The Incubator
A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.
Episodes
#466 - 📑 Journal Club - The Complete Episode from September 19th 2026
Send us Fan MailThis week on The Incubator Podcast, Ben and Daphna dig into four studies reshaping bedside decisions. They open questioning whether routine DAT screening for ABO and RhD incompatibility still earns its place, finding transcutaneous bilirubin alone predicts phototherapy need just as well. Next, a Swedish national registry of over two million births links missed intramuscular vitamin
#466 - [Neo News] - 📌 Why Are 4 in 10 NICU Stays Missing From Birth Records?
Send us Fan MailBen and Eli dig into a Journal of Perinatology study that asks a deceptively simple question: can we trust birth certificate data to tell us how many babies actually need NICU care? The answer, it turns out, is no. Nearly 40% of NICU admissions are missing from birth certificates, with the biggest gaps among full-term and late-preterm infants, and troubling racial disparities in wh
#466 - [Journal Club] - 📌 Does IVF Really Raise the Risk of VACTERL Birth Defects?
Send us Fan MailBen 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 h
#466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants?
Send us Fan MailBen 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
#466 - [Journal Club] - 📌 Oral isn't IM: Sweden's vitamin K data in two million infants
Send us Fan MailIs 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 betw
#466 - [Journal Club] - 📌 Do We Still Need a DAT on Every Newborn at Risk of Hemolytic Disease?
Send us Fan MailDo 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 photothera
#465 - [🫀 From The Heart] - Bringing NICU Feeding Practices to the CICU (ft Dr. Elgersma)
Send us Fan MailIn this episode of From the Heart, Drs. Nim Goldshtrom and Adrianne Bischoff talk with Dr. Kristin Elgersma, a nurse-researcher whose path into neonatal nutrition began at her son's bedside in a cardiac ICU. A former concert pianist turned nurse-researcher, Kristin asked a question no one had: does human milk change outcomes for babies with congenital heart disease? Her multic
#464 - [🫀 From The Heart] - Right Drugs, Wrong Heart - A TTTS Recipient That Fooled Everyone
Send us Fan MailIn this episode of From the Heart, Dr. Nim Goldshtrom and Dr. Adrianne Bischoff dissect a hemodynamics consult that changes shape twice in 48 hours. A 30-week recipient twin from twin-to-twin transfusion syndrome presents with biventricular dysfunction and suprasystemic pulmonary hypertension, starts on epinephrine and milrinone, and stabilizes. Then overnight, everything falls apa
#463 - 🗳️ Meet the Neonatologist Running for AAP President - A Conversation with Dr. Wanda Barfield
Send us Fan MailDisclosure: Dr. Wanda Barfield appeared on this episode in her personal capacity. The views she expresses are her own and do not represent the official positions of the Centers for Disease Control and Prevention, the Department of Health and Human Services, or the United States government.The American Academy of Pediatrics has never had a neonatologist as president. This September,
#462 - 📑 Journal Club - The Complete Episode from September 5th 2026
Send us Fan MailThis week's Journal Club. Monday, nasal CPAP versus NIPPV as the bridge to minimally invasive surfactant in infants born before 30 weeks, first author Dr. Hui Zhang. Tuesday, the PAEAN trial on high-dose erythropoietin for neonatal HIE, led by Dr. Helen Liley. Wednesday, extended infusion versus bolus feeding for weight gain in extremely-low-birth-weight infants, from Dr. Hari
#462 - [Neo News] - 📌 What Does The Pitt Get Right About Boundaries in Medicine?
Send us Fan MailA medical student on The Pitt finishes her shift, is asked to stay, and tells her supervisor to learn some boundaries. The internet did not let it go. Ben and Eli use that moment to work through what boundary setting actually looks like in a NICU, why a tired clinician makes different decisions at three in the morning than at three in the afternoon, and where duty hours collide wit
#462 - [Journal Club] - 📌 Dexamethasone Eye Drops Prevent Treatment Requiring ROP?
Send us Fan MailSteroids 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 nee
#462 - [Journal Club] - 📌 Continuous vs Bolus Feeding, Which One Grows Babies Better?
Send us Fan MailEvery 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 gram
#462 - [Journal Club] - 📌 After HEAL Does a Second Trial Close the Book on EPO?
Send us Fan MailWe 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 m
#462 - [Journal Club] - 📌 After LISA Does CPAP Perform as Well as NIMV Below 30 Weeks?
