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Picture this: You’re caring for a 22-week infant, uncertain whether survival is even possible—and yet you remember that someone like Dr. Ed Bell has been quietly tracking cases just like this for decades.

In this episode of The Incubator Podcast, we welcome Dr. Edward Bell, Professor of Pediatrics and Associate Vice Chair for Faculty Development in Neonatology at the University of Iowa. A leader in the care of extremely preterm infants, Dr. Bell shares the origins of the Tiniest Babies Registry, his views on how viability has shifted over the decades, and why institutional culture—not just technical capability—makes all the difference in outcomes for the smallest patients.

We talk through the evolution of care for infants born at the edge of viability, what defines success at 21–22 weeks, the growing segmentation of neonatology into subspecialties, and how consistency in care delivery plays a vital role. The episode closes with practical advice for young neonatologists entering the field today.

A grounded, no-nonsense conversation with someone who has shaped—and continues to influence—the trajectory of neonatal medicine.

Listen on Apple, Spotify, or wherever you get your podcasts.

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As always, feel free to send us questions, comments, or suggestions to our email: [email protected]. 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!