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The Incubator

Ben Courchia & Daphna Yasova Barbeau

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.

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S5 · E185
October 6 · 27 min
#470 - ABP Reverses Course on Two Year Neo Fellowship
Send us Fan Mail The American Board of Pediatrics has reversed course. After months of pushback from the neonatology community, the ABP has excluded neonatal-perinatal medicine from the two year fellowship waivers it is now granting to seven other pediatric subspecialties. Neonatology fellowship stays at three years. Ben is joined by Dr. Patrick Myers, past chair of ONTPD and fellowship director at Northwestern, and Dr. Brooke Vergales, ONTPD co-chair, to break down how this happened. They describe how program directors, division chiefs, and the AAP Section on Neonatal-Perinatal Medicine presented a unified position, why the ABP listened, and why both guests still consider this a pause rather than a settled outcome. The episode also covers what the reversal did not change: entrustable professional activities are still arriving over the next 18 months, and the scholarly activity requirement is still being dropped. ONTPD's response is a new committee to define what an excellent neonatologist must know at graduation. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E184
October 3 · 1 hr 41 min
#469 - 📑 Journal Club - The Complete Episode from October 3rd 2026
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 probiotics to halved NEC rates, but rising non-NEC mortality and a fatal probiotic sepsis case leave Ben ambivalent. Daphna closes Journal Club with an Australian cohort suggesting nearly a third of NICU deaths met organ donor criteria. The week wraps with Ben and Eli on Neo News, unpacking a sibling-matched study finding no link between prenatal Tylenol and autism or ADHD. ---- Long-Term Outcomes of Expectant Management versus Early Ibuprofen for Patent Ductus Arteriosus: 24-Month Follow-Up of the BeNeDuctus Trial. Apers WMJ, Hundscheid T, Kooi EMW, Onland W, Vijlbrief D, Steiner K, Donders R, Mulder AL, de Boode WP; BeNeDuctus Trial Investigators.J Pediatr. 2026 Sep 17;299:115292. doi: 10.1016/j.jpeds.2026.115292. Online ahead of print.PMID: 42637114 Individually Targeted Human Milk Fortification: A Randomized Clinical Trial. Belfort MB, Ahtam B, Bell KA, Berger P, Cherkerzian S, Ellard D, Foster L, Fusch C, Gagoski B, Grant PE, Kuncham M, Pepin H, Solti M, Steele T, Woodward L, Inder T.JAMA Pediatr. 2026 Sep 14:e264220. doi: 10.1001/jamapediatrics.2026.4220. Online ahead of print.PMID: 42734908 Probiotic Implementation and Necrotizing Enterocolitis Risk in Preterm Infants. Imren C, Jongejans V, Onland W, Keyzer-Dekker CMG, Been JV, Derikx JPM, van Kaam AH, Simons SHP, Twisk JWR, van den Akker CHP, Vermeulen MJ.JAMA Netw Open. 2026 Aug 3;9(8):e2631601. doi: 10.1001/jamanetworkopen.2026.31601.PMID: 42671836 Free PMC article. Potential Neonatal Donors in Australia: A National Cohort Study. Barzegar R, Cavazzoni E, Popat H, Wong G.Pediatrics. 2026 Sep 3:e2025075110. doi: 10.1542/peds.2025-075110. Online ahead of print.PMID: 42686207 The Untapped Potential of Organ Donation from the NICU. Nguyen BV, Coloma M, Crouch EE.Pediatrics. 2026 Sep 3:e2026076954. doi: 10.1542/peds.2026-076954. Online ahead of print.PMID: 42686210 No abstract available. Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts. Luo S, Gong Q, Ai Y, Zhang J, Chan L, Wong WCW, Ip P, Chan EWY, Tanuseputro P, Wong ICK, Wan EYF.JAMA Intern Med. 2026 Sep 1;186(9):1102-1111. doi: 10.1001/jamainternmed.2026.2215.PMID: 42371637 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E183
October 2 · 21 min
#469 - [Neo News] - 📌 Does Tylenol in Pregnancy Really Cause Autism or ADHD?
