-are-closing-as-maternity-care-gaps-grow/

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna explore an exciting new frontier in neonatology: oculomics. Reviewing a recent paper from JAMA Ophthalmology, they discuss how deep learning models applied to routine ROP screening images can predict the development of BPD and pulmonary hypertension in preterm infants. By combining visual features extracted via neural networks with standard demographic data, researchers achieved impressive predictive accuracy weeks before clinical diagnosis is typically made. Tune in to hear how the eyes might just be the window to the neonatal pulmonary vasculature!

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Deep Learning-Based Prediction of Cardiopulmonary Disease in Retinal Images of Premature Infants. Singh P, Kumar S, Tyagi R, Young BK, Jordan BK, Scottoline B, Evers PD, Ostmo S, Coyner AS, Lin WC, Gupta A, Erdogmus D, Chan RVP, McCourt EA, Barry JS, McEvoy CT, Chiang MF, Campbell JP, Kalpathy-Cramer J.JAMA Ophthalmol. 2026 Jan 22:e255814. doi: 10.1001/jamaophthalmol.2025.5814. Online ahead of print.PMID: 41569552

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of Journal Club, Ben and Daphna review a pivotal paper from the Journal of Pediatrics led by the Pediatric Pulmonary Hypertension Network (PPHNet). The study explores invasive hemodynamic metrics and long-term outcomes in infants with BPD-associated pulmonary hypertension. Surprisingly, researchers found an almost equal distribution of pulmonary hypertension across mild, moderate, and severe BPD grades using the Jensen criteria. The hosts discuss the implications of these findings, questioning whether our traditional 36-week assessment timepoint is sufficient and if current grading criteria capture the true severity of pulmonary vascular disease in these vulnerable infants.

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Pulmonary Hemodynamics and Long-Term Outcomes in Children with Pulmonary Hypertension-Associated Bronchopulmonary Dysplasia. Austin ED, Mullen MP, Avitabile CM, Krishnan US, Rosenzweig EB, Keller RL, Kinsella JP, Yung D, Steffes L, Bates A, Elia EG, Romer LH, McGrath-Morrow S, Bernier ML, Mandl KD, Raj JU, Sleeper LA, Abman SH; Pediatric Pulmonary Hypertension Network (PPHNet) Investigators.J Pediatr. 2026 Feb;289:114869. doi: 10.1016/j.jpeds.2025.114869. Epub 2025 Oct 24.

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In this Journal Club episode, Ben and Daphna review a systematic review and meta-analysis from JAMA Network Open questioning the clinical value of predischarge car seat tolerance screening (CSTS). Driven by data suggesting that testing does not reduce 30-day mortality or hospital readmissions, they discuss the high failure rates, varying definitions of bradycardia and desaturation, and the unintended consequence of prolonged NICU stays. They also highlight the practical reality of CSTS in ensuring parents actually have an appropriate car seat at discharge. Tune in for a critical look at whether this 1991 AAP recommendation still holds up today!

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Predischarge Car Seat Tolerance Screening in Preterm and At-Risk Full-Term Infants: A Systematic Review and Meta-Analysis. King BC, Dalvie N, Hay S, Jensen EA, Zupancic JAF.JAMA Netw Open. 2026 Feb 2;9(2):e2558197. doi:0.1001/jamanetworkopen.2025.58197.

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In this Daily Journal Club episode, Ben and Daphna review a massive Swedish national cohort study from JAMA Network Open examining early prophylactic hydrocortisone in extremely preterm infants. They discuss the targeted regimens used, differences in gestational age outcomes, and whether a blanket prophylactic approach is truly effective for preventing BPD. With impressive data covering 98% of all NICU admissions in Sweden, the hosts debate the nuances of targeting 24 to 25-weekers versus older preemies and the potential confounding impact of chorioamnionitis. Tune in for your daily snack of evidence-based medicine and insights into optimizing NICU steroid protocols!

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Early Prophylactic Hydrocortisone and Bronchopulmonary Dysplasia-Free Survival in Extremely Preterm Infants. Smedbäck V, Björklund LJ, Flisberg A, Wróblewska J, Baud O, Wejryd E, Ådén U.JAMA Netw Open. 2026 Feb 2;9(2):e2560146. doi:10.1001/jamanetworkopen.2025.60146.

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Dr. Kelly Mahaney, Assistant Professor of Pediatric Neurosurgery at Stanford and researcher focused on the role of iron in post hemorrhagic hydrocephalus, joins the podcast to challenge the traditional watch and wait approach to IVH complications. She describes Stanford’s early radiographic intervention pathway, which has reduced shunt dependency from 90% to 45% in reservoir-placed infants, explains why waiting for clinical symptoms means waiting too long, and outlines her effort to build a statewide CPQCC nested network to standardize and study early intervention practices across California NICUs.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Sanjay Sinha, interventional pediatric cardiologist, Assistant Professor of Pediatrics at CHOC and UCI, and Co-Director of the UCLA Congenital Lymphatic Imaging and Intervention Program, opens a new chapter for neonatologists on neonatal chylothorax and lymphatic disease. He explains how to recognize lymphatic mimickers at the bedside, why woody edema should raise the index of suspicion, how MR lymphangiography is reshaping diagnosis and surgical planning, and how early targeted intervention is dramatically reducing NPO time and hospital length of stay in a population that was previously managed with a prolonged watch and wait approach.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Clara Song, neonatal intensivist with Southern California Permanente Medical Group, Chair of the AAP Section on Neonatal Perinatal Medicine Executive Committee, and founding leader of the Women in Neonatology group, shares the lessons from her Cool Topics talk on quiet power and soft skills in leadership. She explores how communication, emotional intelligence, and servant leadership drive team performance more than technical expertise, breaks down the four personality types every leader needs to understand, and offers a practical framework for structuring communication so every type of team member actually receives the message.

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Dr. Robin Steinhorn, Professor and Vice Dean for Children’s Clinical Services at UC San Diego and President of Children’s Specialists of San Diego, tackles one of neonatology’s most uncomfortable conversations: compensation. She breaks down how to identify reliable benchmark data, explains why neonatologists are generating more RVUs than ever while pay has not kept pace with workload complexity, addresses gender discrepancy trends in the literature, and offers practical strategies for individuals and division chiefs to use rigorous national data when advocating for fair compensation at the institutional level.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Susan Hintz, Medical Director of the Fetal and Pregnancy Health Program and Robert L. Hess Family Endowed Professor at Stanford Medicine, delivers this year’s Cool Topics keynote on collaboration, shared purpose, and the lessons learned building high risk infant follow-up infrastructure through the CPQCC. She challenges the neonatal community to move beyond the handoff to a pediatrician and think deliberately about true medical home design, including coordinated care teams, clearly defined roles across subspecialty and follow-up clinics, and better use of community based resources to support families long after NICU discharge. 

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Dr. Caitlin Carter, Clinical Director of Nephrology at Rady Children’s Hospital and associate clinical professor at UC San Diego, joins the podcast to challenge how neonatologists recognize and follow up on acute kidney injury. She explains why creatinine alone is insufficient, how biomarkers like NGAL can detect tubular injury before function declines, and why AKI too often disappears from the discharge summary. She also outlines published consensus guidelines on post NICU nephrology follow-up, with clear thresholds based on gestational age and AKI severity.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Tarah Colaizy, Professor of Neonatology at the University of Iowa Stead Family Children’s Hospital and Medical Director of the Mother’s Milk Bank of Iowa, challenges the one size fits all approach to nutrition in periviable infants. She shares the Iowa philosophy of individualized, principle driven feeding management, explains why rigid protocol adherence can backfire in the most immature babies, and walks through her unit’s glycerin protocol for meconium obstruction of prematurity. She also discusses the practical realities of frequent low volume lab monitoring and the importance of patience over speed in enteral feeding advancement.

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Dr. Satyan Lakshminrusimha, Chair of Pediatrics and Pediatrician in Chief at UC Davis Children’s Hospital, makes a compelling case for rebranding and restructuring neonatology as a field. He argues for adopting the title of neonatal critical care physician, addresses the stark disparity between NICU revenue generation and neonatologist compensation, and outlines a step by step resuscitation framework for the field, from restoring professional identity to establishing a dedicated neonatal residency pathway and ultimately recognizing neonatology as its own independent department.

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Dr. Elizabeth Crouch, neonatologist, neuroscientist, and physician scientist at UCSF and co-host of At the Bench on The Incubator Podcast, joins Ben and Daphna live at Cool Topics to discuss palliative and comfort care in the NICU. Drawing from her research on organ donation, autopsy, and research donation after neonatal loss, Dr. Crouch shares how meaning making supports families through grief, offers practical tips for approaching these conversations with compassion and good timing, and reflects on the role of chaplains, ethics consultants, and care pathways in supporting a death with dignity.

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Dr. Shmuel Zangen, Director of Neonatology at Barzilay Medical Center in Ashkelon, Israel, and former chair of the Israeli Neonatal Association, joins the podcast during his California sabbatical embedded with CPQCC. Having already led national QI collaborations targeting nosocomial infections and intraventricular hemorrhage across all 26 Israeli NICUs, he shares what he is learning about the culture, infrastructure, and methodology behind effective statewide quality improvement, and what he hopes to bring home as Israel transitions its neonatal database to the Ministry of Health.

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Dr. Jochen Profit, Chair and Principal Investigator at CPQCC and Wendy J. Tomlin-Hess Endowed Professor of Pediatrics at Stanford Medicine, joins the podcast to discuss what truly separates high performing NICUs from the rest. He makes the case for process metrics over mortality as quality markers, highlighting normothermia on admission, breast milk feeding at discharge, and infection rates as deceptively simple yet deeply revealing indicators of unit culture. The conversation also explores how toxic work environments and provider burnout silently undermine quality improvement efforts.

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Dr. Alexis Davis, Clinical Professor of Pediatrics at Stanford and Medical Director of the NephroNICU at Lucile Packard Children’s Hospital, makes the case that neonatology is entering a nephro era. She discusses how AKI prevention through initiatives like the BABY NINJA collaborative, fluid management strategies, and the emerging concept of the NephroNICU are reshaping how we think about kidney health in premature infants. She also addresses the complex ethical and practical considerations around dialysis and renal replacement therapy in newborns with congenital kidney failure.

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Ra’Niesha Bratton, MPH, CHES, CPQCC Family Advisory Council board member and public health advocate, and Joanne Tillman, CPQCC Family Engagement Coordinator, join the podcast to discuss what genuine family centered care looks like in practice. Drawing from lived NICU experience, Ra’Niesha shares how implicit bias and cultural incompetence harm families at their most vulnerable and how structured family advisory councils can drive systemic change. The conversation also tackles peer to peer support gaps, bereavement resources, and how to access the CPQCC NICU Family Advisory Council Toolkit.

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Silvia Bor, NICU mom to a 24 weeker and Family Advisory Council member for the CPQCC, makes the case for why family centered care must go beyond a philosophy and become a structured practice. She shares how involving parents in quality improvement initiatives, including the NEOBrain early skin to skin project, drives meaningful change at the bedside. She also outlines the CPQCC toolkit for building hospital level Family Advisory Councils and discusses how to identify the right parent advocates, including those whose NICU journeys ended in loss.

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Recorded live at the Cool Topics in Neonatology conference, this episode features Dr. Denise Suttner, Clinical Director of the Rady Children's Hospital NICU, professor of pediatrics at UC San Diego, and director of the San Diego Regional ECMO Program. Dr. Suttner discusses the California Perinatal Quality Care Collaborative (CPQCC) as a model for statewide neonatal quality improvement, the importance of family centered communication in the NICU, and the value of state level professional organizations in advancing advocacy for neonatal healthcare funding and pediatric subspecialty reimbursement.

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In this episode, we sit down with Dr. Jessica Shui, attending neonatologist at Mass General for Children, to explore the game-changing potential of Electrical Impedance Tomography (EIT) in the NICU. We dive into her recent paper in the Journal of Perinatology on using non-invasive EIT to identify optimal PEEP in infants with severe bronchopulmonary dysplasia. Dr. Shui explains how this real-time, radiation-free technology allows clinicians to visualize lung mechanics, dynamically titrate ventilator settings, and confidently reduce PEEP without risking atelectasis. Join us as we discuss moving beyond blind adjustments and stepping into the future of personalized neonatal respiratory care.

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The PDA debate has a new data point. TREOCAPA, a phase 3 multicenter European RCT, tested prophylactic acetaminophen in infants born at 23 to 28 weeks. The ductus closed more reliably. Whether that translated into better survival without severe morbidity at 36 weeks is where the conversation gets interesting.

Also this week: a large multicenter cohort study puts real numbers on diazoxide use across US NICUs and the pulmonary hypertension risk that has driven so much practice variation. The NeoDry trial tests whether drying very preterm infants before plastic wrapping improves normothermia at admission, with results that are a good reminder of why we run trials. And a retrospective from NYU raises the question of whether standard caffeine dosing in the most premature infants is leaving something on the table.

The episode closes with Ben and Eli on Florida’s infant formula heavy metal report and why publishing findings without methods may be as much a public health problem as the data itself.

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In this Neo News episode, Ben and Eli dive into the recent controversial announcement from the state of Florida regarding heavy metals and pesticides found in infant formulas. They discuss the implications of releasing testing data without transparent methodology or clinical context, especially for unregulated or recalled brands like ByHeart and Similac Soy Isomil. How should NICU clinicians counsel parents who want to bring their own formulas from home? Tune in as they unpack the regulatory loopholes, the evolving public health initiatives, and the ongoing challenge of navigating unverified reports in neonatal care!

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https://www.miamiherald.com/news/politics-government/article314266407.html

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In this episode of Journal Club, Ben and Daphna review a retrospective cohort study exploring the effects of higher caffeine maintenance dosing on BPD and neurodevelopmental outcomes. They discuss the transition from the standard CAP trial doses to higher regimens for infants born at or before 28 weeks gestation. Does an average daily dose of over six milligrams per kilogram reduce severe BPD or improve Bayley cognitive scores at six months? Tune in as they debate the safety, clinical implications, and their own unit's practices regarding caffeine management in the NICU!

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Effects of higher caffeine dosing on rates of bronchopulmonary dysplasia and neurodevelopmental outcomes. Fleishaker S, Kazmi SH, Mavrogiannis N, Street H, Ravuri H, Moinuddin T, Pierce K, Verma S.J Perinatol. 2026 Feb 23. doi: 10.1038/s41372-026-02593-1. Online ahead of print.PMID: 41731043

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In this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies!

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Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902.

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In this Journal Club episode, Ben and Daphna review a large cohort study from the Journal of Perinatology on the prevalence and safety of diazoxide in the NICU. With neonatal hypoglycemia seemingly on the rise, they discuss off-label use for transient hyperinsulinism and evaluate real-world data from over 340 Pediatrix units. They dive into the rates of concurrent diuretic therapy, respiratory support, and the dreaded risk of pulmonary hypertension. Tune in for a clinical breakdown of when and how this medication is being utilized across centers, plus Ben's echocardiography struggles with cranky term babies on diazoxide!

