The Incubator

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Dr. Wanda Barfield, MD, MPH, neonatologist at Emory University, former director of the Division of Reproductive Health at the CDC, and former Assistant Surgeon General of the United States Public Health Service, joins Ben and Daphna for a conversation about the broader obligations of pediatricians in an era of growing maternal and infant health disparities. She reflects on what it means to truly know your community — not just your unit — and makes the case that engaging with local health departments, infant mortality review committees, and population health data can make you a better clinician at the bedside. She also offers practical advice on networking at large conferences and why showing up to learn, even without a poster or presentation, can be some of the most valuable time a physician spends at a meeting.

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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. Ravi Patel, neonatologist and leading voice in neonatal hematology and transfusion medicine, joins Ben and Daphna to discuss the launch of NeoHeat — the first dedicated neonatal hematology and transfusion medicine group at PAS. He explains why transfusion medicine in neonatology is still full of unanswered questions, from how we manage iron supplementation to whether we are truly following the latest transfusion threshold guidelines at the bedside. He also introduces one of the most exciting emerging concepts in the field: using cord blood from healthy term newborns to transfuse premature infants, replacing adult hemoglobin with fetal hemoglobin — an innovation already being adopted in some European centers that could have wide-ranging implications beyond anemia alone.

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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. Seetha Shankaran one of the pioneers of therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE) and longtime member of the NICHD Neonatal Research Network, reflects on a career devoted to preventing and treating neonatal brain injury. She discusses what neonatal MRI can and cannot tell us about long-term neurodevelopmental outcomes in infants with HIE, why a normal MRI does not equal a normal future, and how the pattern of brain injury on imaging should shape the counseling conversation with families. She closes with a message that no imaging study can replace: consistent, long-term follow-up remains the most important tool we have.

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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. Charles Roehr, neonatologist from Bristol, UK and faculty member of the Tiny Baby Collaborative, makes the case that caring for extremely preterm infants is as much about engaging families as it is about mastering the medicine. He discusses why parents of tiny babies are among the most vulnerable to enter a research conversation — often facing precipitous deliveries with little to no preparation — and what it takes for clinical teams to meet them where they are. He also addresses one of the hardest conversations in neonatology: how to counsel families around survival and neurodevelopmental outcomes when center-to-center variability is so wide, and why translating evidence from one unit to another remains one of the field's most stubborn unsolved problems.

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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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Jennifer Canvasser, founder of the NEC Society and mother of Micah, a 27-weeker who passed away from necrotizing enterocolitis (NEC) in 2014, shares what is new at the world's largest organization dedicated to NEC. She discusses the upcoming NEC Family Summit — the first of its kind globally — taking place in Davis, California this September, and explains why bringing families together as active research partners is not just about healing but about advancing the science. She also addresses how clinicians can better empower NICU families with information before a diagnosis is ever made, and highlights the free evidence-based resources the NEC Society has developed for units and families navigating this devastating disease.

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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. Atul Malhotra, neonatologist and researcher at Monash University in Melbourne, Australia, makes the case that cell therapy for neonatal brain injury is a slow burn that is finally gaining momentum. He shares why tempering expectations doesn't mean losing hope, how regulatory complexity sets stem cells apart from conventional therapies, and why cell therapy may look different for preterm infants with white matter injury versus term infants with HIE.

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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Breaking news from the American Board of Pediatrics: a proposal to move all 15 pediatric subspecialties to a two-year, competency-based training model by July 2028 just dropped, and Ben and Daphna are breaking it down in real time. What does shifting from time-based to EPA-grounded training mean for neonatology fellows? Is two years actually enough? What happens to scholarship, research exposure, and the physician-scientist pipeline? And should neonatology take this reshuffling of the cards as an opportunity to chart its own course entirely? This is essential listening for fellows, program directors, and anyone who cares about the future of our workforce.

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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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The transfusion threshold consensus is here — but practice hasn't fully caught up. In the second episode of On with VON, Ben and Daphna sit down with Dr. Roger Soll and Dr. Ravi Patel to extend the conversation from the Vermont Oxford Network Grand Rounds on evidence to practice for transfusion thresholds.

The core finding across trials is consistent: lower thresholds for both packed red blood cells and platelets appear safe. The guidelines are freely available in JAMA Network Open and actionable — 11, 10, 9 grams per deciliter across the first three weeks for infants on respiratory support. So why hasn't practice shifted uniformly?

The group works through the populations the trials didn't fully capture — hypoxic-ischemic encephalopathy, the most premature infants, and babies in the first week of life when intraventricular hemorrhage risk peaks. On NEC and feeding during transfusion: the data may surprise you. On transfusion volume and infusion duration: an underappreciated variable, particularly for platelets.

The episode closes with practical guidance on implementing transfusion guidelines at the unit level — who needs to be in the room, how informatics tools can support decision-making, and why understanding protocol deviations matters as much as the guidelines themselves.

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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The AAP has weighed in on therapeutic hypothermia for HIE, and Daphna walks through the clinical report in full. The core eligibility criteria haven't moved — but the edges have gotten more nuanced. Late initiation, the 35-week zone, mild HIE, sentinel events, MRI timing, and feeding during cooling are all addressed.

Also this week: a prospective pilot from Australia tests whether adding bedside ultrasound to plain radiography improves surgical risk stratification in NEC. The X-ray-only model couldn't separate the clusters. The combined model produced a more than six-fold difference in odds of surgery — complex ascites, absent peristalsis, and abnormal bowel perfusion did the heavy lifting.

Daphna then covers F-NeoBright, a small but compelling feasibility study testing intranasal fresh breast milk in infants with moderate to severe HIE. Ten babies, high adherence, no safety signals, and parents administering doses at home.

Ben rounds out Journal Club with the two-year follow-up of the CALI trial examining outcomes after early caffeine plus LISA versus CPAP alone. Mortality trended toward LISA. The statistics didn't get there — but the direction held.

The week closes with Ben and Eli on the Guttmacher Institute study linking restrictive abortion laws to higher maternal mortality across two decades of US data.

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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In this episode of Neo News, Ben and Eli discuss a sobering Guttmacher Institute study recently featured in Bloomberg. Analyzing data from 2005 to 2023, the research reveals a troubling association between restrictive abortion laws and increased maternal mortality, specifically driven by cardiovascular complications and violent deaths. The hosts explore the clinical and social pathophysiology behind these findings, emphasizing how a lack of prenatal care and compounded social stressors disproportionately affect birthing people. Tune in for an important conversation on the "package" of restrictions driving these outcomes and practical ways neonatal professionals can advocate for maternal health equity!

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https://www.bloomberg.com/news/articles/2026-02-12/pregnant-women-die-at-higher-rates-when-states-restrict-abortion?srnd=phx-industries-health

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!