Send us Fan MailMost 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 3
#461 - [🫀 From The Heart] - Blue Baby, Gray Baby: Severe LV Dysfunction Masquerading as PPHN
Send us Fan MailA term newborn looks fine on mom's chest, then crashes within minutes. By the time transport arrives, there's a pH of 6.9, a lactate over 10, and a baby already intubated and on surfactant. Is this pulmonary hypertension, congenital heart disease, or something else entirely? In this episode of From the Heart, It's Complicated, Dr. Adrianne Bischoff and Dr. Nim Goldsh
#460 - Reading as a neuroprotective intervention
Send us Fan MailWhy does reading in the NICU still feel optional when the evidence says otherwise? Daphna sits down with Paige Pedroli, author of the Nic Zoo book and two-time NICU mom, and Dr. Raquel Garcia, a craniofacial and feeding specialist, to unpack why reading to preterm and critically ill infants belongs alongside kangaroo care as neuropromotive, not just neuroprotective. They cover the
#459 - Which AI tools are actually ready for the NICU right now?
Send us Fan MailIs your EMR actually built for neonatology, or just retrofitted to survive it? Ben sits down with Dr. Lindsey Knake, clinical assistant professor and associate chief health information officer at the University of Iowa, to talk AI in the NICU. They cover the real difference between Epic's homegrown tools and third-party options like Evidently and NABLA, why a six-month hospita
#458 - 📑 Journal Club - The Complete Episode from August 15th 2026
Send us Fan MailThe full week of Journal Club in one place. Monday, the PLaNT trial of prophylactic CPAP for late preterm infants born by cesarean, with senior author Dr. Edgardo Szyld. Tuesday, whether parental holding during therapeutic hypothermia changes feeding and length of stay. Wednesday, the Connection Study, the first live biotherapeutic product tested under an IND, and what it means for
#458 - [Journal Club] - 📌 Can the respiratory severity score show us where a baby is heading?
Send us Fan MailThe 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 t
#458 - [Journal Club] - 📌 Could a handheld light probe detect NEC before the X-ray does?
Send us Fan MailNEC 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 le
#458 - [Journal Club] - 📌 Is this the trial that brings probiotics back to the NICU?
Send us Fan MailProbiotics 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%, a
#458 - [Journal Club] - 📌 Does holding during cooling change NICU outcomes in HIE?
Send us Fan MailParents 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 mo
#458 - [Journal Club] - 📌 Should late preterm infants born by cesarean receive prophylactic CPAP?
Send us Fan MailLate 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
#457 - Are We Rethinking When and How We Give Surfactant (ft Dr. Roger Soll)
Send us Fan MailWhen is surfactant "early," and when is it too early, or too late? In this second installment of our two-part series with the Neonatal Resuscitation Symposium, Ben Courchia sits down with Dr. Roger Soll, a leading voice in surfactant research since the 1980s, to trace how our thinking on timing has evolved, from aggressive prophylactic dosing to selective rescue therapy t
#456 - 📑 Journal Club - The Complete Episode from August 1st 2026
Send us Fan MailWhich babies with critical congenital heart disease face the highest risk of brain injury, and does earlier surgery actually help? Why is infant CHD mortality climbing again after years of decline, and who's most affected? Can a mother's cardiovascular status in preeclampsia predict her newborn's circulatory transition? This week's Journal Club brings together f
#456 - [Neo News] - 📌 Why Did the US Fund a Hepatitis B Trial That Withheld the Birth Dose?
Send us Fan MailIn this episode of Neo News, Ben and Eli break down a troubling story in vaccine policy: an unsolicited $1.6 million CDC grant funding a Danish research group's trial in Guinea-Bissau, one designed to withhold or delay the hepatitis B birth dose from thousands of newborns in a country where the disease is highly endemic. They trace the ethical parallels to Tuskegee, the fundin
#456 - [Journal Club] - 🫀 From The Heart - Do These Newborns Have Diastolic Dysfunction, or Just Different Physiology?
Send us Fan MailIn 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 fi
#456 - [Journal Club] - 🫀 From The Heart - Why Does a Sicker Mom Sometimes Mean a Stronger Neonatal Heart?
Send us Fan MailIn 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,
#456 - [Journal Club] - 🫀 From The Heart - Why Is CHD Mortality Rising Again After 15 Years of Progress?
Send us Fan MailIn 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 Nativ
#456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD?