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Prevalence and safety of diazoxide in the neonatal intensive care unit. Collins LC, Daniel KB, Tolia VN, Parikh P, Gray KD, Greenberg RG.J Perinatol. 2026 Feb 3. doi: 10.1038/s41372-026-02568-2. Online ahead of print.PMID: 41634357

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In this Journal Club episode, Ben and Daphna review the highly anticipated TREOCAPA trial results exploring the prophylactic use of acetaminophen for PDA closure in extremely preterm infants. They break down the study's tailored dosing regimens, safety outcomes like cholestasis, and discuss why achieving a higher rate of early ductal closure didn't necessarily translate to improved survival without severe morbidity. Plus, they share a nod to recent Neo Conference interviews and the realities of conducting clinical research in private practice. Tune in for a nuanced discussion on individualizing PDA management in the NICU!

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Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. Rozé JC, Cambonie G, Flamant C, Patkaï J, Mühlbacher T, Gascoin G, Rideau Batista Novais A, Tauzin M, Le Duc K, Beuchée A, Joye S, Babacheva E, Bouissou A, Ligi I, Tammela O, Plourde M, Dempsey E, Tosello B, Nguyen K, Vincent M, Andresson P, Binder C, Kruse C, Barcos Munoz F, Kuhn P, Proença E, Bartocci M, Kermorvant-Duchemin E, Nellis G, Lumia M, Giapros V, Rigo V, Sankilampi U, Mendes da Graça A, Rønnestad A, Soukka H, Mondì V, Aikio O, Torre-Monmany N, Rüegger C, Baud O, Zeitlin J, Morgan AS, Baruteau AE, Ancel PY, Carbajal R, Bouazza N, Diallo A, Levoyer L, Kemper R, Hallman M, Alberti C, Ursino M; TREOCAPA Study Group.JAMA Pediatr. 2026 Feb 16:e256150. doi: 10.1001/jamapediatrics.2025.6150. Online ahead of print.PMID: 41697673

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Live from the NEO Conference in Las Vegas, Ben and Daphna sit down with Dr. Tarek Nakhla to discuss his new book, Saving Babies Behind the Doors of the Neonatal Intensive Care Unit. Moving beyond standard medical textbooks, Dr. Nakhla shares how chronicling nearly 30 years of challenging patient encounters and complex family dynamics can serve as an essential guide for new trainees. The conversation highlights the therapeutic power of narrative medicine for clinicians and the profound impact of non-clinical staff on the family experience. Discover why capturing the human side of neonatology is just as critical as the clinical science.

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How can a database tracking 20% of all US NICU admissions change the way we practice neonatology? Live from the NEO Conference, Ben and Daphna sit down with Dr. Veeral Tolia to discuss his groundbreaking work with the Pediatrix Clinical Data Warehouse. Dr. Tolia dives into the power of leveraging decades of observational data to supplement randomized trials—from analyzing the 50-fold increase in Precedex usage to studying natural experiments like the vitamin A shortage. The group also looks ahead to the Newborn Express dataset, exploring how socioeconomic metrics like the Child Opportunity Index might help us understand the alarming rise in neonatal vitamin K refusals.

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How will artificial intelligence fundamentally change the way we chart, teach, and monitor patients in the NICU? Live from the NEO Conference, Ben and Daphna sit down with Dr. James Barry to explore the critical need for "AI literacy" among bedside clinicians. Dr. Barry draws parallels between driver's education and safe AI use, highlighting the hidden dangers of automation complacency with AI scribes. They also discuss the exciting potential of computer vision in respiratory monitoring and how the CONCERN early warning system is quantifying nursing intuition. Join us as we navigate the guardrails of neonatology's technological future.

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Can groundbreaking neonatal research thrive outside of academic medicine? Live from the NEO Conference, Ben and Daphna sit down with Dr. Kaashif Ahmad, Vice President of Research at Pediatrix. Dr. Ahmad shatters the myth that community NICUs can't drive clinical science, discussing how everyday documentation in systems like Baby Steps quietly fuels hundreds of publications. He also unveils "The Parent Network," a revolutionary initiative designed to partner with family-led organizations from day one to establish comparative effectiveness trial priorities. Tune in to discover how private practice clinicians are successfully balancing bedside care with robust, meaningful research.

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How does individualized medicine shape both patient trust and neonatal careers? Live from the NEO Conference, Ben and Daphna catch up with Dr. Zubin Shah, Clinical Ambassador for Pediatrix. The team explores the power of tailoring bedside conversations to individual babies—whether discussing targeted hemodynamics or framing RSV prevention with nirsevimab—rather than relying solely on generalized trial data. Dr. Shah also sheds light on the evolving landscape of neonatal recruitment, emphasizing how peer mentorship and direct networking can help new physicians find practices that balance rigorous clinical care with research and quality improvement.

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When parents fundamentally disagree on life-saving interventions in the delivery room, how do clinical teams decide the next step? Live from the NEO Conference, Ben and Daphna sit down with Dr. Mark Mercurio, Executive Director of the new Center for Pediatric Bioethics at Boston Children’s Hospital. Dr. Mercurio dissects a highly complex ethical case regarding parental disagreement over resuscitation at the border of viability. Emphasizing the distinction between parental "preference" and parental "judgment," he explores the necessity of clinical humility, the hidden margins of error in gestational age dating, and how admitting our own medical uncertainty is the first step toward honest family counseling.

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Join Ben and Daphna live from the NEO Conference as they welcome the 2026 Legends in Neonatology Award recipient, Dr. Waldemar "Wally" Carlo. In this inspiring conversation, Dr. Carlo discusses the driving forces behind his enduring passion for clinical care and the critical need for robust bedside research. They explore how full-time clinicians can actively shape the research agenda by turning everyday diagnostic uncertainties into innovative trials. Dr. Carlo also offers a preview of his highly anticipated lecture on neonatal oxygen targets, revealing why it remains one of the most rigorously studied—yet complex—areas in modern medicine.

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Does our fear of necrotizing enterocolitis do more harm than good? In this live episode from the Neo conference, Ben and Daphna sit down with Dr. Ariel Salas to challenge the "culture of fear" surrounding neonatal nutrition. Dr. Salas argues that while we obsess over ill-defined NEC risks, we may be sacrificing the proven benefits of early feeding on sepsis reduction. From the emotional weight of "wasted" breast milk to the "illusion of control" provided by strict protocols, this conversation urges neonatologists to move toward a family-centered, evidence-based approach that prioritizes human milk over clinical hesitation.

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Live from the Neo Conference in Las Vegas, Ben and Daphna sit down with Dr. Zach Anderson from Winnie Palmer Hospital to demystify the integration of Point of Care Ultrasound (POCUS) in the NICU. Moving beyond the intimidation of complex cardiac scans, Zach explains why starting with "pinch points" like vascular access or bladder volume can revolutionize bedside decision-making. From the SAFER protocol to managing the agitated infant on ECMO, this episode explores how POCUS serves as a powerful problem-solving tool that bridges the gap between clinical mystery and immediate intervention.

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In this live episode from the Neo Conference in Las Vegas, we welcome back Dr. Souvik Mitra to unpack the evolving landscape of PDA management in extremely preterm infants. We dive into the recent AAP guidelines recommending against early medical treatment and explore potential unintended consequences, including rising transcatheter closure rates and delayed intervention. Dr. Mitra shares his institution's approach using the SMART-PDA criteria, highlighting the importance of treatment timing and proper patient selection. Join us for a nuanced discussion balancing large pragmatic trial data with bedside clinical judgment for our most vulnerable babies.

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In this live episode from the Neo Conference in Las Vegas, we welcome back Dr. Souvik Mitra to unpack the evolving landscape of PDA management in extremely preterm infants. We dive into the recent AAP guidelines recommending against early medical treatment and explore potential unintended consequences, including rising transcatheter closure rates and delayed intervention. Dr. Mitra shares his institution's approach using the SMART-PDA criteria, highlighting the importance of treatment timing and proper patient selection. Join us for a nuanced discussion balancing large pragmatic trial data with bedside clinical judgment for our most vulnerable babies.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this week’s journal club episodes, we review several interesting and important studies in neonatal medicine. Ben and Daphna start with a provocative echocardiography study out of Edmonton showing that standard chest compressions in newborns likely target the right heart and great vessels, not the left ventricle. A small sample size, but a finding that anyone who ultrasounds hearts all day will instantly recognize.

Daphna presents a retrospective multicenter study from Nationwide Children’s on antibiotic duration for Gram-negative bloodstream infections in the NICU. Short course (≤8 days) showed no treatment failures, while 14% of infants in the long duration group developed a multi-drug resistant organism infection. Eight days versus ten: does the difference matter? The data says yes.

Ben reviews a randomized controlled trial from UAB on early vitamin D supplementation in extremely preterm infants fed human milk. Eight hundred units daily for the first two weeks appears safe and effective at achieving vitamin D sufficiency, but did it move the needle on BPD? And is that even the right question to ask?

Daphna brings a QI paper from Levine Children’s on universal social determinants of health screening across nine pediatric divisions, achieving 92% compliance and connecting thousands of families to resources through findhelp.org. A reminder that the tools are already there – we just have to use them.

The episode wraps with Ben, Daphna, and Eli discussing Colorado’s landmark paid NICU leave law – the first in the nation to require employers to provide up to 12 weeks of paid leave for parents with a baby in the NICU. What does the evidence say, and how do we advocate for this in our own states?
 Science, equity, and advocacy – all in one episode.

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In this episode of Neo News, we break down Colorado’s groundbreaking legislation mandating 12 weeks of paid leave for NICU parents—a potential blueprint for national change. We explore the critical intersection of policy, economics, and infant health, discussing why supporting families at the bedside isn't just morally right but economically smart. We also highlight new research from economists like Maya Rossin-Slater and Mariam Khan linking paid leave to reduced neonatal mortality. Plus, find out how you can turn these policy shifts into advocacy tools for your own state. Join us for a concise, high-impact update on the future of NICU care.

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Boese, L. (2024, December 18).Why Colorado’s paid NICU leave law could spark nationwide trend. HR Executive. **https://hrexecutive.com/why-colorados-paid-nicu-leave-law-could-spark-nationwide-trend/**

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Ben and Daphna conclude Journal Club with a quality improvement study from Pediatrics titled "Improving Health-Related Social Needs Screening and Support Across a Pediatric Health Care System". The hosts discuss the successful implementation of universal social determinants of health (SDOH) screening across nine pediatric divisions at Levine Children's. They highlight the impressive results—screening compliance reaching 92%—and the practical impact of connecting families to resources like FindHelp.org, which led to a 56% resolution rate in food insecurity for positive screens. Daphna makes a personal commitment to improve resource accessibility in her own unit.

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Improving Health-Related Social Needs Screening and Support Across a Pediatric Health Care System. Laroia R, Minor W, Carr A, Buitrago Mogollon T, White BB, Mabus S, Stilwell L, Ahmed A, Mehta S, Obita T, Reed S, Senturias Y, Mittal S, Horstmann S, Demmer L, Dantuluri K, Chadha A, Noonan L, Courtlandt C.Pediatrics. 2026 Feb 5:e2024070035. doi: 10.1542/peds.2024-070035. Online ahead of print.PMID: 41638605

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Ben and Daphna review a randomized controlled trial published in The Journal of Pediatrics by Dr. Ariel Salas and colleagues at UAB. The study investigates whether early high-dose vitamin D supplementation (800 IU/day starting day 1) in extremely preterm infants reduces the incidence of Bronchopulmonary Dysplasia (BPD) compared to standard care (starting day 14). The hosts discuss the physiologic rationale linking vitamin D to lung development, the use of impulse oscillometry to measure lung mechanics, and the secondary findings regarding metabolic bone disease. They explore why the "physiologic rationale" doesn't always translate to clinical significance.

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Early Vitamin D Supplementation in Infants Born Extremely Preterm and Fed Human Milk: A Randomized Controlled Trial. Salas AA, Argent T, Jeffcoat S, Tucker M, Ashraf AP, Travers CP.J Pediatr. 2025 Dec;287:114754. doi: 10.1016/j.jpeds.2025.114754. Epub 2025 Jul 24.PMID: 40714046 Clinical Trial.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of Journal Club, Ben and Daphna review a retrospective cohort study from Pediatrics examining antibiotic duration for uncomplicated Gram-negative bloodstream infections in the NICU. The study, a collaboration between Nationwide Children’s Hospital and UT Health San Antonio, compares outcomes between short course (≤8 days) and long course (≥9 days) therapy. The hosts discuss the startling finding that while recurrence rates were similar, the long-duration group had a 14% rate of developing multi-drug resistant (MDR) infections within 90 days, compared to 0% in the short-duration group.

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Duration of Antibiotic Therapy for Gram-Negative Bloodstream Infections in the Neonatal Intensive Care Unit. Djordjevich CJ, Magers J, Cantey JB, Prusakov P, Sánchez PJ.J Pediatr. 2026 Jan 17:114993. doi: 10.1016/j.jpeds.2026.114993. Online ahead of print.PMID: 41554433 Free article.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of Journal Club, Ben and Daphna review a thought-provoking study from the Archives of Disease in Childhood titled "Chest Compression in Newborn Infants: What Anatomical Structures Are We Compressing?". The hosts explore the anatomical findings suggesting that current neonatal CPR guidelines—recommending compressions over the lower third of the sternum—may actually be targeting the right ventricle and great veins rather than the left ventricle. They discuss the implications for the "cardiac pump" vs. "thoracic pump" theories and what this means for the future of resuscitation guidelines.

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Chest compression in newborn infants: what anatomical structures are we compressing? Chua CT, O'Reilly M, Surak A, Schmölzer GM.Arch Dis Child Fetal Neonatal Ed. 2026 Jan 16:fetalneonatal-2025-329582. doi: 10.1136/archdischild-2025-329582. Online ahead of print.PMID: 41545184

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dr. Sheri Fink, Pulitzer Prize-winning correspondent for The New York Times and author of Five Days at Memorial, joins us for a compelling discussion on the ethics of survival. Dr. Fink, an MD-PhD, discusses her recent article "Noah is Still Here," which chronicles one family's journey with Trisomy 18—a condition once universally deemed incompatible with life. She and Eli explore the shifting paradigms of care, the tension between medical prognosis and parental hope, and the "two truths" clinicians must hold when counseling families in the grey zone. A must-listen for anyone navigating complex bioethics in the NICU.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this premiere episode of On with Von, The Incubator launches an exciting new collaboration with the Vermont Oxford Network (VON). Hosts Dr. Ben Courchia and Dr. Daphna Yasova Barbeau sit down with Dr. Roger Soll, President of VON, and Dr. Bob White, a pioneer in NICU design, to explore the critical "Evidence to Practice" gap in the NICU environment. Moving beyond simple neuroprotection, the conversation dives into neuropromotion, examining the impact of light, sound, and sensory inputs on the developing brain. From debunking misconceptions about retinopathy to optimizing design for family integration, this discussion offers actionable insights for every bedside clinician.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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How much oxygen is enough when resuscitating extremely preterm infants? This week on The Incubator Podcast, Ben and Daphna explore the TORPIDO 30/60 trial comparing 60% versus 30% FiO2 at birth. While primary outcomes were similar, babies in the 60% group needed fewer chest compressions and less epinephrine—a signal worth discussing.

They examine an Indian non-inferiority study on surfactant thresholds (40% vs 30% FiO2), where waiting until 40% meant significantly fewer intubations and shorter respiratory support for the youngest babies. Ben presents compelling Melbourne data showing growth-restricted preterm infants face six-fold higher NEC risk—even with identical feeding protocols—and discusses how critical birth history gets "lost" as babies grow.

