The Incubator's Journal Club

#471 - [Journal Club] - 📌 Should a 34 weeker be resuscitated with 21% or 30% oxygen? Oct 14, 2026 918 What FiO2 should you start at for a 34-week preterm infant who needs help breathing at birth? On this Journal Club, Ben reviews the AIROPLANE trial, a cluster randomized crossover study across 26 Australian maternity hospitals comparing initial FiO2 of 30% versus 21% in 1,818 infants born at 32 to 35 weeks. Ongoing respiratory support leaving the delivery room was nearly identical between groups,

#471 - [Journal Club] - 📌 Could Banana Puree Help Preterm Infants Finally Feed? Oct 13, 2026 1263 What do you do when a feeder-grower has tried every bottle, nipple, and pacing strategy and still can’t finish a feed? On this Journal Club, Daphna brings a palate cleanser after yesterday’s deep dive on probiotics: a retrospective study from Rainbow Babies & Children’s Hospital testing banana puree as a natural thickener for NICU infants with dysphagia. Among 43 mature preterm infants who had

#471 - [Journal Club] - 📌 The remarkable effect of probiotics on NEC in Sweden Oct 12, 2026 1627 Has the evidence on probiotics finally reached a tipping point? On this Journal Club, Ben, fresh off a night shift, opens with two announcements: a follow-up on the ABP’s fellowship length decision and a new partnership with Pediatrix that may finally bring CME to the platform. Daphna highlights the Neonatal Insights conference in Houston. Ben then reviews a Swedish national cohort of nearly 4,700

#469 - [Journal Club] - 📌 Should organ donation be part of every neonatal end-of-life conversation? Oct 1, 2026 1617 In this Journal Club episode, Daphna reviews the first national estimate of potential neonatal organ donors, a Pediatrics cohort study from 23 Australian NICUs, along with its companion commentary. Of 1,760 infants who died in the NICU between 2012 and 2022 at 35 weeks corrected age or later, about one in three met conservative eligibility criteria. Most would have donated after circulatory death,

#469 - [Journal Club] - 📌 What did two Dutch NICUs learn from routine probiotics in preterm infants? Sep 30, 2026 1281 In this Journal Club episode, Ben reviews a JAMA Network Open study from two Dutch Level IV NICUs. It examined NEC before and after routine implementation of a three-strain probiotic in 1,413 infants born before 30 weeks or under 1,000 grams. NEC fell from 11.9% to 5.3%, and late-onset sepsis also declined. But non-NEC mortality rose after implementation. NEC also dropped in an unexposed reference

#469 - [Journal Club] - 📌 Does targeted fortification change brain growth at term? Sep 29, 2026 1021 In this Journal Club episode, Daphna presents a JAMA Pediatrics randomized trial led by Mandy Belfort and Terrie Inder. It tested whether point-of-care human milk analysis, used to individually target protein and fat fortification, improves outcomes in infants born at 24 to 30 weeks. Milk was analyzed every weekday with the Miris analyzer. Fortification in the intervention group was adjusted to me

#469 - [Journal Club] - 📌 Early ibuprofen or waiting, does the PDA choice show up at two years? Sep 28, 2026 1408 In this Journal Club episode, Ben and Daphna review the 24-month follow-up of the BeNeDuctus trial, which compared expectant management with early ibuprofen for PDA in infants born before 28 weeks. Survival without neurodevelopmental impairment was identical in both groups, at 49%. Ben places the findings alongside Baby-OSCAR, the PDA trial, TRIOCAPI, and SMART-PDA, and explains why a neutral resu

#466 - [Journal Club] - 📌 Does IVF Really Raise the Risk of VACTERL Birth Defects? Sep 17, 2026 1120 Ben and Daphna dig into a large, population-based study linking IVF conception to VACTERL association, a rare but serious pattern of congenital anomalies spanning the vertebral, anal, cardiac, tracheoesophageal, renal, and limb systems. Drawing on over 1.5 million births across four US states and linked SART registry data, the study finds IVF-conceived infants face significantly higher odds of VA

#466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants? Sep 16, 2026 980 Ben and Daphna dig into a pilot RCT that asks a deceptively simple delivery-room question: should very preterm infants start on CPAP of 5 or CPAP of 8 cmH2O? The PHILODENDRON trial, out of Milan's Buzzi Children's Hospital, randomized 56 babies born between 26 and 29 weeks to find out — testing feasibility, safety, and early physiological adaptation before committing to a larger multicen