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 bedside: how do we explain study methodology to families without dismissing their concerns? Eli shares his approach to vaccine hesitancy in the NICU, built on continuity, persistence, and transparency, and draws lessons from journalism about corrections, trust, and why showing up matters. Tune in. ---- Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts. Luo S, Gong Q, Ai Y, Zhang J, Chan L, Wong WCW, Ip P, Chan EWY, Tanuseputro P, Wong ICK, Wan EYF.JAMA Intern Med. 2026 Sep 1;186(9):1102-1111. doi: 10.1001/jamainternmed.2026.2215.PMID: 42371637 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E182
October 1 · 27 min
#469 - [Journal Club] - 📌 Should organ donation be part of every neonatal end-of-life conversation?
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 neurological determination of death. They discuss referral timing, outcomes of en bloc kidney transplants from neonatal donors, and how NICUs can offer families this option as part of end-of-life care. ---- Potential Neonatal Donors in Australia: A National Cohort Study. Barzegar R, Cavazzoni E, Popat H, Wong G.Pediatrics. 2026 Sep 3:e2025075110. doi: 10.1542/peds.2025-075110. Online ahead of print.PMID: 42686207 The Untapped Potential of Organ Donation from the NICU. Nguyen BV, Coloma M, Crouch EE.Pediatrics. 2026 Sep 3:e2026076954. doi: 10.1542/peds.2026-076954. Online ahead of print.PMID: 42686210 No abstract available. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E181
September 30 · 22 min
#469 - [Journal Club] - 📌 What did two Dutch NICUs learn from routine probiotics in preterm infants?
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 baseline NEC rates, seasonal patterns, and number needed to harm should shape how units weigh probiotic use. ---- Probiotic Implementation and Necrotizing Enterocolitis Risk in Preterm Infants. Imren C, Jongejans V, Onland W, Keyzer-Dekker CMG, Been JV, Derikx JPM, van Kaam AH, Simons SHP, Twisk JWR, van den Akker CHP, Vermeulen MJ.JAMA Netw Open. 2026 Aug 3;9(8):e2631601. doi: 10.1001/jamanetworkopen.2026.31601.PMID: 42671836 Free PMC article. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E180
September 29 · 17 min
#469 - [Journal Club] - 📌 Does targeted fortification change brain growth at term?
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 plethysmography, and term-equivalent brain MRI were no different from standard fortification, and all infants met recommended intakes. Two-year outcomes will be reported separately. ---- Individually Targeted Human Milk Fortification: A Randomized Clinical Trial. Belfort MB, Ahtam B, Bell KA, Berger P, Cherkerzian S, Ellard D, Foster L, Fusch C, Gagoski B, Grant PE, Kuncham M, Pepin H, Solti M, Steele T, Woodward L, Inder T.JAMA Pediatr. 2026 Sep 14:e264220. doi: 10.1001/jamapediatrics.2026.4220. Online ahead of print.PMID: 42734908 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E179
September 28 · 24 min
#469 - [Journal Club] - 📌 Early ibuprofen or waiting, does the PDA choice show up at two years?
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 how targeted neonatal echocardiography and lung ultrasound are changing bedside PDA assessment, and previews an upcoming hemodynamics series with Dr. Gabriel Altit. ---- Long-Term Outcomes of Expectant Management versus Early Ibuprofen for Patent Ductus Arteriosus: 24-Month Follow-Up of the BeNeDuctus Trial. Apers WMJ, Hundscheid T, Kooi EMW, Onland W, Vijlbrief D, Steiner K, Donders R, Mulder AL, de Boode WP; BeNeDuctus Trial Investigators.J Pediatr. 2026 Sep 17;299:115292. doi: 10.1016/j.jpeds.2026.115292. Online ahead of print.PMID: 42637114 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E178
September 25 · 39 min
#468 - 🚀 [Tech Tuesday] - What Would A Shared Language For Feeding Look Like At The Bedside?