Daphna tackles therapeutic hypothermia in late preterm infants, reviewing Toronto's retrospective analysis showing 34-35 weekers experience higher mortality and more brain injury compared to 36-37 weekers. As units rewrite cooling protocols, are we moving too fast on limited evidence?

The episode concludes with Ben, Daphna, and Eli discussing the repeal of "sensitive locations" protections for immigration enforcement. Through the story of a mother detained while visiting her NICU baby in Chicago, they explore how these policies impact family-centered care and highlight advocacy opportunities through the Protecting Sensitive Locations Act.

Current research meets real-world NICU challenges—all in one episode.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of Neo News, the team examines the intersection of immigration policy and neonatal care. We review a recent op-ed discussing the "chilling effect" of immigration enforcement on families seeking care in "sensitive locations" like hospitals. The discussion highlights a harrowing report from The 19th about a family detained by ICE while en route to the NICU, sparking a conversation on how fear impacts parental presence and follow-up adherence. The hosts explore the Protecting Sensitive Locations Act and the critical role neonatologists play in advocating for safe access to healthcare for all families.

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Vernon, L., Swenson, S., & Miller, E. (2025, October). Immigration policies are creating impossible choices for NICU families. Cleveland.com.  https://www.cleveland.com/opinion/2025/10/immigration-policies-are-creating-impossible-choices-for-nicu-families-lelis-vernon-sarah-swenson-and-emily-miller.html

Barclay, M. L. (2025, December). Postpartum immigrant detention by ICE. The 19th. https://19thnews.org/2025/12/postpartum-immigrant-detention-ice/

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this segment, Ben and Daphna review a retrospective study from the Hospital for Sick Children comparing outcomes of therapeutic hypothermia in late preterm (34-35 weeks) versus early term (36-37 weeks) infants. They discuss the significantly higher rates of mortality, hemodynamic instability, and hypoglycemia found in the younger cohort, known as "Group 1". The hosts explore the implications of using MRI scoring systems like the Weeke score for preterm brains and debate the ethical challenges of conducting future randomized trials as clinical practice shifts away from cooling younger babies based on emerging retrospective data.

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Whole-body hypothermia in late preterm and early term infants: a retrospective analysis from a neurocritical care unit. Martinez A, Cikman G, Al Kalaf H, Wilson D, Banh B, Abdelmageed W, Beamonte Arango I, Christensen R, Branson HM, Cizmeci MN.Pediatr Res. 2026 Jan 7. doi: 10.1038/s41390-025-04701-x. Online ahead of print.PMID: 41501407

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of Journal Club, Ben and Daphna review a prospective cohort study from the Journal of Perinatology that examines the care of neonates following in-utero growth restriction. The hosts unpack the critical distinction between Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA), highlighting how the "decay of information" in the NICU can lead clinicians to overlook early risk factors as babies grow. They discuss the study’s alarming findings regarding the six-fold increased risk of Necrotizing Enterocolitis (NEC) in SGA infants and the importance of maintaining a comprehensive medical history throughout a patient's stay.

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Care of neonates following in-utero growth restriction: A prospective cohort study exploring neonatal morbidity. Alda MG, Wood AG, MacDonald T, Charlton JK.J Perinatol. 2025 Sep;45(9):1219-1225. doi: 10.1038/s41372-025-02397-9. Epub 2025 Aug 21.PMID: 40841433 Free PMC article.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of Journal Club, Ben and Daphna review a non-inferiority trial from the European Journal of Pediatrics exploring surfactant administration thresholds in preterm neonates. The study, conducted in India, compares a 30% versus 40% FiO2 threshold for babies 26-32 weeks gestational age. The hosts break down the counterintuitive findings regarding respiratory support duration in younger subgroups and discuss the broader implications of using rigid FiO2 heuristics versus individualized patient assessment. They also debate how resource availability influences clinical protocols and the potential benefits of "LISA" (Less Invasive Surfactant Administration) for avoiding intubation.

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Higher (40%) versus lower (30%) FiO2 threshold for surfactant administration in preterm neonates between 26 and 32 weeks of gestational age: a non-inferiority randomized controlled trial. Haq MI, Datta V, Bandyopadhyay T, Nangia S, Anand P, Murukesan VM.Eur J Pediatr. 2025 Nov 25;184(12):793. doi: 10.1007/s00431-025-06628-1.PMID: 41288797 Clinical Trial.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of The Incubator, Ben and Daphna return from the Delphi Conference to dive back into Journal Club. They review the highly anticipated TORPIDO 30/60 trial published in JAMA, comparing initial oxygen concentrations of 30% versus 60% for preterm resuscitation. The hosts discuss the primary outcomes of survival and brain injury, while highlighting intriguing secondary findings regarding chest compressions and epinephrine use in the delivery room. They also share exciting updates on the Vermont Oxford Network collaboration and a new family study from the GFCNI.

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Targeted Oxygen for Initial Resuscitation of Preterm Infants: The TORPIDO 30/60 Randomized Clinical Trial. Oei JL, Kirby A, Travadi J, Davis P, Wright I, Ghadge A, Yeung C, Cruz M, Keech A, Hague W, Lui K, Vento M, Gordon A, De Waal K, Chaudhari T, Hong TSL, Morris S, Kushnir A, Bonney D, Tracy M, Kumar K, Chhnia AS, Baral VR, Muniyappa P, Cheah FC, Sarnadgouda P, Rajadurai VS, Balakrishnan U, Oleti TP, Aldecoa-Bilbao V, Couce ML, Collados CT, Fernández RE, Moliner E, Ruiz Gonzalez MD, Singhal M, Agrawal G, Singh J, Pal S, Nayya S, Arora R, Amboiram P, Simes J, Tarnow-Mordi W; TORPIDO30/60 Collaborative Group.JAMA. 2025 Dec 10:e2523327. doi: 10.1001/jama.2025.23327. Online ahead of print.PMID: 41369162

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This recording captures the AI panel discussion from the 2026 Delphi Neonatal Innovation Conference, held live on Monday afternoon. Dr. Jim Barry (University of Colorado), Dr. Thao Ho (UCSF), Lindsey Knake (University of Iowa), Selva Selvaraj (Nicklaus Children's Health System), and Dr. Ryan McAdams (University of Wisconsin-Madison) discuss where AI stands in the NICU today.

The panelists cover predictive models for sepsis and NEC, AI documentation tools, and the gap between research prototypes and clinical implementation. They address challenges with generalizability across different units, ethical considerations, parent-facing AI applications, and what might be standard practice in ten years. If you're trying to figure out what's actually working versus what's still theoretical, this conversation covers the current state of play.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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What if the smallest patients finally had a diaper designed just for them? For years, NICUs have struggled to find appropriately sized diapers for extremely premature infants, often resorting to makeshift solutions that compromised skin integrity and care quality. That changes now. In this breaking news episode, Ben sits down with Harry McCusker, Director of Research and Development for North America Pampers Diapers, to discuss the groundbreaking launch of the Pxxs diaper—the world's smallest commercially available diaper, specifically engineered for micropreemies born as early as 21-23 weeks gestation. Weighing less than a nickel and designed with input from NICU professionals worldwide, the Pxxs addresses critical challenges in skin protection, fluid management, and developmental care for our most vulnerable patients. Join us as we explore how this innovation represents more than just a smaller diaper—it's Pampers' commitment that every preemie deserves products designed with their unique needs in mind.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

Could a simple blood test help identify chronic pulmonary hypertension when echo access is limited? This week on The Incubator Podcast, Ben and Daphna explore this question and others relevant to daily NICU practice. A Toronto study examines NT-proBNP as a practical diagnostic tool in extremely preterm infants.

They also examine a puzzling finding from Italy and Belgium: despite near-universal antibiotic use in neonates with HIE undergoing cooling, actual culture-positive sepsis rates are surprisingly low. What does this mean for our approach to empiric antibiotics?

Ben presents Norwegian data showing that serial physical exams cut antibiotic exposure in half for term and late preterm infants—without compromising safety. Daphna follows with research connecting NICU capacity strain to patient outcomes, underscoring why adequate staffing isn’t just about comfort, but about survival.

The episode concludes with Ben, Daphna, and Eli discussing the recent CDC changes to Hepatitis B birth dose recommendations. With federal guidance now diverging from AAP recommendations, how do we navigate conversations with families? They explore transmission risks parents may overlook and share approaches to shared decision-making when expert opinions conflict. 

A full week of neonatal medicine research and real-world clinical challenges, all in one episode

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

This week on Neo News, we tackle the recent and controversial divergence between CDC and AAP guidelines regarding the birth dose of the Hepatitis B vaccine. With the CDC now recommending a deferred schedule for infants of Hepatitis B-negative mothers, we explore the clinical implications, the risks of vertical transmission, and the challenge of navigating discordant public health advice. We discuss how to handle shared decision-making in an era of waning vaccine confidence and why the "birth dose" remains a critical safety net in a community setting. Join us as we break down the data behind the headlines.

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American Academy of Pediatrics. (2025, December 15). AAP: CDC decision on universal birth dose of hepatitis B vaccine irresponsible and purposely misleading. AAP News. https://publications.aap.org/aapnews/news/33980/AAP-CDC-decision-on-universal-birth-dose-of?searchresult=1?autologincheck=redirected

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of Journal Club, Ben and Daphna review a retrospective cohort study from the Journal of Perinatology examining the association between NICU capacity strain and neonatal outcomes. We discuss how high census and acuity on admission day correlate with increased mortality and morbidity when adjusted for hospital and patient factors. Join us as we explore why being "slammed with admissions" is more than just a badge of honor—it’s a critical safety metric for our patients.

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The association of NICU capacity strain with neonatal mortality and morbidity. Salazar EG, Passarella M, Formanowski B, Rogowski J, Edwards EM, Halpern SD, Phibbs C, Lorch SA.J Perinatol. 2025 Dec;45(12):1801-1808. doi: 10.1038/s41372-025-02449-0. Epub 2025 Oct 20.PMID: 41116036 Free PMC article.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of The Incubator Podcast, Ben and Daphna review a pivotal population-based study from Norway examining a new approach to Early-Onset Sepsis (EOS). The hosts discuss whether serial physical examinations can safely replace routine antibiotic prophylaxis in at-risk term and late-preterm infants. With antibiotic exposure often far exceeding sepsis incidence, this study offers compelling data for a "less is more" strategy. Tune in as Ben and Daphna explore the safety, efficacy, and bedside implications of substituting automatic treatment with structured clinical monitoring—and what this means for reducing unnecessary interventions in the NICU.

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Serial physical examination to reduce unnecessary antibiotic exposure in newborn infants: a population-based study. Vatne A, Eriksen BHH, Bergqvist F, Fagerli I, Guthe HJT, Iversen KV, Ud Din FS, van der Weijde J, Kvaløy JT, Rettedal S.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 19:fetalneonatal-2025-329639. doi: 10.1136/archdischild-2025-329639. Online ahead of print.PMID: 41260908

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of Journal Club, Ben and Daphna dive into a multicenter retrospective study from the European Journal of Pediatrics questioning the necessity of universal empiric antibiotics in neonates undergoing therapeutic hypothermia for HIE. Comparing Italian and Belgian cohorts, the team discusses the reality of a 111 Number Needed to Treat (NNT) for a single case of culture-proven sepsis. From the diagnostic challenges of overlapping clinical markers to the fascinating "asymptote" of postnatal leukocyte trends, we explore whether it's time to shift from routine to selective antibiotic use in our most complex patients.

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Antibiotic use in neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia: time to rethink universal empirical treatment. De Rose DU, Piersigilli F, Auriti C, Campi F, Cortazzo V, Samaey A, Carkeek K, Martini L, Maddaloni C, Santisi A, Ronci S, Iacona G, Bersani I, Savarese I, Danhaive O, Cilio MR, Bernaschi P, Dotta A, Ronchetti MP.Eur J Pediatr. 2025 Nov 22;184(12):781. doi: 10.1007/s00431-025-06652-1.PMID: 41275063

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this Journal Club episode of the Incubator Podcast, Ben Courchia and Daphna Yasova-Barbeau review a study from the Journal of Perinatology evaluating NT-proBNP as a diagnostic tool for chronic pulmonary hypertension in extremely preterm infants. The discussion walks through the clinical burden of pulmonary hypertension in babies with bronchopulmonary dysplasia, the limitations of echocardiography, and the appeal of accessible biomarkers. Using data from a SickKids Toronto cohort, the hosts unpack sensitivity, specificity, cutoff values, and real-world applicability, while exploring how NT-proBNP could support screening, risk stratification, and bedside decision-making in everyday NICU practice.

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Can N-terminal pro-brain natriuretic peptide accurately diagnose chronic pulmonary hypertension among extremely low gestational age neonates: A Retrospective Cohort Study. Garcia-Gozalo M, Jain A, Weisz DE, Jasani B.J Perinatol. 2025 Nov 13. doi: 10.1038/s41372-025-02462-3. Online ahead of print.PMID: 41233504

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

This week on The Incubator Podcast, Ben and Daphna review several recent studies in neonatal care. They start with a JAMA trial comparing expectant versus active PDA management in preterm infants, noting a survival signal favoring expectant care and discussing how this fits within current practice. They then review outcomes of 21-week gestation infants from the University of Iowa, focusing on resuscitation strategies and survival at the limits of viability.

The conversation continues with the ICAF trial, examining whether extending caffeine therapy through 41 weeks postmenstrual age meaningfully reduces intermittent hypoxia and for which infants this may matter. A large national cohort study on antenatal corticosteroids between 21 and 24 weeks gestation is also discussed, highlighting practice variation and implications for counseling.

The episode closes with a Neo News segment on legal liability in the NICU following a recent $32 million NEC settlement. Ben, Daphna, and Eli consider informed consent around nutritional care and how evolving legal pressures may influence communication and clinical decision making.

This compilation brings together research and policy discussions from the week in a single long-form episode.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this episode of Neo News, Ben, Daphna, and Eli tackle the complex and emotionally charged landscape of legal liability in the NICU. Following a recent $32 million settlement involving necrotizing enterocolitis (NEC) and cow's milk-based formula, the team debates the future of informed consent for routine nutritional care. They explore how legal precedents may force neonatologists to replace bedside counseling with transactional forms, potentially eroding trust and complicating evidence-based practice. Join us as we discuss how to balance transparency, parental autonomy, and the reality of risk in the pursuit of better outcomes for our tiniest patients.

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WTNH News 8. (2025, December 15). Parents, attorneys emphasizing importance of informed consent to NICUs following baby’s death at Yale New Haven Hospital. WTNH. https://www.wtnh.com/news/connecticut/new-haven/parents-attorneys-emphasizing-importance-of-informed-consent-to-nicus-following-babys-death-at-yale-new-haven-hospital/

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this Journal Club episode, Ben and Daphna review a large national cohort study examining the association between antenatal corticosteroid exposure and survival in extremely preterm infants born between 21 and 24 weeks’ gestation. They discuss biologic plausibility, practice variation, and the challenges of interpreting retrospective data, while focusing on how these findings may inform counseling and shared decision-making at the margins of viability.

