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Delirium in the NICU is an under-recognized and under-assessed challenge. In this episode of The Incubator Podcast, Ben and Daphna sit down with Dr. Karishma Rao and clinical pharmacist Alex Oschman from Children’s Mercy Hospital to explore the complexities of neonatal delirium. Drawing on their collaborative work and recent publication in Frontiers in Pharmacology, they unpack the nuances of distinguishing delirium from pain, agitation, withdrawal, and sedation—particularly in medically complex, long-stay infants.

The conversation highlights the limitations of current assessment tools, such as the CAPD (Cornell Assessment of Pediatric Delirium), and the barriers to implementation in the NICU setting. The team shares practical strategies, including modifying pain and withdrawal protocols, minimizing deliriogenic medications like benzodiazepines and opioids, and emphasizing non-pharmacological interventions like early mobility, sleep hygiene, and environmental optimization.

They also discuss pharmacologic options when needed, such as the selective use of atypical antipsychotics like quetiapine or risperidone, and raise critical questions about how developmental care might reduce the need for sedation altogether. This episode is a call to action for NICU teams to better understand, assess, and address delirium in our most vulnerable patients through collaborative, multidisciplinary care. 

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.

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In this packed episode of Neo News, Eli, Ben, and Daphna dive into the headlines impacting neonatology and public health. The trio starts with the controversial confirmation of Robert F. Kennedy Jr. as head of HHS, analyzing his actions around the CDC, NIH, vaccine policy, and the implications of promoting “informed consent” messaging in place of public health advocacy. Drawing from reporting by The New York Times, STAT News, and Science Magazine, the team unpacks how these shifts could affect vaccine uptake in the NICU.

Next, they examine the threat to birthright citizenship in the U.S., based on analysis from The New York Times, and how immigration policy may directly impact NICU families’ access to care and trust in healthcare systems.

They also discuss a Wall Street Journal article detailing the erosion of trust in physicians post-pandemic and the fallout from a recent JAMA Pediatrics study on therapeutic hypothermia in late preterms, which raised questions about research transparency.

Other highlights include studies from Scientific Reports, JAMA Network Open, and The New York Times on air pollution, paternity leave, language-concordant care, and breastfeeding. The show ends with a call to action from Dr. Shadel Shah’s op-ed advocating for the continuation of the PREEMIE Act.

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.

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In this episode, I had the pleasure of speaking with Dr Ilana Levene, who is now a Neonatology subspeciality trainee at Oxford, England. Ilana has done some fantastic work on exploring the important topic of human milk expression. She described her randomized control trial in using relaxing techniques to facilitate human milk expression in the NICU. She shared the challenges that she had in conducting her RCT. We also talked about RCTs with negative results and how negative results are also important in conducting research. Ilana has now created a website with printables for parents and staff in the NICU on human milk expression. This can be assessed for free here : http://www.hifn.org/printable . Ilana also shared her interest in perinatal equity and shared details on her project Spectrum which involves gathering photos of the lactating breast conditions/chest from people with a wide spectrum of skin
colours. These will be provided as a free educational image library. Currently she is chairing a priority setting partnership for LGBTQIA+ perinatal care.

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.

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In this episode of Beyond the Beeps, Leah discusses the importance of understanding a baby's senses in the NICU with occupational therapists Emily Hills and Lindsay Hardy. They explore the concept of co-occupation and co-regulation, emphasizing the vital role parents play in their baby's development. The conversation delves into the eight senses, the impact of early birth on sensory development, and practical tips for parents to enhance their baby's NICU experience. The episode highlights the significance of parental presence and the right way to interact with babies in a sensitive environment. In this conversation, Lindsay and Emily discuss the vital role of parents in the NICU, emphasizing the importance of breathing, connection, and communication. They explore the concept of touch times, the significance of sensory needs in the NICU environment, and how parents can manage their baby's pain during procedures. The discussion highlights the need for a supportive environment for both parents and healthcare providers, focusing on the shared sensory experiences that can enhance care. Ultimately, they convey a message of hope for families navigating the challenges of the NICU journey.

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.