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 Feeding® Program, the outcomes reported so far, and why nearly half of NICU graduates still struggle with feeding at home. A practical conversation about culture, consistency, and shared language. https://www.drbrownsmedical.com/infant-driven-feeding-program/infant-driven-feeding-program-about/ Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E178
September 21 · 57 min
#467 - Navigating the Future of Pediatric Healthcare Funding
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 how administrative friction alone could push families out of coverage. They also offer a clear playbook: connect with your AAP state chapter, share bedside stories with policymakers, and don't be more intimidated by a congressional office than by a resuscitation. ---- AAP Advocacy page: https://www.aap.org/en/advocacy/?srsltid=AfmBOoqcnlKDsPZkpNg6z6U7OlOuBqUiuCtWHrUPmRGzfqDiQEl-vf7s Myers CN, Beck AF. H.R. 1’s Medicaid cuts threaten children’s health. Health Affairs Forefront. January 20, 2026. Accessed August 28, 2026. https://www.healthaffairs.org/content/forefront/h-r-1-s-medicaid-cuts-threaten-children-s-health Little J, Kohler A. How H.R. 1 cuts and changes to Medicaid played out in 2026 state legislative sessions (Part 2). Georgetown University Center for Children and Families. July 2, 2026. Accessed August 28, 2026. https://ccf.georgetown.edu/2026/07/02/how-h-r-1-cuts-and-changes-to-medicaid-played-out-in-2026-state-legislative-sessions-part-2/ Academy of Managed Care Pharmacy. Implications of H.R. 1 – the One Big Beautiful Bill Act. Academy of Managed Care Pharmacy. 2026. Accessed August 28, 2026. https://www.amcp.org/H.R.1 Park E. New CMS guidance on H.R. 1's restrictions of state directed payments. Georgetown University Center for Children and Families. February 4, 2026. Accessed August 28, 2026. https://ccf.georgetown.edu/2026/02/04/new-cms-guidance-on-h-r-1s-restrictions-of-state-directed-payments/ Mudumala A, Mohamed M, Tolbert J, Burns A. The impact of H.R. 1 on two Medicaid eligibility rules. KFF. September 22, 2025. Accessed August 28, 2026. https://www.kff.org/medicaid/the-impact-of-h-r-1-on-two-medicaid-eligibility-rules/ Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E177
September 19 · 1 hr 29 min
#466 - 📑 Journal Club - The Complete Episode from September 19th 2026
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 risk. Ben then presents the PHILODENDRON pilot trial out of Milan, testing initial delivery-room CPAP of 5 versus 8 cmH2O in infants under 30 weeks, feasible and safe, but not yet enough to settle the physiology question. Daphna closes Journal Club with a SART-linked study tying IVF conception to significantly higher odds of VACTERL association. The week wraps with Ben and Eli on Neo News, unpacking a study showing birth certificates miss nearly 40% of true NICU admissions, with troubling racial disparities. ---- Utility of DAT in Low-Risk Neonates With ABO or RhD Incompatibility. Tsai TL, Ma T, Nester T.Pediatrics. 2026 Sep 1;158(3):e2026076989. doi: 10.1542/peds.2026-076989.PMID: 42642037 Vitamin K Prophylaxis in Newborns and Bleeding in Infancy. Simatou E, Tsamantioti E, Hallström A, Stephansson O, Razaz N, Persson M, Bolk J.JAMA Pediatr. 2026 Sep 1;180(9):995-1004. doi: 10.1001/jamapediatrics.2026.2606.PMID: 42440325 Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial. In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article. Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable. Hughes CS, Lorch SA, Schmitt S, Passarella M, Phibbs CS.J Perinatol. 2026 Jul;46(7):1307-1312. doi: 10.1038/s41372-026-02726-6. Epub 2026 May 27.PMID: 42204354 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E176
September 18 · 14 min
#466 - [Neo News] - 📌 Why Are 4 in 10 NICU Stays Missing From Birth Records?
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 allocate resources, why underreporting could be quietly starving NICUs of funding and attention, and why pairing solid epidemiologic data with individual bedside stories may be the most effective way to make the case for better-resourced newborn care. ---- Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable. Hughes CS, Lorch SA, Schmitt S, Passarella M, Phibbs CS.J Perinatol. 2026 Jul;46(7):1307-1312. doi: 10.1038/s41372-026-02726-6. Epub 2026 May 27.PMID: 42204354 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E175
September 17 · 19 min
#466 - [Journal Club] - 📌 Does IVF Really Raise the Risk of VACTERL Birth Defects?