#466 - [Journal Club] - 📌 Oral isn't IM: Sweden's vitamin K data in two million infants Sep 15, 2026 1371 Is the newborn vitamin K shot really being skipped more often these days, and does that actually matter clinically? This week on Journal Club, Ben and Daphna review a nationwide Swedish cohort study of over two million births, published in JAMA Pediatrics, examining trends in non-receipt of intramuscular vitamin K and its link to bleeding in infancy. Non-receipt nearly doubled between 2006 and 202

#466 - [Journal Club] - 📌 Do We Still Need a DAT on Every Newborn at Risk of Hemolytic Disease? Sep 14, 2026 1605 Do we really need a DAT on every baby born to a group O or Rh-negative mother? This week on Journal Club, Ben and Daphna dig into a new Pediatrics study questioning routine Direct Antiglobulin Testing (DAT) in low-risk neonates with ABO or RhD incompatibility. Using data from over 1,300 infants, the authors found that transcutaneous bilirubin alone predicted the need for phototherapy just as well

#462 - [Journal Club] - 📌 Dexamethasone Eye Drops Prevent Treatment Requiring ROP? Sep 3, 2026 992 Steroids again? This time in the eye. Daphna brings the DROP-ROP trial from JAMA Pediatrics, a double-masked randomized study across fourteen Swedish centers asking whether topical dexamethasone can stop pre-threshold ROP from progressing to type one disease. One hundred infants, born under 30 weeks, dosed for up to twelve weeks, some still getting drops at home. Twenty percent needed laser or ant

#462 - [Journal Club] - 📌 Continuous vs Bolus Feeding, Which One Grows Babies Better? Sep 2, 2026 1040 Every unit has a bolus camp and a continuous camp, and both are usually dug in. Ben brings a single center non-inferiority trial from India, published in the Journal of Pediatrics, randomizing 132 infants born before 29 weeks and under a thousand grams to extended infusion feeding or two hourly bolus feeds. Weight gain at discharge was essentially identical at 15.3 versus 15.7 grams per kilo per d

#462 - [Journal Club] - 📌 After HEAL Does a Second Trial Close the Book on EPO? Sep 1, 2026 1289 We already had HEAL, so why run this trial at all? Daphna brings PAEAN from JAMA Pediatrics, a phase three trial across 24 units in Australia, New Zealand, and Singapore that gave high dose erythropoietin to 313 late preterm and term infants already receiving therapeutic hypothermia for HIE. Same drug, same dosing, nearly the same eligibility criteria as HEAL, by design. Death or moderate to sever

#462 - [Journal Club] - 📌 After LISA Does CPAP Perform as Well as NIMV Below 30 Weeks? Aug 31, 2026 1203 Most trials comparing CPAP and NIMV leave a lingering doubt about whether surfactant explained the difference. This one does not. Ben brings a multicenter noninferiority trial from JAMA Network Open in infants born between 24 and 29 weeks, randomized to nasal CPAP or NIMV with every baby receiving less invasive surfactant administration. The trial stopped early for futility after 312 infants. Noni

#458 - [Journal Club] - 📌 Can the respiratory severity score show us where a baby is heading? Aug 14, 2026 1539 The respiratory severity score is one multiplication most of us already do in our heads, mean airway pressure times FiO2. This week Dr. Dinushan Kaluarachchi joins Journal Club to walk through three papers built on it, RSS trajectories across gestational age in the PROP cohort, an RSS based grading of BPD at 36 weeks, and RSS after 40 weeks as a predictor of tracheostomy. He also talks about writi

#458 - [Journal Club] - 📌 Could a handheld light probe detect NEC before the X-ray does? Aug 13, 2026 1269 NEC still tends to announce itself on an X-ray, usually later than we want. This week Daphna reviews the first-in-human study of broadband optical spectroscopy, a handheld transcutaneous probe out of Lurie Children's that reads reflected light from 350 to 2500 nanometers to look at bowel beneath the skin. Just under 100 preterm infants, more than 11,000 scans, and a machine learning model tha