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The Effects of Antenatal Corticosteroids on Extremely Premature Neonates Born between 21 and 24 Weeks. Yao R, Tritch N, Vedhanayagam K, Ali N, Reimche-Vu H, Gedestad I, Karageuzian S, Contag S.Am J Perinatol. 2025 Nov 6. doi: 10.1055/a-2722-8107. Online ahead of print. PMID: 41086871

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

Ben and Daphna review the ICAF randomized clinical trial evaluating extended caffeine therapy in preterm infants and its impact on intermittent hypoxia through 41 weeks postmenstrual age. They discuss the study design, oximetry outcomes across multiple saturation thresholds, inflammatory biomarkers including TNF-α, and clinically relevant safety signals such as oxygen restart rates, length of stay, and weight gain. The conversation focuses on what intermittent hypoxia may mean for ongoing risk, and whether a targeted subgroup of infants might benefit from extending caffeine beyond traditional stopping points.

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Intermittent hypoxia and caffeine in infants born preterm: the ICAF Randomized Clinical Trial. Eichenwald E, Corwin M, McEntire B, Knoblach S, Limperopoulos C, Kapse K, Kerr S, Heeren TC, Ikponmwonba C, Hunt CE; ICAF Study Group.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 24:fetalneonatal-2025-329230. doi: 10.1136/archdischild-2025-329230. Online ahead of print.PMID: 41285561

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this Journal Club episode, Ben and Daphna review a salient study from JAMA Network Open examining outcomes of infants born at 21 weeks’ gestation at the University of Iowa. They walk through resuscitation practices, early physiologic challenges, survival trends, and short-term developmental outcomes, while placing the data in the broader context of shifting limits of viability. The discussion highlights both cautious optimism and the many unanswered questions that remain as neonatology continues to push the boundaries of what is possible.

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Outcomes of Infants Born at 21 Weeks' Gestational Age. Hyland RM, Mat HD, Boly TJ, Thomas BJ, Stanford AH, Harmon HM, Bermick JR, Davila RC, Colaizy TT, Dagle JM, Klein JM, Greiner AL, Bell EF, McNamara PJ; University of Iowa Neonatology Program.JAMA Netw Open. 2025 Dec 1;8(12):e2548211. doi:10.1001/jamanetworkopen.2025.48211.PMID: 41385227 Free PMC article.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

Enjoy!

In this Journal Club episode, Ben and Daphna review a major randomized clinical trial published in JAMA comparing expectant management with active pharmacologic treatment of patent ductus arteriosus in preterm infants. They walk through the trial design, inclusion criteria, and outcomes, highlighting the unexpected survival difference favoring expectant management despite similar rates of bronchopulmonary dysplasia. The discussion explores the implications for bedside decision-making, the limitations of PDA-focused strategies, and the need for a more physiologic, patient-centered approach to ductal management in extremely preterm infants.

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Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants: The PDA Randomized Clinical Trial. Laughon MM, Thomas SM, Watterberg KL, Kennedy KA, Keszler M, Ambalavanan N, Davis AS, Slaughter JL, Guillet R, Colaizy TT, Cotten CM, Dhawan MA, Bose CL, Talbert J, Smucny S, Benitz WE, Rysavy MA, Ohls RK, Baserga MC, DeMauro SB, Jaleel M, Jackson WM, Carlo WA, Puopolo KM, Hibbs AM, Katheria A, Sánchez PJ, D'Angio CT, Patel RM, Johnson BA, Chock VY, Bhatt AJ, Merhar SL, Moore R, Laptook AR, Ghavam S, Fuller J, Vyas-Read S, Kicklighter SD, Steinbrekera B, Anderson K, Reynolds AM, Wyckoff MH, Montoya C, Das A, Do B, Chang S, Higgins RD, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA. 2025 Dec 9:e2523330. doi: 10.1001/jama.2025.23330. Online ahead of print.PMID: 41364689

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As 2025 comes to a close, Ben and Daphna reflect on a year of growth, community, and evolution for The Incubator Podcast. In this end-of-year wrap-up, they preview major changes coming in 2026, including new standalone podcast feeds, expanded journal club content, CME opportunities, and exciting partnerships with organizations like the Vermont Oxford Network and PAS. They also share what’s ahead for the Delphi Conference and offer a candid look at their personal and professional goals for the year ahead. Thank you for being part of this extraordinary neonatal community.

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Transitioning from fellowship to your first attending job? You're probably not prepared for the business side of medicine—and that's exactly the problem Dr. Tung Giep addresses in this episode. Dr. Giep, a neonatologist with over 30 years of experience, shares hard-earned lessons from building and selling a private practice in Houston, navigating toxic work environments, and eventually finding his place in telemedicine. His new book, The Business of Medicine: The Definitive Guide to Help New Physicians Start Their Career on the Right Path and Avoid Costly Mistakes, tackles what medical training ignores: contract negotiation, non-competes, choosing the right CPA and attorney, and understanding your self-worth.

Ben and Dr. Giep discuss why new physicians get blindsided by job offers, how to vet a practice properly, and the reality of community neonatology versus academic medicine. They also explore the growing role of AI in healthcare and what it means for the next generation of physicians. Whether you're finishing fellowship or reconsidering your current position, this conversation offers practical guidance on taking control of your career—and avoiding costly mistakes along the way.

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In this Journal Club episode, Ben and Daphna review five recent studies with practical implications for neonatal care. The FEED1 trial examines whether starting full milk feeds from day one is safe in 30-32 week preterm infants, finding no difference in length of stay compared to gradual feeding but fewer central line days. A brief communication from UAB explores high-volume feeding strategies (≥170 ml/kg/day) and their impact on body composition in very preterm infants.

The hosts discuss a mannequin study from Italy measuring forces applied during intubation with different laryngoscope types and bed heights, revealing that video laryngoscopy at navel height applies the lowest forces—contrary to most clinicians' perceptions.

A large Japanese cohort study highlights the association between maternal psychological distress and neurodevelopmental delays, with postpartum distress showing stronger effects than prenatal stress. Finally, analysis of Neonatal Research Network data identifies predictors of early cord clamping in extremely preterm infants, with lack of magnesium sulfate, cesarean delivery, and antepartum hemorrhage being key factors.

The episode wraps with reminders about upcoming conferences, including the Delphi Conference in Fort Lauderdale in January 2026.

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Antenatal Prediction of Early Cord Clamping among Infants Born Extremely Preterm.

Katheria A, Dorner RA, Grobman W, Rysavy MA, Koo J, Wyckoff MH, Sandoval G, DeMauro SB, Das A, Lee HC, Cotten M, Calvo L, Saha S; Eunice Kennedy Schriver National Institute of Child Health and Human Development Neonatal Research Network.J Pediatr. 2025 Oct 31:114878. doi: 10.1016/j.jpeds.2025.114878. Online ahead of print.PMID: 41177398

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Maternal Psychological Distress Before and After Childbirth and Neurodevelopmental Delay in Toddlers.

Matsumura K, Tanaka T, Kuroda M, Tsuchida A, Hatakeyama T, Kasamatsu H, Inadera H; Japan Environment and Children’s Study Group.JAMA Netw Open. 2025 Oct 1;8(10):e2540907. doi: 10.1001/jamanetworkopen.2025.40907.PMID: 41171271 Free PMC article.

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Treatment of Hypotension of Prematurity: a randomised trial.

Alderliesten T, Arasteh E, van Alphen A, Groenendaal F, Dudink J, Benders MJ, van Bel F, Lemmers P. Arch Dis Child Fetal Neonatal Ed. 2025 Dec 15;111(1):F60-F66. doi: 10.1136/archdischild-2024-328253.PMID: 40413017 Clinical Trial.

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Applied forces during neonatal intubation with direct and video laryngoscopy at different bed elevations: a randomized crossover manikin study.

Cavallin F, Pasquali G, Maglio S, Villani PE, Menciassi A, Tognarelli S, Trevisanuto D.Eur J Pediatr. 2025 Nov 5;184(12):732. doi: 10.1007/s00431-025-06524-8.PMID: 41191125 Free PMC article. Clinical Trial.

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Early body composition outcomes of infants born very preterm and receiving high volume, human milk feedings (≥170 ml/kg/day) before postnatal day 14.

Gunawan E, Molleti M, Salas AA.J Perinatol. 2025 Oct 31. doi: 10.1038/s41372-025-02469-w. Online ahead of print.PMID: 41174086 No abstract available.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Full exclusively enteral fluids from day 1 versus gradual feeding in preterm infants (FEED1): a open-label, parallel-group, multicentre, randomised, superiority trial.

Ojha S, Mitchell EJ, Johnson MJ, Gale C, McGuire W, Oddie S, Hall SS, Meakin G, Anderson J, Partlet C, Su Y, Johnson S, Walker KF, Ogollah R, Mistry H, Naghdi S, Montgomery A, Dorling J; FEED1 collaborative.Lancet Child Adolesc Health. 2025 Dec;9(12):827-836. doi: 10.1016/S2352-4642(25)00271-8. Epub 2025 Oct 17.PMID: 41115446 Free article. Clinical Trial.

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Three third-year fellows present diverse research at Hot Topics. Juhi from University of Illinois in Chicago demonstrates lung ultrasound's potential to predict respiratory support duration in 30+ week infants, with first six-hour exams showing strongest correlation—suggesting possible replacement for admission chest x-rays. Tanima from Boston Children's applies large language models to extract IVH prognostic variables from AI literature, identifying critical gaps including absence of resolution prediction studies. Hailey conducts qualitative research on physician experiences with NICU mortality/morbidity, identifying three impactful loss categories: outcome-expectation mismatches, meaningful relationships, and weight of responsibilities. Their work exemplifies emerging neonatologist interests in point-of-care ultrasound, artificial intelligence applications, and clinician wellbeing.

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Dr. Jeffrey Gould and Dr. David Stevenson recount founding California Perinatal Quality Care Collaborative (CPQCC) in the mid-1990s, transforming California's fragmented perinatal care system. Initial success required organizational development expertise—not just databases—to transform stakeholders into partners by identifying mutual value. They created California Association of Neonatology, secured Packard Foundation support, and unified competing academic centers and private practitioners. CPQCC's disciplined approach—pods meeting biweekly, shared data, non-hierarchical teams—contributed to California achieving the nation's lowest maternal mortality while national rates climb. Gould emphasizes quality improvement as structural intervention building relationships and improving working conditions. For aspiring leaders, they advise: identify what teams value, use data to reveal challenges, build consensus around shared goals.

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Dr. Elizabeth Foglia, University of Pennsylvania/Children's Hospital of Philadelphia and scientific PI for AAP's DRIVE (Delivery Room Intervention and Evaluation) Network, discusses building a 3,000-hospital US collaboration to understand real-world delivery room practices. Despite robust evidence supporting supraglottic airways for PPV in infants 34+ weeks, surveys show minimal provider use—representing a significant evidence-to-practice gap. The SUGAR trial compares implementation strategies to increase adoption using hybrid effectiveness-implementation design. DRIVE currently includes 50 hospitals with diverse delivery room configurations, providing infrastructure for pragmatic trials, quality improvement, and benchmarking. First network-wide meeting launches multi-center QI project in February. Sites can join via AAP DRIVE Network website.

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 In this episode of The Incubator Podcast, recorded live at Hot Topics in Neonatology in Washington, DC, we sit down with Dr. Daniele De Luca, Chief of Pediatric and Neonatal Critical Care at AP-HP Paris-Saclay University and leader of one of Europe's largest NICUs. Dr. De Luca discusses the groundbreaking Lancet Child & Adolescent Health Commission on the Future of Neonatology, a three-year initiative involving over 100 global key opinion leaders addressing the critical innovation gap in our specialty. He explores why neonatal medicine has experienced a slowdown in therapeutic advances since the 1990s, despite treating patients who will become citizens for decades ahead. The conversation covers the multifactorial barriers to innovation—from regulatory challenges to funding constraints—and the Commission's comprehensive recommendations for industry, regulators, academic centers, and patient representatives. Dr. De Luca emphasizes the urgent need to avoid treating babies in 20 years the same way we did 20 years ago, highlighting specific examples like the decades-long journey from drug development to registration and the paradox of FDA-approved equipment. He calls for a united approach to elevate neonatology's profile, establish formal specialty recognition, and accelerate the translation of research into bedside care. 

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Dr. Michael Narvey, neonatologist and Vice President of Canadian Pediatric Society, challenges the validity of pre-discharge car seat testing. After leading Canadian work resulting in nationwide abandonment of the test in 2016, he argues the test doesn't represent real-world conditions (potholes, movement) and lacks evidence demonstrating it saves lives from apnea or desaturations. Based on 50 years of autopsy data, rare car seat-related deaths result from unsupervised asphyxiation when infants slide down onto straps—not from events in moving vehicles. Narvey distinguishes between eliminating the test versus maintaining essential car seat safety education, emphasizing proper positioning and avoiding unsupervised use outside vehicles. Some US centers are reconsidering this practice.

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Nicole and Maureen from Lactalogics present innovative donor human milk processing using gentle ultra-high temperature pasteurization—exposing milk to heat for only 10 seconds versus 30-40 minutes with traditional methods. Their tube-in-tube system (milk and steam traveling opposite directions) maintains safety by eliminating pathogens while better preserving inherent nutrients. Products launching April 2026 include shelf-stable options for term infants (20 cal, 1.1g protein/100mL) and preterm infants (20 cal, 1.6g protein/100mL), plus a human milk fortifier reaching 24 calories. Donor moms require rigorous screening and 500+ ounce surplus. The shelf-stable format supports both in-hospital use and post-discharge bridging when mothers face milk supply challenges.

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Dr. Matthew Laughon, Professor at University of North Carolina and NICHD Neonatal Research Network investigator, presents the landmark PDA Management Trial comparing expectant management versus active medical treatment (indomethacin, ibuprofen, or acetaminophen). The trial stopped early due to futility and safety concerns—mortality exceeded 10% in the treatment group versus 4% with expectant management, with more infection-related deaths among treated infants. Secondary outcomes (BPD, NEC, ROP) showed no differences. The study included infants with symptomatic PDAs but excluded those with severe cardiopulmonary compromise. Findings support expectant management for symptomatic PDAs through 21 days of life, aligning with recent guidelines recommending no routine treatment in the first two weeks.

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Dr. Elaine Boyle, Professor of Neonatal Medicine at University of Leicester, presents the SURFON trial evaluating early surfactant versus expectant management in 34-38 week infants with respiratory distress. This pragmatic trial enrolled infants requiring 30-45% oxygen or non-invasive support. Primary outcomes showed no difference in hospital length of stay or progression to severe respiratory disease. Early surfactant reduced NICU duration and non-invasive support by less than one day each, with borderline pneumothorax increase requiring treatment of 80+ infants to prevent one case. Findings suggest watch-and-wait approaches remain safe and reasonable for this population, though this group requires continued research given their potential for severe illness.

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Dr. Shalini Ojha, Professor of Neonatal Medicine at University of Nottingham, presents the Feed One trial examining full enteral feeding (60 mL/kg/day) from day one versus gradual advancement in 30-32 week infants. While the primary outcome of hospital length of stay showed no difference (median 32 days), full feeding significantly reduced parenteral nutrition use, IV cannulations, and associated interventions without increasing necrotizing enterocolitis risk (4 versus 6 cases). This pragmatic trial challenges the unfounded fear that early full feeding causes NEC—demonstrating that moderate preterm infants can safely receive complete enteral nutrition from birth, simplifying care particularly in resource-limited settings while avoiding complications from IV access and parenteral nutrition.

