The Incubator's Journal Club

Epizode

• #445 - [Journal Club] - 📌 Are we missing dysphagia in very preterm infants before they leave the NICU? 28.05.2026 18min

  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 difficulties at 38 weeks post-menstrual age, laryngeal penetration was detected in all infants who unde...
• #445 - [Journal Club] - 📌 Does an exclusive human milk diet improve growth in very low birth weight infants? 28.05.2026 23min

  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 infants in Japan. Infants on an exclusive human milk diet gained weight significantly faster, reached f...
• #445 - [Journal Club] - 📌 Can a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? 28.05.2026 22min

  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 breast milk intranasally three times daily showed significantly higher cerebral oxygenation levels, al...
• #445 - [Journal Club] - 📌 Can symptom-based dosing cut hospitalization time for babies with neonatal opioid withdrawal syndrome? 28.05.2026 24min

  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 taper in infants managed with Eat Sleep Console. The results are striking: symptom-based dosin...
• #442 - [Journal Club] - 📌 Does combining EEG and MRI improve neurodevelopmental prognostication in preterm infants? 14.05.2026 12min

  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 pred...
• #442 - [Journal Club] - 📌 Is a low Apgar score more concerning than a low umbilical pH in preemies? 13.05.2026 20min

  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 a...
• #442 - [Journal Club] - 📌 Does 24 hour in house staffing decrease physician productivity metrics? 12.05.2026 17min

  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 cur...
• #442 - [Journal Club] - 📌 Does NIRS guided treatment improve clinical outcomes for extremely preterm infants? 11.05.2026 21min

  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 ...
• #434 - [Journal Club] - 📌 LISA and Caffeine Together: What Do the Two-Year Outcomes Actually Show? 16.04.2026 19min

  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 outco...
• #434 - [Journal Club] - 📌 Could Intranasal Breast Milk Be the Next Adjunct Therapy for HIE? 15.04.2026 12min

  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 compe...
• #434 - [Journal Club] - 📌 Can Ultrasound Help Us Better Identify Surgical NEC? 14.04.2026 16min

  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 addin...
• #434 - [Journal Club] - 📌 AAP update on therapeutic hypothermia for neonates with HIE 13.04.2026 32min

  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 o...
• #431 - [Journal Club] - 📌 Can Retinal Images Predict BPD and Pulmonary Hypertension? 02.04.2026 10min

  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 typi...
• #431 - [Journal Club] - 📌 Rethinking the Link Between BPD Grades and Pulmonary Hypertension 01.04.2026 21min

  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 find...
• #431 - [Journal Club] - 📌 Should We Stop Routine Car Seat Testing for Preterm Infants? 31.03.2026 17min

  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 ens...
• #431 - [Journal Club] - 📌 Prophylactic hydrocortisone to improve BPD-free survival? 30.03.2026 16min

  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 old...
• #410 - [Journal Club] - 📌 Should We Increase Caffeine Dosing for Extremely Preterm Infants? 12.03.2026 15min

  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 implica...
• #410 - [Journal Club] - 📌 Does Drying Very Preterm Infants Before Wrapping Improve Normothermia? 11.03.2026 19min

  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 dow...
• #410 - [Journal Club] - 📌 Is Diazoxide Use Increasing for NICU Hypoglycemia? 10.03.2026 15min

  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 an...
• #410 - [Journal Club] - 📌 Prophylactic Acetaminophen for PDA, Does Early Closure Improve Outcomes? 09.03.2026 21min

  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 ...