The Incubator

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Dr. Bridget Young, researcher at the University of Rochester, shares early but promising work on using freeze-dried mother's own breast milk — including a skim milk fraction — as a fortifier for human milk feeds in the NICU. She explains why milk variability makes accuracy the central challenge in this approach, how her team validated a method using macronutrient analysis to consistently hit a target caloric density of 28 kcal per ounce, and why the skim milk fraction in particular can deliver a protein content that rivals commercial bovine fortifiers. She also introduces the concept of mother's own breast milk cream — a centrifuge-derived calorie booster that families in her unit have found deeply empowering — and lays out honestly what it would take to bring lactoengineering from a research setting into routine clinical practice.

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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.

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From lumbar punctures to mitochondrial recycling, this booth interview from PAS 2026 covers a lot of ground. Ben and Daphna sit down with Dr. Ioanna Kotsopoulou from Mass General to discuss two distinct but equally compelling topics. First, a quality improvement project that took ultrasound-guided LP use from 12 to 73 percent and first attempt success from 32 to 68 percent. Then a pivot to basic science: impaired mitophagy in pulmonary hypertension, and whether dysfunctional mitochondrial recycling in cardiomyocytes may be contributing to the cardiac phenotype we see in these patients. A wide-ranging conversation with something for every neonatologist.

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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.

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Dr. Nathan Kupperman and Dr. Brett Bernstein, lead investigators on a landmark international pooled analysis published in JAMA, present the most comprehensive evidence to date on whether a lumbar puncture can be safely avoided in febrile infants under one month of age. Using a simple three-criteria rule — negative urinalysis, procalcitonin of 0.5 or below, and absolute neutrophil count of 4,000 or below — across more than 2,500 prospectively collected cases from multiple international cohorts, the rule did not miss a single case of bacterial meningitis. They explain what this means for shared decision-making with families, why the number needed to perform a lumbar puncture to identify one case of bacterial meningitis is now vanishingly close to infinity for low-risk infants, and why implementing this approach requires a multidisciplinary coalition across emergency medicine, infectious disease, and inpatient teams before any individual physician changes their practice.

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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.

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What does it actually feel like to be told your 22-week baby has no chance — before anyone asks what you want? In this booth interview recorded live at PAS 2026, Ben and Daphna sit down with two NICU parents, Christelle and Reem, both of whom delivered at the limits of viability. They share candid, at times difficult accounts of prenatal counseling experiences where they felt dismissed, pressured, and unheard — and what it would have taken to make those conversations feel human. This episode is a reminder that listening is not a soft skill. It is the clinical skill.

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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.

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Point-of-care biomarkers for predicting sepsis mortality, not from a resource-rich academic center, but from a tertiary referral hospital in Tanzania. In this booth interview from PAS 2026, Ben and Daphna sit down with Dr. Abigail Sorensen, a pediatrician now based in East Africa, to discuss how a lasso model combining malnutrition, altered mental status, respiratory distress, and procalcitonin can risk-stratify children with sepsis at the bedside. The lessons here are not just for low-resource settings. They are for anyone trying to identify the sickest kids before it is too late, with the tools already in front of them.

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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.

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Dr. Jennifer Harling, pediatrician and neonatologist who spent six years practicing in Burundi, one of the poorest countries in the world, shares what it took to introduce breast milk fortification, bubble CPAP, and revised sepsis protocols in a setting with nurse-to-patient ratios as high as one to forty and near-zero access to medical supplies. She reflects on the extraordinary obstacles of implementing quality improvement in resource-limited environments — from procurement failures to language barriers to training nurses with limited formal education — and explains why sustainability ultimately came down to the same thing it does everywhere: culture. She also turns the lens around and offers what may be the most universally applicable lesson she brought back from Burundi: slow down, and ask the parent what their number one concern is today.

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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.

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Dr. Ward Rice, neonatologist and researcher within the Neonatal Research Network, presents two-year follow-up data from the landmark ACT NOW Eat Sleep Console trial — one of the largest multi-center randomized trials ever conducted on neonatal opioid withdrawal syndrome. He shares findings on neurodevelopmental and behavioral outcomes at two years of age in babies exposed to buprenorphine versus methadone in utero, explaining why the short-term advantages of buprenorphine did not translate into measurable differences at this time point — but why both groups still scored below population norms on Bayley testing, underscoring the ongoing developmental risk in this population. He also discusses why longer follow-up is planned, what a smaller four-year study suggests may still emerge, and why this research ultimately informs prenatal decision-making by obstetric colleagues just as much as neonatal care at the bedside.

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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.

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Dr. Christa Matrone, neonatologist and program director at Winnie Palmer Hospital in Orlando, Florida, joins Ben and Daphna for a candid conversation about one of the most consequential announcements to hit neonatology training in years. She breaks down the American Board of Pediatrics proposal to create an optional two-year clinical training pathway for all pediatric subspecialties — including neonatology — starting as early as 2028, and explains why the neonatology community was largely caught off guard. She shares her nuanced perspective as a program director at one of the highest-volume units in the country, acknowledging both the potential benefits of a shorter clinical pathway and the serious concerns around clinical readiness, trainee wellbeing, and the future pipeline of physician scientists. She also calls on trainees and practicing neonatologists alike to make their voices heard before this conversation moves any further without them.

Support the show

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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Dr. Allison Lure, neonatologist and clinical informatics fellow, presents findings from a large primary care network spanning over 80 practices in Massachusetts on how term and preterm infants grow longitudinally after discharge. She shares why the standard practice of correcting for gestational age until two years may be sufficient for moderate and late preterm infants but falls short for babies born below 32 weeks — who may need correction extended to three years or beyond to avoid being misclassified as failing to thrive. She also sheds light on the often-overlooked growth trajectories of moderate and late preterm babies, a population rarely captured in NICU follow-up clinics, and explains what her work in clinical informatics is teaching her about how to store, structure, and extract meaningful data from the electronic health record.

Support the show

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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Dr. Parvesh Garg, neonatologist and researcher specializing in necrotizing enterocolitis (NEC) and acute kidney injury (AKI) in preterm infants, shares more than a decade of work on two of the most understudied organ systems in the NICU. He explains why surgical NEC is an independent risk factor for long-term neurodevelopmental impairment, how aggressively managing hypotension at the time of diagnosis may protect both the brain and the kidneys, and why the severity of NEC-associated AKI should be used as a prognostic tool in counseling families. He also presents early but fascinating laboratory findings suggesting that low-dose dexamethasone — unlike high doses — may help limit intestinal epithelial loss once NEC has set in, drawing a parallel to what therapeutic hypothermia does for HIE: the event has happened, but the inflammatory cascade may still be containable.

Support the show

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!