#458 - [Journal Club] - 📌 Is this the trial that brings probiotics back to the NICU? Aug 12, 2026 1552 Probiotics left US NICUs after the FDA reclassified them, and NEC rates went up. This week Ben reviews the Connection Study, a 2,158 infant phase 3 trial of IBP-9414, a live biotherapeutic product containing Limosilactobacillus reuteri, run under an IND with the regulatory rigor probiotics never had. Neither primary endpoint reached significance, but all cause mortality fell 27%, and surgically co

#458 - [Journal Club] - 📌 Does holding during cooling change NICU outcomes in HIE? Aug 11, 2026 1039 Parents of babies undergoing therapeutic hypothermia often wait days before they can hold their child, and many never get the chance during cooling at all. This week on Journal Club, Daphna reviews a new Journal of Perinatology retrospective cohort from two level IV NICUs, 379 infants with HIE, where 28% were held during cooling. Held infants reached full oral feeds sooner, were more likely to go

#458 - [Journal Club] - 📌 Should late preterm infants born by cesarean receive prophylactic CPAP? Aug 10, 2026 2161 Late preterm babies born by cesarean fill our NICUs, and most of them are there for respiratory distress that resolves in a day or two. Could 20 minutes of CPAP in the operating room keep them out? This week on Journal Club, Ben and Daphna break down the PLaNT trial, a five center randomized pilot of prophylactic CPAP at 5 to 6 cm of water in spontaneously breathing infants born at 34 to 36 weeks

#456 - [Journal Club] - 🫀 From The Heart - Do These Newborns Have Diastolic Dysfunction, or Just Different Physiology? Jul 30, 2026 838 In this prospective study, Adrianne and Nim dig into an area with almost no normative pediatric data: right ventricular diastolic function. Comparing 57 infants with RV pressure overload after intervention for pulmonic stenosis or tetralogy of Fallot to 134 healthy controls, the authors found a consistent pattern, reduced beat-to-beat variability, a higher atrial contribution to filling, and an E/

#456 - [Journal Club] - 🫀 From The Heart - Why Does a Sicker Mom Sometimes Mean a Stronger Neonatal Heart? Jul 29, 2026 815 In this small prospective pilot study, Adrianne and Nim explore a domain rarely discussed on rounds, how a mother's cardiovascular function in preeclampsia shapes her newborn's circulatory transition. Using maternal echo and neonatal electrical cardiometry across 13 mother-baby dyads, the authors found an inverse relationship: the worse the mother's cardiac function, the higher the

#456 - [Journal Club] - 🫀 From The Heart - Why Is CHD Mortality Rising Again After 15 Years of Progress? Jul 28, 2026 696 In this retrospective national study, Adrianne and Nim look at 25 years of congenital heart disease mortality in the US using CDC WONDER data. Infant mortality remains staggeringly high (54 per 100,000), and after years of steady decline, it has been climbing again since 2014. Disparities run throughout: higher deaths among males, non-Hispanic Black and American Indian/Alaska Native populations, a

#456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD? Jul 27, 2026 1153 In this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predi

#453 - [Journal Club] - 📌 What Happened to NEC When Centers Stopped Using Probiotics? Jul 16, 2026 982 When the FDA warning landed in late 2023, probiotic use in high-use NICUs collapsed from 86% to under 7% almost overnight. What happened to NEC? This week Daphna brings Tolia and Patel's new Journal of Perinatology analysis of the Pediatrix Clinical Data Warehouse, a natural experiment across 347 NICUs and more than 10,000 extremely preterm infants. Centers that stopped saw NEC climb from 2.7

#453 - [Journal Club] - 📌 Should We Cool 35 Week Infants with Encephalopathy? Jul 15, 2026 877 Cooling works at 36 weeks. At 35 weeks, nobody is sure. Ben brings a new Journal of Perinatology analysis of the National Inpatient Sample, covering 1.4 million infants from 2016 to 2022, asking what happens when therapeutic hypothermia is offered just below the evidence line. Cooled 35-weekers died at higher rates than cooled 36-weekers, but within the 35-week group, cooling changed nothing eithe

#453 - [Journal Club] - 📌 Can We Rewire a Preterm Baby's Brain for Language? Jul 14, 2026 1265 In this Journal Club, Daphna takes the reins with the MIND randomized controlled trial from Nathalie Maitre and colleagues in The Journal of Pediatrics. Can a multisensory bundle, combining infant-directed voice, a parent's scent, holding, and gentle containment, do more for a preterm baby's developing brain than recorded voice alone? Using event-related potentials to track how infants t

