The Incubator

101:46

#469 - 📑 Journal Club - The Complete Episode from...

The Incubator ·

2026/10/03

Send us Fan Mail This week on The Incubator Podcast, Ben and Daphna dig into four studies testing what the evidence supports at the bedside. They open with the 24-month BeNeDuctus follow-up, where expectant management and early ibuprofen for PDA yield identical survival without neurodevelopmental impairment. Daphna then presents the Nourish trial, finding individually targeted milk fortification did not improve growth, body composition, or brain MRI outcomes. Next, a Dutch study links probiot...

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21:54

#469 - [Neo News] - 📌 Does Tylenol in Pregnancy...

The Incubator ·

2026/10/02

Send us Fan Mail Does Tylenol in pregnancy cause autism or ADHD? In this edition of Neo News, Ben and Eli break down a major JAMA Internal Medicine study from Hong Kong that followed hundreds of thousands of mother-child pairs and used a sibling-matched design to answer the question. The verdict: no association between prenatal acetaminophen exposure and autism spectrum disorder or ADHD, regardless of timing, pattern, or dose. But data alone doesn't win hearts. The conversation turns to the b...

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27:51

#469 - [Journal Club] - 📌 Should organ donation be...

The Incubator ·

2026/10/01

Send us Fan Mail 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, and a smaller group with severe HIE could potentially have donated after neurol...

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22:15

#469 - [Journal Club] - 📌 What did two Dutch NICUs...

The Incubator ·

2026/09/30

Send us Fan Mail 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 cohort, and one infant died of B. infantis sepsis. Ben and Daphna discuss how b...

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17:53

#469 - [Journal Club] - 📌 Does targeted fortification...

The Incubator ·

2026/09/29

Send us Fan Mail 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 meet protein and energy targets. Growth, body composition by air displacement plet...

en-us

24:21

#469 - [Journal Club] - 📌 Early ibuprofen or waiting,...

The Incubator ·

2026/09/28

Send us Fan Mail 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 result does not mean no PDA should ever be treated. The conversation then turns to h...

en-us

39:53

#468 - 🚀 [Tech Tuesday] - What Would A Shared...

The Incubator ·

2026/09/25

Send us Fan Mail Feeding in the NICU is rarely one person's job, yet the language around it changes from nurse to therapist to physician to parent. In this Tech Tuesday episode, Ben and Daphna sit down with Lisa Kleinz and Erin Lesage of Dr. Brown's Medical to unpack feeding together, a philosophy built on team approach, family at the center, and feeding that begins on day one rather than at first bottle. They discuss what separates cue-based feeding from a truly standardized Infant-Driven Fe...

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57:04

#467 - Navigating the Future of Pediatric Healthcare...

The Incubator ·

2026/09/21

Send us Fan Mail Ben sits down with Dr. Shetal Shah and AAP federal advocacy director Stephanie Glier to unpack HR1, the sweeping reconciliation bill that could cut $1.15 trillion in federal Medicaid spending over the next decade. With 40% of US births and up to 65% of NICU graduates covered by Medicaid, the stakes for neonatology are enormous. Shetal and Stephanie break down state directed payments, provider taxes, shortened retroactive coverage windows, and new work requirements, explaining...

en-us

89:10

#466 - 📑 Journal Club - The Complete Episode from...

The Incubator ·

2026/09/19

Send us Fan Mail This 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 K, and rising oral substitution, to a near-doubling of bleeding and intracranial hemorrhage ris...

en-us

14:29

#466 - [Neo News] - 📌 Why Are 4 in 10 NICU Stays...

The Incubator ·

2026/09/18

Send us Fan Mail Ben 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 which admissions get missed. Ben and Eli unpack what this means for how states and hospitals alloc...

en-us

19:31

#466 - [Journal Club] - 📌 Does IVF Really Raise the...

The Incubator ·

2026/09/17

Send us Fan Mail 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 VACTERL and related multiple anomaly syndromes compared to naturally conceive...

en-us

17:14

#466 - [Journal Club] - 📌 Should we start CPAP at 8...

The Incubator ·

2026/09/16

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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23:45

#466 - [Journal Club] - 📌 Oral isn't IM: Sweden's...

The Incubator ·

2026/09/15

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 ...

en-us

27:39

#466 - [Journal Club] - 📌 Do We Still Need a DAT on...

The Incubator ·

2026/09/14

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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54:36

#465 - [🫀 From The Heart] - Bringing NICU Feeding...

The Incubator ·

2026/09/13

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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53:41

#464 - [🫀 From The Heart] - Right Drugs, Wrong Heart...

The Incubator ·

2026/09/10

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...

en-us

43:14

#463 - 🗳️ Meet the Neonatologist Running for AAP...

The Incubator ·

2026/09/07

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...

en-us

83:13

#462 - 📑 Journal Club - The Complete Episode from...

The Incubator ·

2026/09/05

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 ...

en-us

18:38

#462 - [Neo News] - 📌 What Does The Pitt Get Right...

The Incubator ·

2026/09/04

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 ...

en-us

17:26

#462 - [Journal Club] - 📌 Dexamethasone Eye Drops...

The Incubator ·

2026/09/03

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...

en-us

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