Send us Fan MailIn 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 clinic
#455 - [Neo News] - Is Communication a Procedural Skill We're Failing to Train?
Send us Fan MailWhat if communication were treated as a procedure, something we train for and get feedback on, just like an intubation? In this episode of Neo News, Eli Cahan talks with Dr. Jessica Fry of Northwestern University and Lurie Children's Hospital about her NeoReviews piece, "Recognizing Communication as a Procedural Skill in Neonatology." Dr. Fry shares the personal los
#454 - PEEP, Tidal Volume, and Physiology, How Far Has Resuscitation Science Traveled? (ft Dr. Charles Roehr)
Send us Fan MailHow far has delivery room ventilation really come? In this special episode, recorded in collaboration with the Neonatal Resuscitation Symposium, Ben sits down with Dr. Charles Roehr, professor of neonatology and perinatal medicine at the University of Bristol, clinical trialist at the University of Oxford, and member of ILCOR. Together they trace the evolution of respiratory suppor
#453 - 📑 Journal Club - The Complete Episode from July 18th 2026
Send us Fan MailWhich PDAs actually need treatment? Can maternal voice and scent shape language outcomes? Should we cool at 35 weeks? And did stepping away from probiotics come at a cost? This week’s Journal Club takes on five papers that push back on standard practice. Ben reviews the SMART-PDA trial and a comparative study of PDA pharmacotherapy, Daphna covers the MIND trial on multisensory mate
#453 - [Neo News] - 📌 Are You Still Assuming Every Newborn Got Vitamin K?
Send us Fan MailVitamin K refusal has crossed 5%. That's one in twenty babies, and the curve is bending the wrong way. Ben and Eli work through a new Pediatrics case review that opens with a warning shot, that hemorrhagic presentation in an infant should no longer be a diagnostic mystery, alongside a JAMA letter tracking refusal from 2.9% in 2017 to 5.2% in 2024. Eighty-one times the risk. In
#453 - [Journal Club] - 📌 What Happened to NEC When Centers Stopped Using Probiotics?
Send us Fan MailWhen 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 NE
#453 - [Journal Club] - 📌 Should We Cool 35 Week Infants with Encephalopathy?
Send us Fan MailCooling 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 chang
#453 - [Journal Club] - 📌 Can We Rewire a Preterm Baby's Brain for Language?
Send us Fan MailIn 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 tra
#453 - [Journal Club] - 📌 Should We Treat the PDA Based on Size Alone? (SMART PDA Trial)
Send us Fan MailIn 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
#452 - 🚀 [Tech Tuesday] - Why Midline Positioning Matters More Than We Think
Send us Fan MailIn this episode, Ben and Daphna sit down with Dr. Scott, pediatrician, neonatologist, and inventor of the Tortle. She shares how a simple observation in her Idaho practice, babies developing flat heads despite diligent parents, sparked a second career in medical device innovation. The conversation covers the evolution from the original corrective beanie to the Midliner and Transpor
#451 - On with VON (EPS 3) - Re-examining the Evidence for Erythropoiesis-Stimulating Agents in Preterm Infants
Send us Fan MailDoes the latest Cochrane evidence finally tip the balance in favor of erythropoiesis stimulating agents in preterm infants? In this VON Grand Rounds follow-up episode, Ben sits down with Dr. Roger Soll and Dr. Souvik Mitra to review the 2026 Cochrane systematic review on early ESA use in preterm newborns. Across 37 trials and over 6,000 infants, early ESAs consistently reduce the n
#450 - 📑 [Journal Club] - 🫀From The Heart - The Complete Episode from July 4th 2026
Send us Fan MailNeonatal sepsis physiology, steroids, vasopressors, and moms.gov. A full week on The Incubator Journal Club.Adrianne and Nim open with a retrospective study from Toronto challenging the assumption that hypoxemic respiratory failure in septic preterm infants is driven by elevated pulmonary vascular resistance. The data points instead to left ventricular dysfunction as a key contribu
#450 - [Neo News] - 📌 What Does the Launch of moms.gov Mean for Your Patients?
Send us Fan MailIn this episode of Neo News, Ben and Eli discuss the federal government's Mother's Day press conference and the launch of moms.gov, a new website aimed at supporting new and expecting mothers. They examine what the administration got right, including the real barriers families face in accessing maternal care and the economic challenges of having children in America today.
#450 - [Journal Club] - 🫀 From The Heart - Is Dopamine Still Defensible as First-Line for Neonatal Septic Shock?