#453 - [Journal Club] - 📌 Should We Treat the PDA Based on Size Alone? (SMART PDA Trial) Jul 13, 2026 2573 In this Journal Club, Ben and Daphna dig into two new papers on PDA management in our smallest patients. First, the SMART-PDA pilot RCT from Souvik Mitra and colleagues, which uses comprehensive hemodynamic screening to selectively treat high-volume shunts in infants born before 26 weeks, and whose striking Bayesian signal for reduced pulmonary hemorrhage and NEC stopped the trial early. Then a co

#450 - [Journal Club] - 🫀 From The Heart - Is Dopamine Still Defensible as First-Line for Neonatal Septic Shock? Jul 1, 2026 956 In this double-blind randomized controlled trial, Adrianne and Nim examine whether norepinephrine outperforms dopamine as a first-line vasoactive agent in neonates with fluid-refractory septic shock. The primary outcome, shock reversal at 30 minutes, was not significantly different between groups, at 32 percent for norepinephrine and 46 percent for dopamine. Secondary outcomes including mortality,

$#450 - [Journal Club] - 🫀 From The Heart - Does Early Hydrocortisone Actually Move the Needle in Fluid-Refractory Shock?$

#450 - [Journal Club] - 🫀 From The Heart - Does Early Hydrocortisone Actually Move the Needle in Fluid-Refractory Shock? Jun 30, 2026 982 In this double-blind randomized controlled trial from northern India, Nim and Adrianne review whether early hydrocortisone reduces 14-day all-cause mortality in preterm infants with fluid-refractory shock. The primary outcome showed no statistically significant difference between groups, though an 11 percent absolute reduction in mortality in the hydrocortisone group raised clinical interest. A ma

#450 - [Journal Club] - 🫀From The Heart - When Nitric Oxide Fails: Is the Left Ventricle the Culprit in Septic Preterm Infants? Jun 29, 2026 1344 In this retrospective single-center study from Toronto, Adrianne and Nim explore the echo findings of preterm infants with septic shock and hypoxemic respiratory failure. Contrary to the common assumption that elevated pulmonary vascular resistance drives hypoxemia in sepsis, the data points to left ventricular dysfunction as a key contributor. Babies with hypoxemic respiratory failure showed lowe

#447 - [Journal Club] - 📌 Is a Five-Day Antibiotic Course Enough to Treat UTIs in the NICU? Jun 11, 2026 1294 Is five days of antibiotics enough to treat a urinary tract infection in a NICU infant? In this Journal Club episode, Ben and Daphna review a single-center study from Nationwide Children's Hospital examining adherence and safety of a five-day antibiotic treatment guideline for culture and urinalysis-proven UTIs in the NICU. Among 77 infants with 93 bacterial UTIs, the five-day course was asso

#447 - [Journal Club] - 📌 Does Extended CPAP Reduce Intermittent Hypoxemia in Stable Preterm Infants? Jun 10, 2026 1097 What happens to intermittent hypoxemia when you keep a stable preterm infant on CPAP for two extra weeks? In this Journal Club episode, Ben and Daphna review a secondary analysis from the Journal of Pediatrics by Mamidi and McEvoy. Among 95 infants randomized to either two additional weeks of bubble CPAP on room air or discontinued CPAP, those in the extended CPAP group experienced significantly f

#447 - [Journal Club] - 📌 Are we missing UTIs in neonates hospitalized for unexplained jaundice? Jun 9, 2026 916 In this Journal Club episode, Daphna reviews a retrospective cohort study from Istanbul examining clinical, laboratory, and ultrasound factors associated with UTI in neonates hospitalized for unexplained hyperbilirubinemia. Among 96 term and near-term infants, 31% had culture-proven UTIs, a striking prevalence. Pathological renal ultrasound findings were independently associated with UTI, with aff

#447 - [Journal Club] - 📌 Is phototherapy doing more harm than good in very preterm infants? Jun 8, 2026 1400 In this Journal Club episode, Ben and Daphna review a nationwide Swedish cohort study examining the association between phototherapy duration and neonatal outcomes in very preterm infants (22 to 31 weeks). The study’s primary outcome, late neonatal mortality on days 8 to 27, was not significantly associated with phototherapy duration. However, longer phototherapy exposure was associated with incre

