The Incubator

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In this Journal Club episode, Ben reviews a secondary analysis of the CALI trial, published in JAMA Network Open, examining two-year neurodevelopmental and pulmonary outcomes in preterm infants who received early caffeine combined with LISA versus caffeine and CPAP alone. Building on the original CALI trial's finding that early caffeine prior to LISA reduced intubation rates and BPD, this follow-up asks the next logical question: does that early advantage translate into better long-term outcomes? Ben walks through the Bayley scores, gross motor function, ASQ-3, M-CHAT, and pulmonary outcomes — and delivers a reassuring if not statistically significant picture. Tune in for a deep dive into the evidence behind one of neonatology's most debated respiratory strategies!

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Two-Year Outcomes of Less Invasive Surfactant Administration Among Preterm Neonates: A Secondary Analysis of a Randomized Clinical Trial. Dorner RA, Morales A, Banerji A, Uy C, Ines F, Finer N, Vaucher Y, Katheria AC.JAMA Netw Open. 2026 Mar 2;9(3):e263852. doi: 10.1001/jamanetworkopen.2026.3852.PMID: 41915392

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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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In this Journal Club episode, Daphna presents the F-NeoBright trial — a pilot feasibility and safety study out of Hungary exploring intranasal fresh breast milk administration in neonates with moderate to severe HIE undergoing therapeutic hypothermia. With so few adjunct therapies available beyond cooling, the idea of harnessing breast milk's rich bioactive components — including neurotrophic growth factors, cytokines, and multipotent stem cells — to support the developing brain is both compelling and refreshingly low-risk. Daphna walks us through the protocol, the feasibility outcomes, and why 100% of approached families consented, including those who had never planned to breastfeed. Sometimes the simplest intervention really is the right one!

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F-NEO-BRIGHT: feasibility and safety of intranasal fresh breast milk in neonatal encephalopathy. Tarjanyi E, Jermendy A, Szabo M, Brandt FA, Szasz B, Nyilas N, Meder U.Pediatr Res. 2026 Mar 3. doi: 10.1038/s41390-026-04847-2. Online ahead of print.PMID: 41776367

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!

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In this Journal Club episode, Ben takes the lead and reviews a prospective cohort pilot study from the Archives of Disease in Childhood examining whether combining abdominal ultrasound with plain radiography can improve surgical risk stratification in neonates with suspected NEC. With mortality remaining as high as 20–40% and diagnosis still heavily reliant on clinical judgment, the stakes couldn't be higher. Ben walks through the study's unsupervised clustering approach, explaining how adding ultrasound data to X-ray findings produced a more than six-fold difference in the odds of surgery between risk groups — something X-ray alone simply couldn't achieve. Tune in to hear why dynamic ultrasound features like peristalsis, ascites, and bowel perfusion may be the missing piece in your NEC diagnostic toolkit!

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Combining abdominal ultrasound and radiography for surgical risk stratification in necrotising enterocolitis: a prospective cohort pilot study. Priyadarshi A, Angiti R, Chabra S, McAdams R, Webb A, Badawi N, Hinder MK, Tracy MB.Arch Dis Child Fetal Neonatal Ed. 2026 Mar 5:fetalneonatal-2025-329960. doi: 10.1136/archdischild-2025-329960. Online ahead of print.

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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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In this Journal Club episode, Ben and Daphna dive into the American Academy of Pediatrics' February Clinical Report on Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy. Daphna, who presented this paper at the Florida Neonatal Neurologic Network, walks us through the key action statements — from the established 33.5°C target temperature to the more nuanced discussions around late cooling (6–24 hours), gestational age eligibility at 35 weeks, and the controversial question of cooling mild HIE. They also cover optimal MRI timing post-rewarming, continuous EEG monitoring, early enteral feeds during cooling, and the growing evidence supporting the "cool cuddle." A must-listen for anyone navigating the evolving landscape of HIE management!

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Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Clinical Report. Zanelli SA, Wusthoff CJ, Lucke AM, Kaufman DA; Committee on Fetus and Newborn; Section on Neurology.Pediatrics. 2026 Feb 1;157(2):e2025073627. doi: 10.1542/peds.2025-073627.PMID: 41581784 Review.