Send us Fan MailIn 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 incl
#450 - [Journal Club] - 🫀 From The Heart - Does Early Hydrocortisone Actually Move the Needle in Fluid-Refractory Shock?
Send us Fan MailIn 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 clinica
#450 - [Journal Club] - 🫀From The Heart - When Nitric Oxide Fails: Is the Left Ventricle the Culprit in Septic Preterm Infants?
Send us Fan MailIn 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 fai
#449 - What Do Division Heads Think About the Shortened Fellowship Proposal?
Send us Fan MailWhat would it really mean to shorten neonatology fellowship training to two years? In this episode, Ben and co-host Dr. Shetal Shah sit down with three division heads, Dr. Jill Maron (Brown), Dr. Patrick McNamara (University of Iowa), and Dr. Sarah Taylor (Yale), to examine the ABP's proposed changes from the perspective of those who run major academic NICUs. From the operatio
#448 - Are NICU Outcomes Actually Getting Better Over Time? (ft Dr. Joseph Kaempf)
Send us Fan MailWhat does it mean to truly improve outcomes for very low birth weight infants, and are we actually doing it? In this episode, Daphna sits down with Dr. Joseph Kaempf, neonatologist and Medical Director of Value Research and Innovation at Providence Health System in Oregon, to examine some uncomfortable truths about neonatal quality improvement. Dr. Kaempf shares findings from a stu
#447 - 📑 Journal Club - The Complete Episode from June 13th 2026
Send us Fan MailPhototherapy duration, jaundice and UTIs, extended CPAP, and The Pitt. A full week on the Incubator Journal Club.Ben opens with a nationwide Swedish cohort study from JAMA Network Open examining phototherapy duration in nearly 5,000 very preterm infants. Longer phototherapy was not significantly associated with late neonatal mortality, but six to seven days was associated with sign
#447 - [Neo News] - 📌 - Why Are Doctors Flocking to HBO Max's The Pitt?
Send us Fan MailIn this episode of Neo News, Ben and Eli discuss the cultural phenomenon of HBO Max’s new hit medical drama, The Pitt. Sparked by an insightful critique in The New Yorker by Dr. Dhruv Khullar, they dive into why this Noah Wyle-led series is capturing the attention of millions of Americans, including healthcare workers and patients alike. They explore how the show’s unflinching port
#447 - [Journal Club] - 📌 Is a Five-Day Antibiotic Course Enough to Treat UTIs in the NICU?
Send us Fan MailIs 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
#447 - [Journal Club] - 📌 Does Extended CPAP Reduce Intermittent Hypoxemia in Stable Preterm Infants?
Send us Fan MailWhat 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
#447 - [Journal Club] - 📌 Are we missing UTIs in neonates hospitalized for unexplained jaundice?
Send us Fan MailIn 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 wi
#447 - [Journal Club] - 📌 Is phototherapy doing more harm than good in very preterm infants?
Send us Fan MailIn 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 assoc
#446 - Is Bedside Transcatheter PDA Closure Ready for Your NICU?
Send us Fan MailWhat if closing a PDA could be done at the bedside in under 10 minutes, without transporting a fragile preterm infant to the cath lab? Dr. Shyam Sathanandam, Chief of Cardiovascular Medicine at Nicklaus Children's Heart Institute, joins us to discuss the evolution of transcatheter PDA closure in extremely preterm infants. We cover how bedside procedures protect the most vulner
#445 - 📑 Journal Club - The Complete Episode from May 30th 2026
Send us Fan MailOpioid withdrawal dosing, intranasal breast milk, human milk fortification in Japan, neonatal dysphagia, and vaccine policy. A full week on the Incubator Journal Club.Ben opens with the Optimized NOW trial in JAMA: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days in NOWS infants managed with Eat Sleep Console, and allowed 65% of pha
#445 - [Neo News] - 📌 Are Regulatory Roadblocks Threatening the Future of Neonatal Vaccines?
Send us Fan MailIn this fast-paced episode of Neo News, Eli and Ben tackle the rapidly shifting landscape of vaccine regulation and economics in the US. They discuss recent political maneuvers surrounding the Vaccine Injury Compensation Program (VICP) and how expanding liability could quietly push manufacturers out of the market entirely. The hosts also examine the FDA's recent hesitation to
#445 - [Journal Club] - 📌 Are we missing dysphagia in very preterm infants before they leave the NICU?