#445 - [Journal Club] - 📌 Are we missing dysphagia in very preterm infants before they leave the NICU? May 28, 2026 1111 How often are we missing dysphagia in our most vulnerable NICU patients? In this episode of Journal Club, Daphna reviews a retrospective cohort study from the Journal of Perinatology examining the incidence and risk factors of dysphagia confirmed by flexible endoscopic evaluation of swallowing (FEES) in very preterm and very low birth weight infants. Among infants showing persistent feeding diffic

#445 - [Journal Club] - 📌 Does an exclusive human milk diet improve growth in very low birth weight infants? May 28, 2026 1412 Japan has some of the best survival rates for extremely preterm infants in the world, yet feeding practices there look very different from what many of us are used to. In this episode of Journal Club, Ben reviews the JASMINE trial, a multicenter phase three randomized controlled trial evaluating an exclusive human milk diet compared to a standard cow milk-based diet in very low birth weight infant

#445 - [Journal Club] - 📌 Can a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? May 28, 2026 1334 Could putting a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? In this episode of Journal Club, Daphna reviews a randomized controlled trial from the European Journal of Pediatrics investigating the physiologic effects of intranasal expressed breast milk (EBM) administration in preterm infants. The study found that infants receiving 0.2 mL of fresh

#445 - [Journal Club] - 📌 Can symptom-based dosing cut hospitalization time for babies with neonatal opioid withdrawal syndrome? May 28, 2026 1452 One infant is diagnosed with neonatal opioid withdrawal syndrome every 27 minutes, and rates are rising. In this episode of Journal Club, Ben and Daphna review the Optimized NOW randomized clinical trial, a landmark multicenter study published in JAMA. The trial compared symptom-based dosing, a single opioid dose given when a withdrawal threshold is met against the traditional scheduled opioid ta

#442 - [Journal Club] - 📌 Does combining EEG and MRI improve neurodevelopmental prognostication in preterm infants? May 14, 2026 754 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 th

#442 - [Journal Club] - 📌 Is a low Apgar score more concerning than a low umbilical pH in preemies? May 13, 2026 1247 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 disc

#442 - [Journal Club] - 📌 Does 24 hour in house staffing decrease physician productivity metrics? May 12, 2026 1030 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

#442 - [Journal Club] - 📌 Does NIRS guided treatment improve clinical outcomes for extremely preterm infants? May 11, 2026 1282 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 maintain

#434 - [Journal Club] - 📌 LISA and Caffeine Together: What Do the Two-Year Outcomes Actually Show? Apr 16, 2026 1180 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 fol

#434 - [Journal Club] - 📌 Could Intranasal Breast Milk Be the Next Adjunct Therapy for HIE? Apr 15, 2026 774 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

#434 - [Journal Club] - 📌 Can Ultrasound Help Us Better Identify Surgical NEC? Apr 14, 2026 964 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&

#434 - [Journal Club] - 📌 AAP update on therapeutic hypothermia for neonates with HIE Apr 13, 2026 1933 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 aroun

#431 - [Journal Club] - 📌 Can Retinal Images Predict BPD and Pulmonary Hypertension? Apr 2, 2026 620 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

#431 - [Journal Club] - 📌 Rethinking the Link Between BPD Grades and Pulmonary Hypertension Apr 1, 2026 1290 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,

#431 - [Journal Club] - 📌 Should We Stop Routine Car Seat Testing for Preterm Infants? Mar 31, 2026 1061 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 uninten

#431 - [Journal Club] - 📌 Prophylactic hydrocortisone to improve BPD-free survival? Mar 30, 2026 1008 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

#410 - [Journal Club] - 📌 Should We Increase Caffeine Dosing for Extremely Preterm Infants? Mar 12, 2026 915 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 i

#410 - [Journal Club] - 📌 Does Drying Very Preterm Infants Before Wrapping Improve Normothermia? Mar 11, 2026 1171 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 r

#410 - [Journal Club] - 📌 Is Diazoxide Use Increasing for NICU Hypoglycemia? Mar 10, 2026 921 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 sup