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Dr. Pankaj Agrawal, Division Chief of Neonatology at University of Miami, discusses rapid genomic advances—from six-month diagnostic timelines in 2000 to same-day sequencing today. While current practice targets phenotype-based testing for unexplained conditions or dysmorphic features, Agrawal advocates moving toward universal NICU sequencing to identify previously unrecognized conditions. Key barriers include administrative buy-in, cost concerns, consent processes, and result disclosure challenges. Even negative results provide value—offering families reassurance and contributing to research databases. With only 5,000 of 20,000 genes linked to human disease, ongoing gene discovery work continues. Agrawal emphasizes the NICU as ideal for genomic implementation given high genetic disease prevalence and intervention opportunities.

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Three first-year fellows from University of Virginia—Jamie, Megan, and Brianne—share their Hot Topics conference experience. Despite being early in training, they engage deeply with cutting-edge research across diverse interests: POCUS and hemodynamics (Jamie), ENT non-surgical interventions (Brianne), and neurodevelopmental outcomes with Tiny Baby projects (Megan). They value learning from practice variation across institutions, particularly regarding fluid management and humidity protocols. Rather than finding evidence gaps discouraging, they're inspired by opportunities for future research. They plan to share conference insights through journal club upon returning to UVA. The fellows emphasize how accessible and collaborative neonatology speakers are, encouraging early-career engagement with research leaders.

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Julie Raskin, representing Congenital Hyperinsulinism International (CHI), advocates for universal newborn glucose screening following her son's brain injury from undiagnosed hyperinsulinism in 1996. Registry data reveals 28% of affected infants lack traditional risk factors (abnormal birth weight), and even high-risk babies are often discharged inappropriately. CHI's "Glucose is a Vital Sign" campaign promotes screening protocols currently under research, examining glucose plus ketone monitoring during initial days to identify affected infants without over-medicalizing healthy newborns. The organization maintains eight centers of excellence globally and provides international treatment guidelines at congenitalhi.org. Over 30 genes cause this diagnosable, treatable condition requiring immediate intervention to prevent preventable brain damage from prolonged hypoglycemia.

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Dr. Ariel Salas, recent R01 recipient, discusses challenging traditional feeding volume targets in preterm infants. His multi-center trial compares 180-200 versus 140-160 mL/kg/day volumes, examining body composition changes rather than weight alone. Salas emphasizes targeting fat-free mass gains over simple weight gain, as this component associates with better long-term neurodevelopmental outcomes. Body composition analysis reveals compartmental changes invisible to daily weights—distinguishing extracellular versus intracellular water shifts. This outcome provides reasonable compromise between immediate intervention effects and long-term results. Salas advocates acknowledging practice variation as opportunity for equipoise and fair testing, challenging arbitrary standards that persist despite limited evidence supporting them.

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Dr. Kavya Rao from University of Buffalo discusses quality improvement initiatives following completion of her master's in QI. Her team successfully implemented antibiotic stewardship by safely discontinuing antibiotics at 24 hours for early onset sepsis in clinically well infants with negative blood cultures, initially studying all gestational ages with plans for subset analysis. Additional projects include reducing PRBC and platelet transfusions using lower thresholds based on updated guidelines. Rao emphasizes finding QI topics through clinical passion and data-driven identification of performance gaps, using benchmarking with Vermont Oxford Network data. She co-mentors fellows in QI with Dr. Valerie Albertson and expresses enthusiasm for the Tiny Baby Collaborative, recognizing 22-weekers require distinct physiologic approaches.

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Dr. Ravi Patel, Professor at Emory University and Chair of the Georgia Perinatal Quality Collaborative, examines the tension between quality improvement and evidence-based medicine. He argues NICUs should prioritize high-certainty interventions (antenatal steroids, delayed cord clamping) rather than standardizing practices based on low-certainty evidence. Using tools like GRADE to assess evidence certainty helps determine when standardization is appropriate versus when practice variation allows for shared decision-making. Patel advocates re-energizing evidence generation as improvement in common morbidities has stalled. Examples like Eat Sleep Console demonstrate the value of prospective evaluation when adopting new practices. When evidence is uncertain, integrating family values and preferences becomes essential for individualized care decisions.

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Dr. Edgardo Szyld from Indiana University presents the PLANT study evaluating 20 minutes of prophylactic CPAP for late preterm infants (34-36+6 weeks) born via cesarean section. This population represents 70% of US preterm births and experiences five times higher respiratory distress rates with cesarean delivery. The pragmatic pilot enrolled 100 patients, demonstrating reduced NICU admissions without pneumothorax cases—addressing previous safety concerns from observational data. Szyld's team is planning PLANT 2, targeting 35-36 weekers across 11 international centers, which will compare outcomes with and without antenatal steroids. This pragmatic approach addresses a high-volume but understudied population significantly impacting NICU resources.

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Dr. Clara Song, Chair of the AAP Section on Neonatal-Perinatal Medicine, discusses urgent workforce challenges facing neonatology. With average neonatologist age around 50-55 and stable fellowship applications despite growing positions, the field faces potential shortages. The section launched initiatives addressing fair compensation, including a new website comparing negotiated commercial payer rates across states and engaging state chapters for payer advocacy. Song highlights concerning trends where neonatologist productivity increased while compensation decreased as the field became female-dominated. She discusses the section's comprehensive staffing toolkit and proposes restructured training pathways—potentially shortened residency with targeted 2-5 year fellowships—to attract trainees while ensuring adequate clinical preparation for increasingly complex neonatal care.

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Dr. Louise Owen from Royal Women's Hospital Melbourne presents the AEROPLANE trial comparing 21% versus 30% oxygen for 32-35 week infants at birth. This understudied cohort represents 80% of preterm births globally. Using cluster randomization with waived consent, the trial captured real-world practice across centers. Infants receiving 30% oxygen required less delivery room intervention including assisted ventilation, intubation, and chest compressions. Three-quarters of infants needing initial support continued requiring respiratory support beyond delivery. Both groups ultimately received average oxygen in the 50s, suggesting moderate preterm infants may behave more like very preterm rather than term babies regarding oxygen needs.

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Dr. Divya keerthy (New York Presbyterian Queens/Weill Cornell Medicine) and Dr. Katherine Nyman (UCSD/Rady Children's, San Diego) discuss their Hot Topics conference experience. Keerthy presents research on prenatal polycyclic aromatic hydrocarbon exposure measured via backpack monitors and silicone wristbands during the third trimester. Her longitudinal study tracked infant microbiome at three time points over six months, identifying two air pollutants affecting microbiome development. Nyman highlights interest in the Tiny Baby collaborative, particularly PDA management challenges in extremely premature infants. Both emphasize the value of Hot Topics' evidence-based sessions including "green and rotten apples" that stress-test current practices. They note the conference's focus on moderate preemies (32-34 weekers) who comprise 80% of NICU populations yet receive less research attention.

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Dr. Katherine P Callahan, neonatologist and bioethicist at Children's Hospital of Philadelphia, discusses the complexity of genetic testing in neonatal care. While the NICU serves as a launch point for genetic technologies due to high prevalence of genetic disease, genetic information is often ambiguous or uncertain rather than straightforwardly diagnostic. Variants of uncertain significance represent just one challenge—even clearly pathogenic findings may have unclear implications for individual patients, as demonstrated when parents carry the same mutation as their severely affected child. Callahan emphasizes that genetic information poses "informational hazards" requiring careful consideration of psychological and ethical impacts. She advocates for acknowledging complexity, rethinking outcomes beyond traditional measures, and embracing shared decision-making rather than standardized approaches to genomic counseling.

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In this episode, Mandy Daly shares her profound journey as a NICU parent and her advocacy work through the Irish Neonatal Health Alliance (INHA). She discusses the emotional challenges faced by parents of preterm infants, the importance of family-centered care, and the need for systemic changes in neonatal healthcare. Mandy emphasizes the significance of building support networks, empowering families through education, and the impact of lived experiences in shaping healthcare policies. The conversation highlights the collaborative efforts required to improve outcomes for families navigating the complexities of neonatal care.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of NeoNews, the team returns from a brief hiatus with a refreshed format and a packed review of neonatal stories dominating recent headlines. Eli, Ben, and Daphna open with updates on RSV prevention, highlighting new MMWR data showing significant gaps in nirsevimab and maternal vaccine uptake—despite strong evidence and renewed availability. They discuss how supply chain issues, insurance delays, and vaccine confusion continue to limit access, and they emphasize the unique role neonatologists can play in counseling families early and often. The hosts also review concerning national trends in congenital syphilis, noting that many affected infants had parents who received prenatal care but were never tested—an avoidable systems failure with major downstream costs. Additional segments cover the severity of last year’s influenza season, the emergence of new RSV monoclonal antibodies, and the rising use of polygenic risk scoring in IVF. The team reflects on the ethical tension between innovation and eugenics concerns, and how neonatal providers can prepare for these conversations. Finally, the deep dive explores Sherri Fink’s powerful reporting on trisomy 18, variability in care across institutions, and the growing emphasis on transparent, value-driven shared decision-making with families.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In the final episode of our Rethinking Phototherapy series, Ben speaks with Steve Falk, Chief Engineer of the Maternal Infant Care Strategic Business Unit at GE Healthcare. With more than three decades of engineering leadership, Steve has been instrumental in the development of landmark neonatal technologies, including the Giraffe Omnibed and Panda platforms.

This conversation highlights the critical role of engineering in making phototherapy precise, reliable, and safe. Steve explains how advances in LED technology have transformed phototherapy devices, ensuring consistent irradiance and long product life. He describes how engineers translate clinical needs—wavelength, intensity, surface coverage, and distance—into product requirements, and how rigorous usability testing with clinicians shapes intuitive bedside tools. The discussion also explores innovation on the horizon, from refining intermittent phototherapy strategies to integrating technologies that simplify care and support earlier discharge.

Listeners will gain a behind-the-scenes perspective on how engineering teams think about phototherapy as a true pharmacotherapy, and how collaboration between clinicians and industry can directly improve outcomes for newborns and families. This episode closes the series by reminding us that innovation in neonatal care happens not only in clinical practice, but also in the design labs where these essential tools are created.

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What happens when we challenge our long-standing assumptions about phototherapy in the NICU? In this special installment of our Rethinking Phototherapy series, Ben and Daphna are joined by Dr. Deepak Manhas to examine one of the most complex questions: how should we manage hyperbilirubinemia in preterm infants?

Unlike term babies, preemies face unique risks—shorter red blood cell lifespan, immature bilirubin conjugation, lower albumin binding, and increased blood-brain barrier permeability—all of which make them more vulnerable to bilirubin-induced neurologic dysfunction. This conversation explores why traditional guidelines cannot simply be applied to preterm infants and why clinicians often initiate phototherapy earlier.

Dr. Manhas discusses the creation of gestation-specific treatment charts, the challenges and dangers of exchange transfusion in this fragile population, and the uncertain role of therapies such as IVIG, albumin, and phenobarbital. The team also unpacks practical issues: what “double phototherapy” should really mean, how to order irradiance and body surface area coverage with precision, and the role of bili blankets in promoting family bonding.

By situating this discussion in the broader Rethinking Phototherapy series, the episode highlights both the progress and the unanswered questions in caring for preterm infants.

📖 Reference: Pathogenesis and Management of Indirect Hyperbilirubinemia in Preterm Neonates Less Than 35 Weeks: Moving Toward a Standardized Approach (NeoReviews)

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In the second installment of our Rethinking Phototherapy series, Ben and Daphna welcome Dr. Daniel Rauch, Professor of Pediatrics at the Hackensack Meridian School of Medicine and Division Chief of Pediatric Hospital Medicine and General Academic Pediatrics at Joseph Sanzari Children’s Hospital. Dr. Rauch co-authored the AAP technical report on phototherapy and brings a unique perspective on how light therapy should be understood and applied in clinical practice.

This conversation reframes phototherapy as a true pharmacotherapy—an intervention that must be delivered in precise doses with attention to wavelength, irradiance, body surface exposure, and treatment duration. Dr. Rauch explains why more light is not always better, how technology has evolved from “easy-bake oven” style lamps to modern LED systems, and why maximizing body surface exposure often matters more than piling on extra light banks. The discussion also touches on cycling strategies, the value and limitations of transcutaneous monitoring, and the potential of home phototherapy to reduce unnecessary hospitalizations while supporting family bonding.

Listeners will gain practical insights into the art and science of phototherapy: how to optimize treatment, minimize harm, and communicate clearly with families navigating jaundice management.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of The Incubator Podcast, Ben and Daphna sit down with Dr. Alex Kemper, Division Chief of Primary Care Pediatrics at Nationwide Children’s Hospital and Editor-in-Chief of Pediatrics. Dr. Kemper served as chair of the American Academy of Pediatrics subcommittee that authored the 2022 revision of the neonatal hyperbilirubinemia guidelines.

Together, they explore the motivations behind revisiting the 2004 guideline, the major changes introduced, and how these revisions are shaping clinical care. Dr. Kemper explains why treatment thresholds for phototherapy were raised, the careful balance between avoiding unnecessary interventions and preventing kernicterus, and the rationale for moving away from the risk stratification nomogram. The discussion highlights phototherapy as an effective but not benign therapy—one that can disrupt bonding, prolong hospitalization, and create family stress when overused.

Listeners will gain insight into the complexities of evidence review, the challenges of consensus-building over eight years of work, and the importance of shared decision-making and reliable follow-up after discharge. This conversation not only demystifies the new guidelines but also reframes the way clinicians think about jaundice management, risk stratification, and the broader impact on families.

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In this discussion, Dr. Hevil Shah (Cook Children’s Hospital) and Dr. Julie Lindower (UI Children’s) highlight the work of the CHNC Focus Group on Extremely Preterm Infants, centered on babies born between 21–23 weeks’ gestation. They share insights from a workshop on precision care, emphasizing lessons from Iowa’s long-term data showing improved survival and neurodevelopmental outcomes. The conversation explores variability in resuscitation and counseling practices across centers, and the importance of unified messaging among care teams. The group’s next steps include publishing survey results and strengthening collaborations—particularly with the nutrition focus group—to advance standardized, evidence-based care for the most premature newborns.