Send us Fan MailHow 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 persisten
#445 - What Can Japan Teach Us About Treating Human Milk Fortifier as a Drug? (Part 2)
Send us Fan MailWhat does it take to turn a single struggling baby into a national standard of care? In this episode, Ben sits down with Professor Katsumi Mizuno (Showa Medical University) and Dr. Melinda Elliott (Chief Medical Officer, Prolacta Bioscience) to discuss the landmark Jasmine Trial, the first randomized controlled trial of an exclusive human milk diet (EHMD) in Japan. The results: sig
#445 - [Journal Club] - 📌 Does an exclusive human milk diet improve growth in very low birth weight infants? (Part 1)
Send us Fan MailJapan 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 bir
#445 - [Journal Club] - 📌 Can a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation?
Send us Fan MailCould 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
#445 - [Journal Club] - 📌 Can symptom-based dosing cut hospitalization time for babies with neonatal opioid withdrawal syndrome?
Send us Fan MailOne 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 sch
#444 - Can a Beanie Protect NICU Infants from Harmful Noise While Keeping Them Connected to Their Parents?
Send us Fan MailThe NICU is one of the loudest environments a newborn will ever experience, yet it is also where the most vulnerable infants spend their earliest, most developmentally critical days. In this Tech Tuesday episode, Ben and Daphna sit down with Gabby Daltoso and Sophie Ishiwari, co-founders of the Sonura Beanie. Their device tackles two pressing NICU challenges at once: harmful noise
#443 - Could NeoGuide Be the Answer to the NICU’s Variability Problem?
Send us Fan MailEvery neonatologist has built a protocol or written a guideline, and most have done it completely alone. In this episode, Ben sits down with Dr. Christina Muffy Sollinger (UC Davis) and Dr. Sarvin Ghavam (CHOP), the co-founders of NeoGuide, a national collaborative dedicated to connecting clinicians around the shared work of clinical guidelines and practice pathways. Born from a si
#442 - 📑 Journal Club - The Complete Episode from May 16th 2026
Send us Fan MailCerebral 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
#442 - [Neo News] - 📌 What Is the Ripple Effect of Defunding Disease Surveillance?
Send us Fan MailIn 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 pr
#442 - [Journal Club] - 📌 Does combining EEG and MRI improve neurodevelopmental prognostication in preterm infants?
Send us Fan MailIn 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
#442 - [Journal Club] - 📌 Is a low Apgar score more concerning than a low umbilical pH in preemies?
Send us Fan MailBen 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 p
#442 - [Journal Club] - 📌 Does 24 hour in house staffing decrease physician productivity metrics?
Send us Fan MailIs 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
#442 - [Journal Club] - 📌 Does NIRS guided treatment improve clinical outcomes for extremely preterm infants?
Send us Fan MailIn 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 improve
#441 - Is Two Years Enough? Fellowship Directors Respond to the ABP’s Proposed Training Overhaul
Send us Fan MailThe 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 (O
#440 - 🔵 [PAS 2026] - What Goes Into Planning the Biggest Pediatric Conference in the World?
Send us Fan MailDr. 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
#440 - 🔵 [PAS 2026] - Is the Neonatology Job Market About to Shift Dramatically in Fellows' Favor?
Send us Fan MailDr. 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
#440 - 🔵 [PAS 2026] - Are We Ready for Gentle Hemodynamics the Way We Embraced Gentle Ventilation?
Send us Fan MailDr. 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 — interv
#440 - 🔵 [PAS 2026] - When Is the Right Time to Talk to a Family About a Tracheostomy for BPD?
Send us Fan MailDr. 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
#440 - 🔵 [PAS 2026] - What Does It Take to Build a World-Class NICU From the Ground Up?
Send us Fan MailDr. 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 o
#440 - 🔵 [PAS 2026] - How Did One NICU Take 22-Weeker Survival From 12% to 72%?
Send us Fan MailDr. 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 institutio
#440 - 🔵 [PAS 2026] - Do We Even Know What a Healthy Preterm Gut Looks Like on Ultrasound?
Send us Fan MailDr. 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 d
#440 - 🔵 [PAS 2026] - Is LISA the Future of Surfactant Delivery for Premature Babies?
Send us Fan MailDr. 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 l
#440 - 🔵 [PAS 2026] - Could Donor Milk Cream Replace Dextrose Gel for Newborn Hypoglycemia?
Send us Fan MailDr. 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 i
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