The Incubator

#446 - Is Bedside Transcatheter PDA Closure Ready for Your NICU? 01.06.2026 47分

Send us Fan Mail What 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 vulnerable neonates, which infants are most likely to benefit from closure, the learning curve and complica...

#445 - 📑 Journal Club - The Complete Episode from May 30th 2026 30.05.2026 1時間 39分

Send us Fan Mail Opioid 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 pharmacologically treated infants to avoid scheduled opioids entirely. Daphna reviews a small RCT ...

#445 - [Neo News] - 📌 Are Regulatory Roadblocks Threatening the Future of Neonatal Vaccines? 29.05.2026 20分

Send us Fan Mail In 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 review Moderna’s new mRNA flu vaccine, highlighting how these administrative roadblocks threaten the ...

#445 - [Journal Club] - 📌 Are we missing dysphagia in very preterm infants before they leave the NICU? 28.05.2026 19分

Send us Fan Mail 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...

#445 - What Can Japan Teach Us About Treating Human Milk Fortifier as a Drug? (Part 2) 27.05.2026 33分

Send us Fan Mail What 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: significantly better weight and length gain, fewer antibiotic days, and improved feeding tolerance ...

#445 - [Journal Club] - 📌 Does an exclusive human milk diet improve growth in very low birth weight infants? (Part 1) 27.05.2026 24分

Send us Fan Mail 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 ...

#445 - [Journal Club] - 📌 Can a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? 26.05.2026 23分

Send us Fan Mail 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 oxyge...

#445 - [Journal Club] - 📌 Can symptom-based dosing cut hospitalization time for babies with neonatal opioid withdrawal syndrome? 25.05.2026 25分

Send us Fan Mail 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: sy...

#444 - Can a Beanie Protect NICU Infants from Harmful Noise While Keeping Them Connected to Their Parents? 22.05.2026 21分

Send us Fan Mail The 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 exposure and disrupted parental connection. By embedding a low-pass filtration system tuned to t...

#443 - Could NeoGuide Be the Answer to the NICU’s Variability Problem? 18.05.2026 43分

Send us Fan Mail Every 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 single email that broke a listserv and generated over 120 responses overnight, NeoGuide has grown ...

#442 - 📑 Journal Club - The Complete Episode from May 16th 2026 16.05.2026 1時間 24分

Send us Fan Mail Cerebral oxygenation, staffing economics, delivery room scoring, neurodevelopmental prognostication, and public health — a full week on the Incubator Journal Club. Ben walks through the NIRTURE trial, a single-device RCT testing cerebral oximetry-guided care in infants born under 29 weeks. The intervention dramatically reduced the burden of cerebral hypoxia and hyperoxia compared to standard care. Secondary clinical outcomes were neutral and neurodevelopmental follow-up is ...

#442 - [Neo News] - 📌 What Is the Ripple Effect of Defunding Disease Surveillance? 15.05.2026 20分

Send us Fan Mail In this episode of Neo News, Ben and Eli tackle the recent, quiet—but massive—public health funding cuts implemented by the Department of Health and Human Services. With $600 million pulled back from four targeted states and additional CDC block grants eliminated, they discuss the severe domestic implications for local health departments, HIV/STI surveillance, and lead poisoning prevention. They also zoom out to examine the global health consequences of the US withdrawing fro...

#442 - [Journal Club] - 📌 Does combining EEG and MRI improve neurodevelopmental prognostication in preterm infants? 14.05.2026 13分

Send us Fan Mail 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, parti...

#442 - [Journal Club] - 📌 Is a low Apgar score more concerning than a low umbilical pH in preemies? 13.05.2026 21分

Send us Fan Mail 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 wh...

#442 - [Journal Club] - 📌 Does 24 hour in house staffing decrease physician productivity metrics? 12.05.2026 18分

Send us Fan Mail 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...

#442 - [Journal Club] - 📌 Does NIRS guided treatment improve clinical outcomes for extremely preterm infants? 11.05.2026 22分

Send us Fan Mail 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...

#441 - Is Two Years Enough? Fellowship Directors Respond to the ABP’s Proposed Training Overhaul 10.05.2026 47分

Send us Fan Mail The American Board of Pediatrics (ABP) recently announced a move toward competency-based subspecialty training that would shorten fellowships — including neonatology — from three years to two. The proposal has sent shockwaves through the training community. In this episode, Daphna sits down with three leaders from the Organization of Neonatal Perinatal Training Program Directors (ONTPD): Dr. Patrick Myers from Northwestern, Dr. Heather French from the Children's Hospital of P...

#440 - 🔵 [PAS 2026] - What Goes Into Planning the Biggest Pediatric Conference in the World? 29.04.2026 12分

Send us Fan Mail Dr. Daniel Rauch, PAS 2026 program chair, joins Ben for a behind-the-scenes look at what it takes to pull off a conference of this scale — and what he's learned from this year's record-breaking attendance in Boston. He reflects on the sessions that packed rooms beyond capacity, from the Tiny Baby Collaborative to AI in pediatrics, and shares what's on the horizon for PAS 2027 in Minneapolis and PAS 2028 in Vancouver. He also makes the case for why PAS remains uniquely valuabl...

#440 - 🔵 [PAS 2026] - Is the Neonatology Job Market About to Shift Dramatically in Fellows' Favor? 29.04.2026 11分

Send us Fan Mail Dr. Benny Rossner, PGY-2 pediatrics resident and veteran physician recruiter with 15 years of experience building clinical teams across the country, joins Ben and Rupa for a candid look at the neonatology workforce from a side of the conversation trainees rarely hear. He breaks down why demand for neonatologists is rising — sicker and younger patients, a shrinking APP pipeline into high-acuity specialties, and hospitals stretching budgets on locums before finally raising perm...

#440 - 🔵 [PAS 2026] - Are We Ready for Gentle Hemodynamics the Way We Embraced Gentle Ventilation? 28.04.2026 22分

Send us Fan Mail Dr. Gabriel Altit and Daniela Villegas from the NeoCardioLab at Montreal join Ben and Rupa to reflect on a packed PAS filled with hemodynamics science — from pulmonary hypertension phenotyping to heart-brain interactions in the golden hour. Dr. Altit makes the case that just as neonatology learned to embrace gentle ventilation, it is time to think about gentle hemodynamics — intervening thoughtfully, recognizing different clinical phenotypes, and knowing when to remove interv...