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 conceived infants. Daphna and Ben unpack what this means for clinical suspicion at the bedside, why some VACTERL phenotypes may be easy to miss, and how better tracking of conception history through delivery could change how NICU teams approach anomaly workups in IVF-conceived infants. ---- In Vitro Fertilization and VACTERL Birth Defects. Tark JY, Richard MA, Schraw JM, Fisher SC, Betancourt D, Stone SL, Forestieri NE, Baker VL, Cameron K, Eisenberg ML, Belva F, Lu Y, Williams CL, Sutcliffe AG, Lupo PJ, Luke B.JAMA Netw Open. 2026 Aug 3;9(8):e2629355. doi: 10.1001/jamanetworkopen.2026.29355.PMID: 42616500 Free PMC article. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E174
September 16 · 17 min
#466 - [Journal Club] - 📌 Should we start CPAP at 8 instead of 5 in the delivery room for very preterm infants?
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 thresholds faster, while higher CPAP trended toward fewer air leaks and shorter ventilation. Ben and Daphna weigh the physiology against the data, and ask whether trials like this even test the right question in the first place. ---- Initial CPAP of 5 versus 8 cmH2O during delivery room stabilisation of very preterm infants: the PHILODENDROOM pilot randomised trial. Cavigioli F, Bresesti I, Castoldi F, Gatto S, Lupo E, Rossi S, La Verde A, Bianchi S, Meneghin F, Viaroli F, Pivetti V, Manfredini V, Cannata G, Bastrenta P, Fontana P, Stucchi I, Daniele I, Chiera M, Lista G.Eur J Pediatr. 2026 Aug 17;185(9):673. doi: 10.1007/s00431-026-07322-6.PMID: 42608615 Free PMC article. Clinical Trial. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E173
September 15 · 23 min
#466 - [Journal Club] - 📌 Oral isn't IM: Sweden's vitamin K data in two million infants
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 bleeding, including intracranial bleeding, than those who received it — oral vitamin K carried an even higher bleeding risk still. Ben and Daphna also discuss home birth data, families requesting oral alternatives, and how best to counsel parents navigating a vitamin K refusal in clinic today. ---- Vitamin K Prophylaxis in Newborns and Bleeding in Infancy. Simatou E, Tsamantioti E, Hallström A, Stephansson O, Razaz N, Persson M, Bolk J.JAMA Pediatr. 2026 Sep 1;180(9):995-1004. doi: 10.1001/jamapediatrics.2026.2606.PMID: 42440325 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E172
September 14 · 27 min
#466 - [Journal Club] - 📌 Do We Still Need a DAT on Every Newborn at Risk of Hemolytic Disease?
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 caused significant hemolysis in RhD-incompatible infants. Ben and Daphna also discuss what this means for institutions running DAT on every newborn, how to tell passive anti-D apart from true alloimmunization, and why a more targeted approach to bilirubin screening may be overdue. ---- Utility of DAT in Low-Risk Neonates With ABO or RhD Incompatibility. Tsai TL, Ma T, Nester T.Pediatrics. 2026 Sep 1;158(3):e2026076989. doi: 10.1542/peds.2026-076989.PMID: 42642037 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E171
September 13 · 54 min
#465 - [🫀 From The Heart] - Bringing NICU Feeding Practices to the CICU (ft Dr. Elgersma)
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 human milk and NEC, though bovine-derived formula or fortifier tripled NEC risk within five days, while higher human milk intake meant roughly nine fewer hospital days. They cover lactation support, donor milk gaps between NICUs and CICUs, and practical next steps. ---- Elgersma et al. Human milk feeding, fortification initiation, and clinical outcomes in neonates with critical congenital heart disease: A multi-institutional study. medRxiv 2026. DOI 10.64898/2026.08.20.26360934 (preprint, no PMID) Elgersma et al. Human milk feeding and direct breastfeeding improve outcomes for infants with single ventricle congenital heart disease: Propensity score-matched analysis of the NPC-QIC registry. J Am Heart Assoc 2023. PMID 37642030 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
- Transcript
S5 · E170
September 10 · 53 min
#464 - [🫀 From The Heart] - Right Drugs, Wrong Heart - A TTTS Recipient That Fooled Everyone