#410 - [Journal Club] - 📌 Prophylactic Acetaminophen for PDA, Does Early Closure Improve Outcomes? Mar 9, 2026 1294 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 survi

#399 - [Journal Club] - 📌 From Screening to Solution: Resolving Food Insecurity in Pediatrics Feb 26, 2026 1295 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

#399 - [Journal Club] - 📌 Early Vitamin D: Can 800 IU Prevent BPD in Preterms? Feb 25, 2026 952 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

#399 - [Journal Club] - 📌 8 Days vs. 14 Days: Can We Shorten Antibiotics for Gram-Negative Sepsis? Feb 24, 2026 1270 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 sta

#399 - [Journal Club] - 📌 Are We Compressing the Wrong Ventricle in Neonatal CPR? Feb 23, 2026 840 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 targ

#396 - [Journal Club] - 📌 Cooling Late Preterms: Higher Mortality in 34-35 Weekers? Feb 12, 2026 1321 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 impli

#396 - [Journal Club] - 📌 The 6-Fold Risk of NEC in Growth Restricted Infants Feb 11, 2026 1014 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 over

#396 - [Journal Club] - 📌 Surfactant Thresholds: Is 40% FiO2 as Safe as 30%? Feb 10, 2026 876 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

#396 - [Journal Club] - 📌 TORPIDO 30/60: Is Higher Initial Oxygen Safer for Preterm Infants? Feb 9, 2026 1215 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 regardin

#393 - [Journal Club] - 📌 Are We Too Busy? NICU Strain and Adverse Outcomes Jan 15, 2026 1414 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 ad

#393 - [Journal Club] - 📌 Replacing Sepsis Screens with Serial Physical Exams: Is It Safe? Jan 14, 2026 1022 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 compellin

#393 - [Journal Club] - 📌 Antibiotic Use in HIE, A Tale of Two Strategies Jan 13, 2026 1243 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. F

#393 - [Journal Club] - 📌 Can NT-proBNP Guide Clinical Suspicion of Chronic Pulmonary Hypertension? Jan 12, 2026 1245 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 echocardiograp

#392 - [Journal Club] - 📌 Do Antenatal Corticosteroids Improve Survival for Babies Born at 21–24 Weeks? Jan 8, 2026 939 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 counseli

#392 - [Journal Club] - 📌 Could Longer Caffeine Treatment Reduce Hypoxia and Speed Discharge? Jan 7, 2026 814 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

#392 - [Journal Club] - 📌 Early Outcome Data After Resuscitation at 21 Weeks’ Gestation Jan 6, 2026 1619 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 h

#392 - [Journal Club] - 📌 Is PDA Treatment Doing More Harm Than Good in Preterm Infants? Jan 5, 2026 1228 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 bronchop

#388 - 📑 Journal Club - The Complete Episode from December 21st 2025 Jan 1, 2026 5101 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 (≥1

#388 - [Journal Club Shorts] - 📌 Can We Predict Which Extremely Preterm Infants Need Early Cord Clamping? Jan 1, 2026 876 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 p

#388 - [Journal Club Shorts] - 📌 Can Maternal Mental Health Predict Neurodevelopmental Delays in Toddlers? Jan 1, 2026 833 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. Support the showAs always, feel free to send us questio

#388 - [Journal Club Shorts] - 📌 EBNEO Commentary - Treatment of Hypotension of Prematurity: a randomised trial. Jan 1, 2026 1326 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. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast

#388 - [Journal Club Shorts] - 📌 Are forces applied to a baby's airway lower with video laryngoscopy? Jan 1, 2026 857 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. Support the showAs always, feel free to send us qu

#388 - [Journal Club Shorts] - 📌 Does Early High-Volume Feeding Improve Body Composition in Preterm Infants? Jan 1, 2026 532 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. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nic

#388 - [Journal Club Shorts] - 📌 Should Preterm Infants Receive Full Feeds from Day One? Jan 1, 2026 910 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 Healt

#371 - 📑 Journal Club - The Complete Episode from October 26th 2025 Jan 1, 2026 4310 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

#371 - [Journal Club Shorts] - 📌 Risk Factors for NEC in Preterm Infants on an Exclusive Human Milk Diet Jan 1, 2026 967 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 Support the showAs always, feel free to send us questions, comments, or sug

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