The Incubator

Episódios

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  #466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants? 16.09.2026 17min

  Send us Fan Mail 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 multicenter trial. No major safety signals emerged, but babies on lower CPAP reached surfactant th...
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  #466 - [Journal Club] - 📌 Oral isn't IM: Sweden's vitamin K data in two million infants 15.09.2026 23min

  Send us Fan Mail 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 2021, and infants without intramuscular vitamin K had significantly higher odds of ...
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  #466 - [Journal Club] - 📌 Do We Still Need a DAT on Every Newborn at Risk of Hemolytic Disease? 14.09.2026 27min

  Send us Fan Mail 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 as DAT in ABO-incompatible babies, and that passive anti-D from RhoGAM rarely ca...
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  #465 - [🫀 From The Heart] - Bringing NICU Feeding Practices to the CICU (ft Dr. Elgersma) 13.09.2026 54min

  Send us Fan Mail In 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 multicenter PC4 study of day-by-day data from over 800 infants across 25 centers found no link between huma...
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  #464 - [🫀 From The Heart] - Right Drugs, Wrong Heart - A TTTS Recipient That Fooled Everyone 10.09.2026 53min

  Send us Fan Mail In 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 apart: hypotension, rising lactate, falling urine output. Only on repeat echo does the real diagnos...
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  #463 - 🗳️ Meet the Neonatologist Running for AAP President - A Conversation with Dr. Wanda Barfield 07.09.2026 43min

  Send us Fan Mail Disclosure: 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, that could change. In this special episode, Ben sits down with Dr. Wanda Barfield, neonatologi...
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  #462 - 📑 Journal Club - The Complete Episode from September 5th 2026 05.09.2026 1h 23min

  Send us Fan Mail This 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. Haribalakrishna Balasubramanian's team in India. Thursday, the DROP-ROP trial, testing dexamethasone eye ...
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  #462 - [Neo News] - 📌 What Does The Pitt Get Right About Boundaries in Medicine? 04.09.2026 18min

  Send us Fan Mail A 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 with the fact that patients do not arrive on a curriculum. Also, why handing a resident your pager ...
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  #462 - [Journal Club] - 📌 Dexamethasone Eye Drops Prevent Treatment Requiring ROP? 03.09.2026 17min

  Send us Fan Mail 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 anti-VEGF in the dexamethasone arm versus thirty-eight percent on placebo, a relati...
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  #462 - [Journal Club] - 📌 Continuous vs Bolus Feeding, Which One Grows Babies Better? 02.09.2026 18min

  Send us Fan Mail 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 day, but the infusion group lost two fewer days to interrupted feeds. Ben and Dap...
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  #462 - [Journal Club] - 📌 After HEAL Does a Second Trial Close the Book on EPO? 01.09.2026 22min

  Send us Fan Mail 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 severe developmental deficit at two years was 34 percent with EPO versus 29 percent w...
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  #462 - [Journal Club] - 📌 After LISA Does CPAP Perform as Well as NIMV Below 30 Weeks? 31.08.2026 20min

  Send us Fan Mail 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. Noninvasive ventilation failure within 72 hours was 26 percent on CPAP versus 13 per...
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  #461 - [🫀 From The Heart] - Blue Baby, Gray Baby: Severe LV Dysfunction Masquerading as PPHN 24.08.2026 55min

  Send us Fan Mail A 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 Goldshtrom work through a real, complex neonatal cardiac case in real time — the kind of case that keeps neonatologis...
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  #460 - Reading as a neuroprotective intervention 21.08.2026 46min

  Send us Fan Mail Why 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 evidence behind auditory stimulation and language outcomes, why reading gives overwhelmed parent...
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  #459 - Which AI tools are actually ready for the NICU right now? 17.08.2026 45min

  Send us Fan Mail Is 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 hospital stay breaks most chart summarization tools, and how ambient AI is starting to change documentation ...
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  #458 - 📑 Journal Club - The Complete Episode from August 15th 2026 15.08.2026 2h

  Send us Fan Mail The 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 probiotics returning to the NICU. Thursday, a handheld light probe that reads bowel through the...
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  #458 - [Journal Club] - 📌 Can the respiratory severity score show us where a baby is heading? 14.08.2026 26min

  Send us Fan Mail 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 writing that last paper with his son, a high school junior, and why a brief communica...
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  #458 - [Journal Club] - 📌 Could a handheld light probe detect NEC before the X-ray does? 13.08.2026 22min

  Send us Fan Mail 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 that separated NEC from non-NEC scans with 100% sensitivity and a 100% negative predicti...
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  #458 - [Journal Club] - 📌 Is this the trial that brings probiotics back to the NICU? 12.08.2026 26min

  Send us Fan Mail 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 confirmed NEC favored treatment after 14 days of dosing. The discussion may be the...
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  #458 - [Journal Club] - 📌 Does holding during cooling change NICU outcomes in HIE? 11.08.2026 18min

  Send us Fan Mail 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 home on breast milk, and had shorter stays, but they were also less sick to begi...