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 diagnosis emerge: hypertrophic obstructive cardiomyopathy (HOCM) with dynamic left ventricular outflow tract obstruction, where the "correct" initial therapy becomes dangerous. Nim and Adrianne unpack why milrinone can worsen outflow obstruction, why vasopressin beats dobutamine, and when esmolol helps or harms. It's a masterclass in resisting anchoring bias and treating evolving physiology, not just numbers. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
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S5 · E169
September 7 · 43 min
#463 - 🗳️ Meet the Neonatologist Running for AAP President - A Conversation with Dr. Wanda Barfield
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, neonatologist, retired Rear Admiral and Assistant Surgeon General in the US Public Health Service, and longtime director of the CDC's Division of Reproductive Health, to hear what she would bring to the role. She lays out her three priorities, supporting pediatricians, protecting access, and leading with science and equity, and addresses the questions our field is wrestling with right now: training, staffing, the erosion of trust in science, and whether neonatology should go it alone. Her answer is that we are stronger together, and that having a neonatologist at the helm of the AAP would give our specialty a voice it has never had. Voting is open to AAP members through September 16. Meet the candidate, then go vote. Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
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S5 · E168
September 5 · 1 hr 23 min
#462 - 📑 Journal Club - The Complete Episode from September 5th 2026
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 drops against treatment-requiring ROP, led by Dr. Ann Hellström. Friday, Neo News: Eli and Ben on The Pitt's viral boundary-setting scene and what it says about burnout in medicine. ---- Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation in Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial. Zhang H, Zhang Y, Zeng L, Tong X, Piao M, He H, Zhao C, Xie H, Zheng Z, Cui Q, Lai Y, Wang H, Wang L, Liu H, Tian X, Wu H, Kang L, Han T.JAMA Netw Open. 2026 Jun 1;9(6):e2619785. doi: 10.1001/jamanetworkopen.2026.19785. Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial. Liley HG, Hunt RW, O'Connell RL, Battin MR, Novak I, Wu YW, Ballard R, Askie L, Badawi N, Ghadge A, Jacobs SE, Juul SE, Sebastian L, Wagh D, Simes RJ; PAEAN Study Investigators.JAMA Pediatr. 2026 Jul 27:e263082. doi: 10.1001/jamapediatrics.2026.3082. Online ahead of print. Effect of Extended Infusion Versus Intermittent Bolus Feedings on Hospital Weight Gain in Extremely Low Birth Weight Infants Born at <29 Weeks of Gestation: A Randomized Noninferiority Clinical Trial. Balasubramanian H, Sahoo M, Chhadva D, Choubey R, Sakharkar S, Pillai A, Kabra NS.J Pediatr. 2026 Jul 13;298:115235. doi: 10.1016/j.jpeds.2026.115235. Online ahead of print. Dexamethasone Eye Drops to Prevent Treatment-Requiring Retinopathy of Prematurity: The DROPROP Randomized Clinical Trial. Hellström A, Petrishka-Lozenska M, Sjöbom U, Wallander J, Nilsson AK, Löfqvist C, Ley D, Gränse L, Öhnell HM, Hård AL, Jakobsson G, Sävman K, Domellöf M, Löfgren S, Larsson E, Smith LEH, Pivodic A, Lundgren P; DROPROP Collaboration Group.JAMA Pediatr. 2026 Aug 3:e263247. doi: 10.1001/jamapediatrics.2026.3247. Online ahead of print. Haridasani Gupta A. On "The Pitt," She Clocked Out on Time. In Real Life, It Started a Debate. The New York Times. May 11, 2026. https://www.nytimes.com/2026/05/11/style/the-pitt-joy-kwon-irene-choi-work-life-balance.html Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
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S5 · E167
September 4 · 18 min
#462 - [Neo News] - 📌 What Does The Pitt Get Right About Boundaries in Medicine?
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 at two PM may be the cheapest patient safety intervention available. ---- Haridasani Gupta A. On "The Pitt," She Clocked Out on Time. In Real Life, It Started a Debate. The New York Times. May 11, 2026. https://www.nytimes.com/2026/05/11/style/the-pitt-joy-kwon-irene-choi-work-life-balance.html Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!
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