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In this week’s episode, Daphna hosts a powerful roundtable featuring Drs. Kerri Machut, Milenka Cuevas-Guaman, Emily Miller, Christine Bishop, and Christiane Dammann—leaders of a national effort to improve neonatology staffing. Together, they share insights from their recently developed recommendations, created through a Delphi consensus process and supported by a strategic grant from the AAP Section on Neonatal-Perinatal Medicine. These evidence-informed guidelines aim to promote safer, more sustainable, and more transparent staffing models in NICUs across the country. The team discusses key themes including defining clinical FTEs in hours per year, ensuring flexible scheduling, protecting time for scholarly and administrative work, and how to advocate for systemic change. Notably, these landmark recommendations have been accepted for publication in the journal Pediatrics and will be available online in May 2025. Listeners will also learn about an upcoming toolkit designed to help individuals and institutions apply these recommendations in practice. Whether you’re a practicing neonatologist, a trainee, or in a leadership role, this conversation offers timely solutions to address burnout, support workforce well-being, and ultimately improve care for the smallest and sickest patients.

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.

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In this episode of the Incubator, Dr. Paul Rozance discusses his research on fetal metabolism and growth regulation, emphasizing the role of insulin, glucagon, and placental function in development. He shares insights on how metabolic signals influence fetal growth and how complications like placental insufficiency impact long-term health. The conversation also highlights the challenges of translating research from animal models to clinical applications and the importance of collaboration in advancing neonatal science. Get your popcorn! There are some suspenseful stories #getyourpopcorn. #barker hypothesis #neuroendocrinology

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.

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In this episode of From The Heart, hosts Dr. Nim Goldshtrom and Dr. Adrianne Bischoff explore the latest research in neonatal cardiac care, focusing on congenital heart disease (CHD) and its impact on premature infants. They discuss a study analyzing survival trends in preterm infants with CHD, highlighting the “double jeopardy” these babies face due to both prematurity and congenital cardiac anomalies. Another study compares neurodevelopmental outcomes between preterm infants and those with CHD, revealing that term infants with CHD exhibit similar motor and cognitive challenges as preterm infants, yet receive less developmental support. The conversation then shifts to emerging research showing a decline in postoperative brain injuries in CHD patients, possibly due to improved surgical and perioperative care. Finally, they discuss a survey on neonatal cardiac care models, emphasizing the evolving role of neonatologists in managing CHD patients and the need for better integration between NICUs and CICUs. Nim and Adrianne reflect on the importance of specialized care teams, advocating for neonatologists to play a greater role in optimizing outcomes for this vulnerable population. Tune in for a compelling discussion on bridging the gaps in neonatal cardiac care.

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.

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Integrated cardiac care models of neonates with congenital heart disease: the evolving role of the neonatologist.

Hamrick SEG, Ball MK, Rajgarhia A, Johnson BA, DiGeronimo R, Levy PT; Children’s Hospital Neonatal Consortium (CHNC) Cardiac Focus Group.J Perinatol. 2021 Jul;41(7):1774-1776. doi: 10.1038/s41372-021-01117-3. Epub 2021 Jun 17.PMID: 34140645 No abstract available.

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.

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Declining Incidence of Postoperative Neonatal Brain Injury in Congenital Heart Disease.

Peyvandi S, Xu D, Barkovich AJ, Gano D, Chau V, Reddy VM, Selvanathan T, Guo T, Gaynor JW, Seed M, Miller SP, McQuillen P.J Am Coll Cardiol. 2023 Jan 24;81(3):253-266. doi: 10.1016/j.jacc.2022.10.029.PMID: 36653093 Free PMC article.

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.

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Similarities and Differences in the Neurodevelopmental Outcome of Children with Congenital Heart Disease and Children Born Very Preterm at School Entry.

Wehrle FM, Bartal T, Adams M, Bassler D, Hagmann CF, Kretschmar O, Natalucci G, Latal B.J Pediatr. 2022 Nov;250:29-37.e1. doi: 10.1016/j.jpeds.2022.05.047. Epub 2022 Jun 2.PMID: 35660491 Free article.

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.

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