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In this keynote discussion, Dr. Natasha Henner (Lurie Children’s Hospital) examines how evolving reproductive policies are reshaping neonatal practice, from counseling at the limits of viability to supporting families after restrictive abortion laws. She discusses rising NICU admissions for infants with congenital differences, ethical tensions around “life-limiting” diagnoses, and gaps in perinatal hospice and home care resources. Dr. Henner emphasizes the need for shared frameworks among neonatologists, obstetricians, and palliative care teams, as well as simulation-based training to navigate moral distress and complex communication. Her call to action: welcome these difficult conversations to improve compassionate, coordinated family-centered care.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this keynote conversation, Dr. Amy Baughcum, PhD (Nationwide Children’s), Dr. Elizabeth Fischer, PhD (Children’s Wisconsin), and Dr. Lamia Soghier, MD, MeD, MBA (Children’s National) discuss building comprehensive perinatal mental health support systems that span from prenatal diagnosis to life after NICU discharge. Drawing inspiration from Dr. Joanna Cole’s fetal psychology model at CHOP, they emphasize early screening, interdisciplinary collaboration, and embedding psychologists or social workers within NICU teams. The speakers highlight strategies to normalize emotional distress, empower families to seek help, and align institutional priorities with psychosocial care. Their shared message: supporting parental mental health is essential, evidence-based, and foundational to optimal infant outcomes.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This episode addresses NICU staff mental health with Dr. Chavis Patterson, PhD (Children’s Hospital of Philadelphia). He reviews common problems—toxic stress, compassion fatigue, irritability, sleep disturbance—and practical mitigation strategies: brief micro-practices (five-minute arrival/departure routines), peer debriefs (e.g., “pink flags”), unit multidisciplinary check-ins, and institutional resources such as employee assistance programs and embedded NICU psychologists. Patterson stresses normalizing emotional responses, reducing stigma around seeking psychotherapy, and building structural supports by advocating for funded on-unit psychology positions. Immediate actions: start regular team debriefs, map local mental-health resources, pilot embedded psychology coverage, and lead institutional advocacy to make staff mental health standard NICU practice.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This keynote episode features Dr. Jennifer Sucre (Vanderbilt University Medical Center), whose research bridges bedside observation and molecular biology to uncover why some preterm infants develop severe bronchopulmonary dysplasia (BPD) while others recover. Through innovative live imaging of lung development and mouse and human tissue models, her lab discovered that capillary “guidance” signals—semaphorins—are crucial for lung repair and resilience. Loss of these pathways marks irreversible injury. Dr. Sucre emphasizes “bedside-to-bench” science, finding lessons from resilient infants to inform therapy. Clinically, she urges providers to recognize individual resilience, foster hopeful communication with families, and envision a future where BPD is preventable—not inevitable.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This episode features Dr. Giulia Lima (Boston Children’s Hospital), a CHNC Mentored Fellow, discussing risk factors for morbidity and mortality among preterm infants with congenital heart disease (CHD) using data from over 11,000 NICU admissions. Surprisingly, older gestational age did not predict improved survival once infants survived beyond three days. Major mortality predictors included surgical NEC, bloodstream infection, trisomy 21, airway anomalies, and compromised systemic output lesions. Multiple gestation appeared protective, though reasons remain unclear. Dr. Lima highlights the importance of standardized prenatal steroids, care coordination, and exploring socioeconomic and ethnic disparities to improve outcomes in this uniquely vulnerable CHD population.

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This episode features Dr. Sofia Isabel Perazzo (Children’s National Hospital) and Dr. Rakesh Rao (St. Louis Children’s Hospital) discussing a CHNC Explore analysis of intestinal stricture formation following surgical necrotizing enterocolitis (NEC). Using 15 years of CHND data, they examined over 2,400 surgical NEC cases, finding an overall stricture incidence of about 31%, with striking inter-center variability (24–38%). Lower gestational age, stoma creation, and combined drainage-laparotomy increased risk, while peritoneal drainage was protective. Hispanic ethnicity was associated with lower risk. Although their predictive model (AUC 0.67) was modest, the findings offer valuable benchmarks for parent counseling, quality improvement, and hypothesis generation.

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In this episode Dr. Murali Premkumar (Texas Children’s) presents an Explore/CHNC analysis of stricture formation after surgical NEC using 2010–2024 CHND data (2,411 surgical NEC infants). Overall CHNC stricture incidence ≈31% with marked inter-center variability (adjusted center rates ~24–38%). Multivariable analysis identified lower gestational age and stoma/laparotomy as associated with higher stricture risk, while initial peritoneal drainage associated with lower risk; Hispanic ethnicity showed lower unadjusted risk. A predictive model yielded AUC 0.67, highlighting missing variables (antibiotic duration, feeding practices). Practical implications: use these benchmarks to counsel families, generate hypotheses, and target QI by studying low-risk centers.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This episode features Dr. Sarah Swenson (Children’s Nebraska), Dr. Cara Solness, PhD (Children’s Nebraska), and Dr. Desiree Leverette (Emory/Children’s Healthcare of Atlanta) discussing equitable approaches to parental mental health screening in the NICU. They highlight that traditional programs often screen only mothers for depression, missing significant distress among non-gestational parents, especially fathers. Universal screening identified five times more affected partners, improving opportunities for support. The guests underscore the developmental importance of including all caregivers, the need to address stigma and fears of CPS involvement, and the value of trauma-informed communication. They advocate for integrated NICU psychologists and tailored, equity-focused interventions, including telehealth and culturally responsive materials.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This episode features Joshua Hess, MSN, RN discussing strategies to encourage more nurses to attend neonatal conferences where interdisciplinary collaboration drives meaningful quality improvement. Hess highlights how nurse involvement ensures clinical decisions reflect bedside realities, especially in managing conditions like BPD. He describes his unit’s culture of first-name, physician-nurse partnership and how institutional support and presenting a poster helped him attend. He also shares his team’s safe sleep quality initiative, which standardized education, created an order for “safe sleep readiness,” and significantly reduced unsafe sleep environments. Hess encourages NICUs to empower nurses as conference participants, educators, and change leaders.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Marina Metzler (St. Louis Children’s) shares her experience as a mentored fellow within the CHNC network, focusing on her project investigating genetic diagnoses in neonates with hypoxic-ischemic encephalopathy (HIE). She discusses the application and mentorship process, the support available from statisticians and CHNC collaborators, and early findings showing that infants with genetic conditions often experience longer NICU stays, more ventilator support, and greater feeding challenges. Dr. Metzler highlights the potential for genetic testing to refine diagnosis, guide care, and inform families, while emphasizing the need for larger datasets and multi-center collaboration to advance understanding in this complex population.

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This episode reflects on key themes emerging from day two of the 2025 CHNC Symposium. Hosts highlight ongoing work within CHNC focus groups, including defining emergent neonatal transport criteria and improving care pathways for infants with intestinal failure. They emphasize the pivotal role of family partners in research and quality improvement, noting the need to reduce financial and logistical barriers that limit caregiver participation at conferences. The discussion also underscores the growing recognition of parental mental health as central to infant outcomes, encouraging universal screening and structured support. Overall, the episode calls for intentional collaboration across disciplines and with families to drive meaningful neonatal care improvement.

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This episode features Dr. Carolina Adams (Emory) and Dr. Faizah Bhatti (Oklahoma Children’s Hospital) discussing findings from the CHNC Retinopathy of Prematurity (ROP) Focus Group. Their survey of pediatric ophthalmologists across U.S. centers revealed wide variability in screening practices, communication with neonatologists, sedation protocols, and anti-VEGF dosing. Many clinicians continue using higher bevacizumab doses despite emerging evidence supporting dose reduction. The guests emphasize the need for consistent, collaborative protocols, especially for infants outside standard screening criteria and extremely premature infants now surviving earlier gestational ages. They preview upcoming technology, including handheld NICU-compatible OCT devices, that may enhance early detection, shared decision-making, and long-term visual outcomes.

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In this episode, Dr. Katie Huff (Cincinnati Children’s) and Dr. Pritha Nayak (Dallas Children’s) discuss the work of the CHNC Intestinal Failure Focus Group. They highlight the unique challenges of managing neonates post-NEC, including TPN, nutrition, and long-term outcomes. The group’s recent survey revealed significant variability across centers, including the presence of dedicated intestinal rehab teams and approaches to outpatient follow-up. Future efforts will focus on neurodevelopmental support, optimizing feeding practices, and standardizing criteria for discharge on TPN. This work demonstrates how descriptive, collaborative research within CHNC can spark new hypotheses and improve outcomes for this complex neonatal population.

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In this episode, neonatologists Dr. Megan Paulsen (Children’s Minnesota) and Dr. Sarah Swenson explore strategies for supporting parental mental health in the NICU, emphasizing universal screening for depression, anxiety, and trauma. They highlight the critical impact of parental well-being on infant neurodevelopment, family stability, and long-term quality of life. Drawing on personal and professional experience, Dr. Paulson shares her journey as a NICU parent, illustrating gaps in current care. Practical recommendations include integrating psychologists and social workers into NICU teams, implementing structured follow-up, and advocating for system-level changes to ensure equitable, sustained mental health support for families.

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In this episode, Dr. Jacqueline Evans, Dr. Theresa Grover, and Dr. Karna Murthy provide an update on the Children’s Hospitals Neonatal Consortium (CHNC), highlighting its growth to 52 centers and over 375,000 infants in the registry. They discuss the symposium’s expansion, multi-center quality improvement collaboratives, and focus groups that enable data-driven research and clinical innovation. Emphasis is placed on leveraging the registry for rare disease insights, supporting career development, and fostering collaboration across institutions. Practical takeaways include opportunities for hospitals to join CHNC, engage with focus groups, and utilize registry data for research, QI, and improved neonatal patient care outcomes.

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In this episode, Dr. Elizabeth Anson and Dr. Luke Viehl from the CHNC Transport Focus Group discuss establishing consensus definitions for emergent neonatal transports across North American NICUs. Using a modified Delphi process, they surveyed 48 CHNC sites on diagnoses, clinical signs, and specialized equipment, achieving over 80% consensus in all categories. Standardized criteria aim to improve timely stabilization, support resource allocation, and facilitate advocacy with hospital administrators and insurers. Practical implications include guiding training, optimizing transport team composition, and integrating with initiatives such as therapeutic hypothermia for HIE. This work lays the foundation for research, system-level improvements, and safer, more equitable neonatal transport practices.

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This discussion features Dr. Charada Gowda and Dr. Jessica Fry, leaders in the CHNC collaborative network, highlighting ongoing work within the CDH and Palliative Care & Ethics (PACE) focus groups. The CDH group is developing consensus clinical practice guidelines and has created an outcomes calculator to support more informative prenatal counseling and individualized care planning. The PACE group focuses on improving collaboration between neonatology and palliative care teams and recently surveyed CHNC centers regarding resources to support clinicians after patient loss. Findings emphasize that simply knowing support tools exist improves staff well-being. Both groups model multidisciplinary collaboration that enhances clinical guidance, communication, and family-centered care across the NICU.

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This discussion features Dr. Malathi Balasundaram and Morgan Kowalski, leaders of the CHNC Family-Centered Care Task Force, outlining how Family Partnership Councils integrate families as true partners in NICU care, policy development, and quality improvement. Instead of providing feedback after decisions are made, families co-create guidelines and initiatives from the start, promoting empowerment and more meaningful parent presence. They describe barriers such as recruitment, compensation, scheduling, and staff uncertainty, and offer practical strategies including foundation support, transparent role expectations, and diversifying family representation. The Task Force’s webinars, office hours, and survey-driven improvement tools help units build sustainable, equitable, family-centered practices across both NICU and follow-up care settings.

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This discussion features Dr. Clyde Wright, Professor of Pediatrics at Children’s Hospital Colorado and the University of Colorado School of Medicine, who studies perinatal innate immunity and neonatal lung injury. He highlights the rapid rise of acetaminophen as the most commonly used medication for ductal closure in preterm infants despite limited long-term safety data. Dr. Wright explains how acetaminophen metabolism via CYP2E1 produces a reactive metabolite that may affect mitochondrial function in developing lung cells, prompting consideration beyond hepatic toxicity markers. He encourages clinicians to remain judicious, especially outside optimal treatment windows, and calls for research incorporating respiratory outcomes and nuanced, individualized risk–benefit discussions at the bedside.

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This discussion features Dr. Beena Kamath-Rayne, a neonatologist at Lurie Children’s and Senior Vice President of Global Health and Clinical Skills at the American Academy of Pediatrics, describing how collaborative programs are improving neonatal care quality nationwide. She explains the AAP’s NICU Verification (Neonatal Excellence) Program, which supports level II–IV units in evaluating their structures, processes, and outcomes against national standards through a collaborative, non-punitive survey model. Dr. Kamath-Rayne also highlights the DRIVE Network, which captures delivery room practices to address variation, including CPAP use in term infants. Key takeaways include coordinating with obstetric teams, preparing early for NRP updates, and engaging in mentorship and global neonatal initiatives.

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In this CHNC 2025 conversation, Daphna speaks with Dr. Beverley Brozanski (St. Louis Children’s) and Dr. Anthony Piazza (Children’s Healthcare of Atlanta) about the evolution of quality improvement within the Children’s Hospitals Neonatal Consortium (CHNC). They trace the journey from the first collaborative—reducing central line infections—to today’s data-driven, multicenter initiatives powered by the Children’s Hospitals Neonatal Database (CHND). Reflecting on lessons learned, they emphasize data over time, inclusion of data abstractors as core collaborators, and mentorship that nurtures the next generation of QI leaders, illustrating how sustained collaboration continues to advance neonatal outcomes nationwide

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In this episode from the CHNC 2025 Symposium, The Incubator welcomes Dr. Briana Bertoni and Dr. Gene Pallotto to discuss the Children’s Hospitals Neonatal Consortium’s (CHNC) CIQI program and its ongoing quality improvement initiatives. They share results from Project Home, a multicenter effort to increase human milk use at discharge—highlighting how transport teams, unified family education, and cultural awareness helped drive progress. The next phase takes a flexible “choose-your-own-adventure” approach, empowering NICUs to target unplanned extubations, nosocomial infections, or oral feeding readiness. With benchmarking, data support, and shared learning, CHNC continues to help diverse teams improve outcomes and shorten NICU stays across the network

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In this CHNC 2025 episode, The Incubator speaks with Dr. Sandy Johng (Seattle Children’s) and Dr. Kelsey Montgomery (Riley Children’s Hospital) about the collaborative work of the CDH Focus Group within the consortium. They discuss a national effort to evaluate bivalirudin versus heparin for ECMO anticoagulation in infants with congenital diaphragmatic hernia—a shift driven by promising anecdotal evidence but lacking robust data. Through shared cases, systematic review, and consensus guideline development, the group aims to unify practice and elevate research quality. The conversation highlights how real-time collaboration accelerates learning, improves care consistency, and fosters innovation across Level IV NICUs nationwide.

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Live from the Children’s Hospitals Neonatal Consortium (CHNC) 2025 Symposium in Denver, The Incubator host Dr. Daphna Yasova Barbeau sits down with Dr. Diana Montoya Williams, neonatologist and researcher, to explore how in-person collaboration shapes the future of neonatal medicine. They discuss CHNC’s role in connecting clinicians across Level IV NICUs through data sharing, quality improvement, and meaningful dialogue. The conversation highlights how conferences like CHNC rekindle professional motivation, strengthen care networks, and translate shared learning into improved outcomes for high-risk infants—reminding neonatal providers why gathering, reflecting, and innovating together still matters in an increasingly digital world.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Join Dr. Daphna Yasova Barbeau as she kicks off The Incubator’s live coverage from the Children’s Hospitals Neonatal Consortium (CHNC) 2025 Symposium in Denver. This opening episode sets the stage for two days of conversations focused on improving care for high-risk infants through data sharing, collaboration, and quality improvement across Level IV NICUs. Daphna introduces the mission behind CHNC and its powerful Children’s Hospitals Neonatal Database (CHND)—a resource driving benchmarking and innovation nationwide. Tune in for context, purpose, and the energy that fuels this year’s meeting before diving into interviews with CHNC leaders and attendees

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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The Incubator Podcast welcomes Dr. Henry Lee, Associate Editor of the Textbook of Neonatal Resuscitation, to discuss the ninth edition of the Neonatal Resuscitation Program (NRP). They review major updates released October 22, 2025, including the extended 60 second delayed cord clamping, new guidance on cord milking, refined oxygen targets, ventilation parameters, and updates to airway management and corrective steps. They also highlight three new educational modules, NRP Cardiac, Resuscitation in the NICU, and Neonatal Education for Prehospital Professionals, emphasizing how these changes support evidence based and effective neonatal care worldwide.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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What’s new in neonatal innovation and research this week?

Join Ben and Daphna for a lively Journal Club episode of The Incubator Podcast, recorded after a long NICU day but packed with energy and insight. They begin with an update on the newly released NRP 9th Edition, preview their excitement for the upcoming Delphi Neonatal Innovation Conference, and then dive into five remarkable studies shaping neonatal care.

From the use of CARPEDIEM for renal replacement therapy in the tiniest infants to a meta-analysis on high-dose vitamin D supplementation, the hosts explore how evolving evidence can transform bedside care. They examine a novel trial of nebulized nitroglycerin for PPHN, the role of electrical impedance tomography (EIT) in optimizing PEEP for infants with severe BPD, and new insights into NEC risk factors even among exclusively human-milk-fed babies.

With their trademark mix of curiosity, humor, and critical reflection, Ben and Daphna make complex studies both understandable and relevant for everyday NICU practice.

Stay informed and inspired—listen now, and explore more neonatal research and conference updates at www.the-incubator.org.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Risk factors associated with the development of necrotizing enterocolitis in preterm infants on an exclusive human milk diet: a single-center case-control study.

Ailumerab H, Miller JL, DeShea L, Beasley WH, Chaaban H, Bergner EM.J Perinatol. 2025 Aug 30. doi: 10.1038/s41372-025-02401-2. Online ahead of print.PMID: 40885806

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Identifying optimal positive end-expiratory pressure with electrical impedance tomography guidance in severe bronchopulmonary dysplasia.

Shui JE, LaVita CJ, Alcala GC, Nichols JH, Jassar RK, Turcu RM, Lerou PH, Cereda MF, Carroll RW, Ribeiro De Santis Santiago R, Berra L.J Perinatol. 2025 Sep 30. doi: 10.1038/s41372-025-02433-8. Online ahead of print.PMID: 41028823

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Azithromycin for Prevention of Bronchopulmonary Dysplasia and Other Neonatal Adverse Outcomes in Preterm Infants: An Updated Systematic Review and Meta-Analysis.

Joseph M, Murali Krishna M, Karlinksi Vizentin V, Provinciatto H, Ezenna C.Neonatology. 2025 Aug 12:1-10. doi: 10.1159/000547537. Online ahead of print.PMID: 40795809 Free article.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Nebulized nitroglycerin as an adjuvant drug in management of persistent pulmonary hypertension of newborns: a randomized controlled trial.

Farag MM, Ghazal HAE, Abdel-Mohsen AM, Rezk MA.Eur J Pediatr. 2025 Sep 1;184(9):586. doi: 10.1007/s00431-025-06381-5.PMID: 40888971 Free PMC article. Clinical Trial.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Short-term and long-term effects of vitamin D supplementation for preterm infants: a systematic review and meta-analysis.

Shin SH, Kim HJ, Heo JS.J Perinatol. 2025 Oct 7. doi: 10.1038/s41372-025-02440-9. Online ahead of print.PMID: 41057557

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Infant Renal Replacement Therapy Using Carpediem™: A Multicenter Observational Cohort Study from the ICONIIC Learning Network.

Slagle CL, Vuong KT, Krallman KA, Casey L, Gist KM, Jetton JG, Joseph C, Luckritz K, Martin SD, Morgan J, Merrill KA, Plomaritas K, Ramirez D, Tran CL, Shin HS, Snyder AN, Van Wyk B, Yalon L, Goldstein SL, Menon S.J Pediatr. 2025 Sep 26:114838. doi: 10.1016/j.jpeds.2025.114838. Online ahead of print.PMID: 41016463 Free article.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this special episode recorded live at the NeoHeart Conference 2025 in San Diego, California, Ben and Daphna sit down with Dr. Steve Abman, the Dr. John Patrick Cleary Living with Legends Keynote Address Speaker. A true leader in pediatric medicine, Dr. Abman serves as Professor of Pediatric Pulmonary Medicine, Co-Director of the Pediatric Pulmonary Hypertension Program, Director of the Pediatric Heart and Lung Center, and President of the American Pediatric Society.

Through candid reflection and storytelling, Dr. Abman discusses his journey from social activism to medicine, his mentors who shaped his path, and the power of collaboration in improving outcomes for children with cardiopulmonary disease. He reminds us that the future of neonatology depends on staying curious, working together, and keeping the baby—and the family—at the center of every decision.

This conversation is an inspiring reminder that science advances not just through data, but through generosity, humility, and shared purpose.

🎧Listen now and explore more at www.the-incubator.org.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of the Incubator Podcast, Dr. Mario Rüdiger, a prominent neonatologist from Germany, shares his journey into the field of neonatology, discussing the differences between European and American practices, the importance of flexibility in adopting new therapies, and the role of evidence in neonatal care. He emphasizes the significance of empowering parents in the NICU and advocates for a family-centered approach to care. The conversation also touches on the future of neonatal education, the impact of podcasting in the field, and the challenges of work-life balance for healthcare professionals. Dr. Rüdiger's insights provide a comprehensive view of the evolving landscape of neonatal care and the importance of advocacy in shaping policies that benefit both patients and practitioners. 

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Journal Club episode, Ben and Daphna review a wide range of new research shaping neonatal practice and policy.

The discussion begins with a randomized controlled trial from Korea examining antenatal corticosteroid use in twin pregnancies at risk for late preterm delivery, showing reductions in neonatal respiratory morbidity. They then turn to a meta-analysis on DHA with or without ARA supplementation in preterm infants, where results raised concerns about potential increased risk of BPD, highlighting the need for more precise dosing and study design.

A major feature of this episode is the release of the Improving Neonatology Staffing Toolkit, presented with guests Dr. Kerri Machut and Dr. Milenka Cuevas Guaman. They explain how the toolkit builds on consensus recommendations to offer practical guidance, case studies, and advocacy resources for units of all sizes.

Ben and Daphna also review a multi-center study comparing transcatheter closure and surgical ligation of the PDA in extremely preterm infants, finding similar neurodevelopmental outcomes at 2 years. Additional topics include an analysis of opt-out consent in neonatal trials, new data on the association between critical congenital heart disease and infant cancer, and a systematic review of autism screening tools for preterm children.

A dense episode full of data and practical implications for neonatology.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Screening for Autism in Preterm Children: A Systematic Review.

Thomas KE, Raghuram K, Banihani R, Church PT, Mbuagbaw L, Penner M.Pediatrics. 2025 Sep 3:e2024069837. doi: 10.1542/peds.2024-069837. Online ahead of print.PMID: 40897396

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Critical Congenital Heart Disease and Infant Cancer.

Chin S, Lupo PJ, Baer R, Hobbs CA, Chambers CD, Bandoli G.Pediatrics. 2025 Sep 25:e2025072934. doi: 10.1542/peds.2025-072934. Online ahead of print.PMID: 40992753 No abstract available.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Parent and practitioner experiences of opt-out consent in neonatal intensive care: a mixed methods study within a trial.

Mitchell T, Andrzejewska I, Battersby C, Cole C, Daskalopoulou Z, Dorling J, Gale C, Graham M, Hubbard M, Hardy P, Hurd M, King AR, Manley BJ, Murray D, Nuthall E, O'Connor H, Ojha S, Roberts CT, Rodriquez A, Roehr CC, Stanbury K, Tume L, Young L, Woolfall K.Arch Dis Child Fetal Neonatal Ed. 2025 Aug 31:fetalneonatal-2025-328693. doi: 10.1136/archdischild-2025-328693. Online ahead of print.PMID: 40889884

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Comparison of neurodevelopmental outcomes of extremely preterm infants undergoing trans-catheter closure of the patent ductus arteriosus compared to surgical ligation.

Kaluarachchi DC, Chock VY, Do BT, Rysavy MA, Sankar MN, Laughon MM, Backes CH, Colaizy TT, Bell EF, McNamara PJ, Hintz SR, Natarajan G.J Perinatol. 2025 Sep 23. doi: 10.1038/s41372-025-02417-8. Online ahead of print.PMID: 40987835

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Effect of enteral supplementation of DHA with or without ARA in preterm infants: a meta-analysis.

Dang D, Gao Z, Zhang C, Mu X, Lv X, Wu H.Arch Dis Child Fetal Neonatal Ed. 2025 Apr 15:fetalneonatal-2024-327606. doi: 10.1136/archdischild-2024-327606. Online ahead of print.PMID: 40233974

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Antenatal Corticosteroid in Twin-Pregnant Women at Risk of Late Preterm Delivery: A Randomized Clinical Trial.

Lee SM, Park HS, Choi SR, Lee J, Kim HJ, Park JY, Oh KJ, Cho GJ, Oh MJ, Chung JH, Kim SM, Kim BJ, Kim SY, Hong S, Jung YM, Lee SJ, Seong JS, Kim H, Oh S, Lee J, Jin YR, Kim JH, Cho HY, Park CW, Park JS, Jun JK.JAMA Pediatr. 2025 Sep 22:e253284. doi: 10.1001/jamapediatrics.2025.3284. Online ahead of print.PMID: 40982289

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Ben and Daphna sit down with Cassie Carrigan and Sacha Force to share the story of Cassie’s son, Caleb, and the lessons his short life continues to teach. Cassie, a mother, mental health therapist, and NICU parent, walks us through Caleb’s complex diagnostic journey, multiple surgeries, and ultimately the genetic condition that explained his struggles. She reflects candidly on the emotional toll of repeated bad news, the challenge of decision-making in crisis, and the importance of partnership between parents and medical teams.

Alongside her, Sacha—Caleb’s NICU nurse and now a clinical educator—offers her perspective on building trust with families, balancing medical expertise with empathy, and carrying Caleb’s legacy forward in her teaching of new nurses. Together, Cassie and Sacha describe how their bond has grown into an ongoing collaboration, bringing parents’ voices directly into staff training and helping future NICU teams understand the lasting impact of compassionate care.

This conversation highlights the reality of navigating grief, the role of faith and resilience, and the importance of remembering that every baby—and every family—shapes the professionals who care for them

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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What if you could hold in your hands a roadmap to the most influential studies that have shaped modern neonatology? In this special episode of The Incubator Podcast, Ben and Daphna sit down with Dr. John Zupancic, Dr. Susanna Hay, and Dr. Roger Soll to discuss the release of their new book, 50 Studies Every Neonatologist Should Know. Together with their co-editors Dr. Barbara Schmidt and Dr. Haresh Kirpalani, the team has distilled decades of neonatal research into an accessible, thoughtfully structured volume designed to guide clinicians, trainees, and educators.

The conversation explores the motivation behind the book, the editorial process of selecting just 50 landmark trials from thousands, and the importance of revisiting historical studies to understand how evidence has evolved over time. From the groundbreaking DART trial to the early work of pioneers like Bill Silverman, the authors emphasize not only the science but also the stories, challenges, and human insights that lie behind each study.

Whether you are a seasoned neonatologist or just beginning your training, this episode provides a behind-the-scenes look at a project that brings clarity and context to evidence-based practice.

📖 Get your copy of the book here: https://amzn.to/4nVTqcq

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Daphna Barbeau is joined by Dr. Neal Halfon (UCLA) and Dr. Shirley Russ (Cedars-Sinai/UCLA), two leading voices in life course health development, to explore how this framework reshapes our understanding of preterm infant care and follow-up. Together, they discuss their article, Ensuring Optimal Outcomes for Preterm Infants After NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up.

Dr. Halfon introduces the seven principles of life course health development—development, unfolding, complexity, timing, plasticity, thriving, and harmony—and explains how each reveals the dynamic, multilayered nature of health trajectories. Far from abstract, these principles highlight how small adjustments in the NICU can shape long-term outcomes, with early interventions compounding over time.

Dr. Russ reflects on how harmony across biology, family, and society is essential, while also emphasizing the risks posed by mismatches between development and environment. The discussion expands to consider how interventions can be more developmentally tailored, family-centered, strength-based, and designed for long-term optimization rather than short-term problem detection.

This episode encourages neonatal professionals to see beyond the walls of the NICU, adopting a design mindset that views care as a team process and recognizes the far-reaching impact of early decisions on a child’s ability not just to survive, but to thrive.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Daphna Barbeau welcomes Dr. Shirley Russ, Senior Project Scientist for the Life Course Translational Research Network, to discuss how life course health development can reframe neonatal care and follow-up after prematurity. Drawing from her extensive work leading the Prematurity Node within the network, Dr. Russ highlights why translating research into practice at scale is essential for improving lifelong outcomes.

The conversation emphasizes moving beyond a problem-focused, deficit-based model of NICU follow-up toward a strength-based approach that recognizes resilience, family capacity, and the broader developmental ecosystem surrounding each child. Dr. Russ outlines how interventions should not only detect problems but proactively optimize development—by supporting parents’ mental health, fostering nurturing environments, and integrating community resources into care.

She also shares insights into co-designing research and interventions with families, ensuring that their lived experiences guide both priorities and solutions. Practical examples include addressing parental trauma, redesigning follow-up clinics, and viewing prematurity in the context of interconnected systems—from family and community supports to schools and policies.

This forward-looking episode challenges clinicians to rethink follow-up care as more than monitoring milestones. Instead, it presents an opportunity to partner with families and communities to build healthier, more resilient futures for children born preterm.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Daphna Barbeau sits down with Dr. Richard Shaw (Stanford University) and Dr. Soudabeh Givrad (Weill Cornell Medical College), child psychiatry experts and co-authors of Neurodevelopmental, Mental Health, and Parenting Issues in Preterm Infants. Their conversation shines a spotlight on the often-overlooked intersection of prematurity, neurodevelopment, and family mental health.

Dr. Givrad explains how the rapid brain growth that normally occurs late in pregnancy makes preterm infants especially vulnerable to stress, pain, separation, and environmental influences in the NICU. She and Dr. Shaw outline the higher risks for challenges in cognition, language, and motor development, while emphasizing opportunities for early interventions that can positively shape outcomes.

The discussion then turns to “infant mental health” and the ways relationships in the early years set the stage for emotional regulation, social development, and resilience. Both guests highlight how parental trauma, PTSD, depression, and anxiety affect not only caregivers’ well-being but also how they interact with and raise their children. Concepts such as vulnerable child syndrome, overprotection, and parental guilt are explored in depth.

Ultimately, this episode underscores why supporting parental mental health is as essential as any medical treatment—because how parents experience and process the NICU journey profoundly shapes the lifelong health and development of their children.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this moving episode, Dr. Ben Courchia and Dr. Daphna Barbeau are joined by LaToshia Rouse, a certified doula and patient engagement consultant, and Dr. Jessica DiBari from the Maternal and Child Health Bureau. Together, they share insights from their two Parent Perspective articles in the special issue of Children, which focus on the NICU experience and the critical transition to home.

LaToshia and Jessica describe the NICU as a culture all its own—one that parents enter suddenly, without preparation, and often with a sense of trauma and grief. They discuss the psychological distress families carry, the challenges of bonding with fragile infants, and the ways communication can either deepen wounds or help parents feel empowered. Practical steps like hand hugs, skin-to-skin care, and peer support emerge as powerful tools for connection.

The conversation then shifts to life after discharge, which both guests describe as one of the most daunting transitions. From feeding challenges and equipment management to the constant worry about emergencies, families must adapt quickly while navigating limited community support. LaToshia and Jessica emphasize the need for honest preparation, early planning, and continued guidance that helps parents shed the “fragile baby” mindset and embrace their child’s resilience.

This episode highlights how listening to families transforms not only the NICU experience but also the long journey that follows.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, Dr. Daphna Barbeau speaks with Dr. Paige Terrien Church and Dr. Ashwini Lakshmanan about one of the most delicate yet essential aspects of neonatal care: communication. Drawing on their recent articles, the discussion highlights how the words we choose in the NICU profoundly shape families’ experiences, hopes, and perceptions of their child’s future.

Dr. Church addresses the discomfort many clinicians feel when discussing disability, emphasizing how entrenched medical training and ableism can unintentionally bias conversations. She introduces the concepts of microethics—the subtle, everyday interactions between families and providers—and how language choices like “risk” versus “possibility” can dramatically shift tone and meaning. The group explores how framing outcomes around abilities and opportunities, rather than limitations, helps families make sense of uncertainty with dignity and clarity.

Dr. Lakshmanan’s qualitative work brings in the voices of parents, revealing how uncertainty permeates the NICU journey and affects bonding, mental health, and confidence. Together, the guests highlight strategies for building trust, addressing parental guilt, and creating systems of support during the transition from hospital to home.

This episode challenges clinicians to pause, examine their own biases, and recognize language as a tool as powerful as any intervention delivered in the NICU.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode, we chat with Dr. Tim Nelin and Dr. Yarden Fraiman, two authors from the recently published special issue of Children on the life course implications of preterm birth. Together, they explore how inequities—both environmental and social—can shape the long-term health trajectories of preterm infants.

Dr. Nelin introduces the idea of “micro” and “macro” environments, showing how factors such as air pollution, green space, violence, and neighborhood social vulnerability not only contribute to preterm birth risk but also affect infants once they leave the NICU. His research underscores how the same exposures tied to prematurity continue to drive health disparities long after hospital discharge.

Dr. Fraiman focuses on ADHD as a case study of inequity across the life course. He describes the “ADHD care cascade,” illustrating how systemic bias and structural racism impact recognition, diagnosis, and treatment of ADHD among children born preterm. The conversation highlights how inequities layer over time, widening gaps in health and educational outcomes.

While the challenges are significant, the discussion also points to solutions—ranging from policy interventions and community partnerships to family-centered approaches. This episode emphasizes the urgent need to think upstream, addressing the drivers of inequity to create meaningful change for preterm infants and their families.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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This episode sets the stage for a collection of conversations inspired by a recently published special issue in Children: Implications of Preterm Birth for Health and Well-Being Over the Life Course. Host Dr. Daphna Barbeau is joined by the editors, Dr. Susan Hintz and Dr. Jonathan Litt of Stanford University, to discuss why the concept of “life course” is so critical for understanding the long-term impact of preterm birth.

Dr. Hintz and Dr. Litt explain how survival is only the beginning of the story. Preterm birth often shapes health trajectories well into childhood and adulthood, influenced not only by medical factors but also by family, environment, and community supports. They highlight how the issue’s twelve articles bring together diverse perspectives—from developmental science to family voices—that reveal both the challenges and opportunities faced by preterm infants and their families.

For busy clinicians, this conversation reframes day-to-day NICU care within a broader, lifelong context. It shows how even routine interactions in the NICU can influence resilience, parental well-being, and future outcomes. More than an introduction, this episode is an invitation to think differently about what it means to care for premature infants—not just today, but across their entire life course.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this week’s Journal Club, Ben and Daphna review several recent neonatal studies with direct implications for practice.

They begin with the BORN trial from Italy, which investigated whether transfusing preterm infants with cord blood–derived red blood cells, rather than adult donor blood, could reduce severe retinopathy of prematurity (ROP). While the intention-to-treat analysis showed no difference, per-protocol findings suggest potential benefits that warrant larger trials.

Next, they review a large international cohort study of outcomes in infants born at 22–23 weeks, highlighting striking variability in survival and morbidity across networks, with Japan showing the highest survival rates.

The EBNeo segment features Dr. Gabriel Altit discussing an Indian randomized trial comparing norepinephrine vs. dopamine as first-line therapy for neonatal septic shock. Although primary outcomes were similar, norepinephrine showed some favorable metabolic and perfusion markers.

The hosts then cover a delivery room resuscitation study identifying expiratory tidal volumes of 4–5 ml/kg as key for successful lung aeration, a Canadian trial of atropine for neonatal intubation, and a retrospective study from Alabama on optimal timing and frequency of pulmonary hypertension screening in BPD.

The episode concludes with a case report on the use of continuous glucose monitoring in a neonate with congenital hyperinsulinism.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Continuous glucose monitoring in a neonate with hyperinsulinemic hypoglycemia and ABCC8 gene mutation. Iwańczyk P, Majewska A, Issat T, Hoffman-Zacharska D, Krajewski P, Lipska-Karpińska K.Endocrinol Diabetes Metab Case Rep. 2025 Jun 5;2025(2):e250002. doi: 10.1530/EDM-25-0002. Print 2025 Apr 1.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Screening for pulmonary hypertension in preterm infants with bronchopulmonary dysplasia: when, how often and does it matter? Gentle SJ, Carlo WA, Ambalavanan N.Arch Dis Child Fetal Neonatal Ed. 2025 Sep 5:fetalneonatal-2024-328405. doi: 10.1136/archdischild-2024-328405. Online ahead of print.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Atropine Versus Placebo for Neonatal Nonemergent Intubation: A Randomized Clinical Trial. Afifi J, El-Naggar W, Hatfield T, Sandila N, Baier J, Narvey M.J Pediatr. 2025 Jul 9;286:114719. doi: 10.1016/j.jpeds.2025.114719. Online ahead of print.PMID: 40645282

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Respiratory Targets Associated With Lung Aeration During Delivery Room Resuscitation of Preterm Neonates. Rub DM, Hsu JY, Weinberg DD, Felix M, Nadkarni VM, Te Pas AB, Kuypers KLAM, Davis PG, Ratcliffe SJ, Kirpalani HM, Foglia EE.JAMA Pediatr. 2025 Aug 11:e252521. doi: 10.1001/jamapediatrics.2025.2521. Online ahead of print.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Outcomes of Preterm Infants Born at 22 to 23 Weeks' Gestation in 11 International Neonatal Networks. Isayama T, Norman M, Kusuda S, Reichman B, Lehtonen L, Lui K, Adams M, Vento Torres M, Filippi L, Battin M, Guinsburg R, Modi N, Håkansson S, Klinger G, de Almeida MF, Helenius K, Bassler D, Su YC, Shah PS; International Network for Evaluation of Outcomes (iNeo) Investigators.JAMA Pediatr. 2025 Aug 25:e252958. doi: 10.1001/jamapediatrics.2025.2958. Online ahead of print.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Cord red blood cell transfusions for severe retinopathy in preterm neonates in Italy: a multicenter randomized controlled trial. Teofili L, Papacci P, Pellegrino C, Dani C, Cresi F, Remaschi G, Ansaldi G, Giannantonio C, Campagnoli MF, Vania B, Fabbri M, de Vera d' Aragona RP, Molisso A, Beccastrini E, Dragonetti A, Pasciuto T, Gabbriellini S, Baroni S, Serrao F, Purcaro V, Raffaeli G, Villa S, Prati D, Mondello I, Falcone A, Patti ML, Boggini T, Bergamaschi P, Lepore D, Franco FGS, Orazi L, Mozzetta I, Baldascino A, Valentini CG, Locatelli E, Albiani R, Besso FG, Cantone GV, Coscia A, Trimarchi A, Cavallaro G, Ghirardello S, Vento G.EClinicalMedicine. 2025 Aug 13;87:103426. doi: 10.1016/j.eclinm.2025.103426. eCollection 2025 Sep.PMID: 40838199 

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Dopamine versus epinephrine for neonatal septic shock: an open labeled, randomized controlled trial. Singh G, Bhaskar V, Batra P, Gupta P.J Perinatol. 2025 Aug 28. doi: 10.1038/s41372-025-02399-7. Online ahead of print.PMID: 40877444

EBNEO Commentary: Review of the 'Norepinephrine Versus Dopamine for Septic Shock in Neonates: A Randomised Controlled Trial'. Altit G.Acta Paediatr. 2025 Jul 23. doi: 10.1111/apa.70241. Online ahead of print.PMID: 40698742 No abstract available.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of The Incubator Podcast, Ben and Daphna sit down with Dr. Dena Hubbard, neonatologist and Director of Quality at Santa Barbara Cottage Hospital’s NICU. Dr. Hubbard is widely recognized for her leadership in trauma-informed care, physician well-being, and advocacy work within the American Academy of Pediatrics.

She shares her journey from private practice to becoming a national voice for trauma-informed approaches in neonatal care. Dr. Hubbard explains how an early encounter with a NICU family transformed her understanding of parental stress, judgment, and resilience—and how that moment shaped her mission to change the way care is delivered. She outlines the principles of trauma-informed care and how these practices differ from traditional family-centered models, emphasizing curiosity over judgment and building trust across the care team.

The conversation also explores physician wellness. Dr. Hubbard speaks candidly about burnout, the role of coaching and therapy, and how she redefined her professional path after personal challenges, including grief and illness. Her perspective offers both practical insights for the bedside and a message of hope for healthcare providers navigating stress and systemic pressures.

This episode highlights the importance of culture change in NICUs and the value of caring for both families and providers.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Tech Tuesday episode, Ben speaks with Jason Beyer, Business Unit Leader for the Care Franchise at Chiesi USA, about the development of NeoCarePal, a free mobile app designed to simplify daily workflows in the NICU.

NeoCarePal brings together a curated collection of the most commonly used neonatal calculators and formulas in one easy-to-use platform. Instead of searching across multiple sources, clinicians can access tools for glucose infusion rates, oxygenation index, gestational and corrected age, umbilical catheter positioning, endotracheal tube depth, Sarnat scoring, bilirubin management based on the 2022 guidelines, and early onset sepsis risk — all validated and referenced directly in the app.

Jason explains how Chiesi moved beyond therapeutics to address unmet needs by listening to clinicians, running focus groups, and designing a solution that reduces frustration at the bedside. The conversation also covers the importance of user experience, ongoing updates based on feedback, and why providing NeoCarePal free of charge was central to its mission.

This episode highlights how industry and clinicians can collaborate to create practical, accessible tools that make neonatal care more efficient and reliable.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this Tech Tuesday episode, Ben speaks with Laurence Gulliver, General Manager for Humidification at Fisher & Paykel Healthcare. With nearly two decades at the company and a background in mechanical engineering and product development, Laurence has helped guide innovations that have shaped respiratory support for neonatal, pediatric, and adult patients worldwide.

The conversation explores the role of humidification in neonatal respiratory care and why it is often overlooked despite its impact on mucociliary function, secretion management, bronchoconstriction, and thermoregulation. Laurence explains the engineering challenges of delivering consistent humidity through ventilator circuits, the burden of condensation management, and how newer platforms like the F&P 950 are designed to improve performance and usability.

They also discuss Fisher & Paykel’s approach to product development, which relies heavily on feedback from caregivers to ensure technology addresses real-world challenges. The episode closes with a broader look at CPAP therapy, opportunities for further innovation in a seemingly simple modality, and the global vision that drives Fisher & Paykel to design solutions adaptable to diverse healthcare settings.

This conversation highlights how thoughtful engineering and collaboration with caregivers translate into meaningful improvements in neonatal outcomes.

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of The Incubator Podcast, Dr. Guilherme Sant’Anna, Professor of Pediatrics at McGill University, joins Ben and Daphna to discuss his team’s work on implementing an early bubble CPAP protocol in the delivery room. Although CPAP has long been considered standard practice for preterm infants, Dr. Sant’Anna explains why intubation rates remain high in the most immature babies and how his group sought to change this pattern.

The conversation reviews the background of the protocol, which began at McGill in 2014, and the cultural shift required to adopt bubble CPAP as the default approach. Dr. Sant’Anna describes the importance of multidisciplinary training, technical details such as proper prong sizing, fixation, humidification, and suctioning, as well as the challenges of sustaining practice change over a decade.

The results of this initiative are striking: lower rates of delivery room intubation, reduced severe BPD, and improvements in outcomes particularly for infants born before 28 weeks. Dr. Sant’Anna also reflects on lessons learned, the global implications of bubble CPAP in resource-limited settings, and the importance of sharing knowledge to improve care everywhere.

This episode highlights how attention to detail, persistence, and team culture can transform neonatal respiratory care.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of The Incubator Podcast, we welcome Dr. Cindy McEvoy, Professor of Pediatrics and Director of Neonatal Research at OHSU, to discuss her work on the use of extended CPAP in preterm infants. CPAP has long been a cornerstone of neonatal care, but how long should stable infants remain on support? Dr. McEvoy shares findings from two randomized controlled trials that explored whether an additional two weeks of CPAP could promote lung growth and improve longer-term outcomes.

We review the physiologic rationale behind extended CPAP, including the role of mechanical stretch in stimulating alveolar and vascular development. Dr. McEvoy explains the stability criteria used to determine eligibility for extended CPAP and how her team measured pulmonary function in neonates. Results from her studies showed significant improvements in lung volume, diffusion capacity, and expiratory flows, with early signals of reduced wheezing at one year of age.

The conversation also touches on feeding tolerance, the practicalities of implementing extended CPAP in the NICU, and the need for larger multicenter studies to confirm these findings. This episode offers an evidence-based look at how a simple extension of an existing therapy might reshape respiratory outcomes for preterm infants.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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In this episode of The Incubator Podcast, we sit down with Dr. David Askenazi, Dr. Heidi Steflik, and Dr. Kimmy Vuong to explore the latest research and practice shifts in neonatal nephrology. The discussion begins with the often-overlooked role of the kidney in the NICU and why kidney health has direct implications for outcomes far beyond discharge.

The group reviews three recent high-impact papers. The first, a secondary analysis of the PENUT trial, examines whether PDA treatment in extremely low gestational age infants influences two-year kidney outcomes, raising questions about long-term renal risks and benefits of medical and surgical interventions. The second paper presents a consensus statement on kidney health monitoring for NICU graduates, offering structured recommendations on risk stratification and follow-up for preterm, critically ill, and cardiac infants. Finally, we highlight a quality improvement initiative that used the “Can You PLOTS” bundle to reduce ventilator days by addressing fluid overload systematically, underscoring the importance of early, proactive kidney-focused care.

This conversation emphasizes kidney disease as a critical factor in neonatal medicine, the growing pathways for neonatal nephrology training, and practical steps teams can take now to better integrate kidney health into NICU care.

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As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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Reducing NICU ventilator days by preventing fluid overload with the CAN-U-P-LOTS standardized bundle.

Askenazi DJ, Gordon L, Griffin R, Collins M, Black A, Ambalavanan N, Webb T, Mathis M, Short K, Umberger A, Travers C.Pediatr Res. 2025 Jul 11. doi: 10.1038/s41390-025-04078-x. Online ahead of print.PMID: 40646283

Support the show

As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.

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