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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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In this Tech Tuesday episode, Ben sits down with Dr. Itamar Nitzan and Alon Meritrikin-Gold, the co-founders of SkinCubator, a revolutionary wearable incubator designed to transform neonatal skin-to-skin care. They discuss how reframing kangaroo care from a rare procedure to a continuous necessity inspired this paradigm-shifting device. The hosts dive into the clinical logistics, from safely transferring intubated extremely preterm infants to alleviating parental anxiety and nursing resistance. Tune in to hear how this innovative "pocket incubator" maintains thermoregulation, secures critical lines, and promises to safely extend skin-to-skin duration for our most vulnerable NICU patients!

Learn more about the skincubator: https://www.skincubator-neocare.com/

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 interview episode, Ben and Daphna sit down with Professor Brett Manley to discuss a paradigm shift in neonatal research: adaptive platform trials. Frustrated by the inefficiencies and underpowered results of traditional RCTs, Dr. Manley outlines the ambitious Platypus Adaptive Platform Trial launching in Australia and New Zealand. They dive into how shared primary outcomes, novel consent models, and massive cross-center collaboration can answer pressing clinical questions—like optimal PPROM antibiotics and caffeine dosing—simultaneously. Tune in for a fascinating conversation on moving beyond medical dogma, embracing humility, and keeping families at the center of NICU research!

Learn more about the Platipus trial here: https://www.platipustrial.org/

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!

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This week on The Incubator Podcast, Ben and Daphna cover five topics spanning clinical practice, emerging technology, and neonatal policy. They open with a large Swedish national cohort study from JAMA Network Open examining early prophylactic hydrocortisone in extremely preterm infants, debating whether a blanket approach to BPD prevention holds up across gestational ages and in the presence of chorioamnionitis.They then take a critical look at predischarge car seat tolerance screening, questioning whether this decades-old AAP recommendation still earns its place in routine NICU discharge planning given its failure to reduce mortality or readmissions.

The conversation shifts to BPD-associated pulmonary hypertension, reviewing a PPHNet study that challenges whether current grading criteria and assessment timepoints adequately capture pulmonary vascular disease severity. They then explore oculomics — a compelling new frontier in which deep learning applied to routine ROP screening images can predict BPD and pulmonary hypertension weeks ahead of clinical diagnosis.

The week closes with a Neo News policy discussion on the regulatory pressures threatening freestanding birth centers nationwide, and the downstream consequences for maternal health equity, newborn screening, and neonatal advocacy.

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 Neo News segment, Ben and Eli tackle a pressing Stateline report on the paradoxical struggle of freestanding birth centers. While hospital labor and delivery units are closing nationwide, alternative birth centers are facing aggressive regulatory hurdles and forced closures in states like Alabama. The hosts discuss the downstream effects on maternal health equity, the rise of unregulated crisis pregnancy centers, and the clinical realities of out-of-hospital births like hyperbilirubinemia and missed newborn screens. Plus, they dive into the EMTALA implications for hospital transfers and highlight key takeaways on neonatal advocacy and teleneonatology from the recent Delphi Conference. Tune in for a critical policy discussion!

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https://stateline.org/2026/01/05/freestanding-birth-centers-are-closing-as-maternity-care-gaps-grow/

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!

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In this Journal Club episode, Ben and Daphna explore an exciting new frontier in neonatology: oculomics. Reviewing a recent paper from JAMA Ophthalmology, they discuss how deep learning models applied to routine ROP screening images can predict the development of BPD and pulmonary hypertension in preterm infants. By combining visual features extracted via neural networks with standard demographic data, researchers achieved impressive predictive accuracy weeks before clinical diagnosis is typically made. Tune in to hear how the eyes might just be the window to the neonatal pulmonary vasculature!

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Deep Learning-Based Prediction of Cardiopulmonary Disease in Retinal Images of Premature Infants. Singh P, Kumar S, Tyagi R, Young BK, Jordan BK, Scottoline B, Evers PD, Ostmo S, Coyner AS, Lin WC, Gupta A, Erdogmus D, Chan RVP, McCourt EA, Barry JS, McEvoy CT, Chiang MF, Campbell JP, Kalpathy-Cramer J.JAMA Ophthalmol. 2026 Jan 22:e255814. doi: 10.1001/jamaophthalmol.2025.5814. Online ahead of print.PMID: 41569552

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 Journal Club, Ben and Daphna review a pivotal paper from the Journal of Pediatrics led by the Pediatric Pulmonary Hypertension Network (PPHNet). The study explores invasive hemodynamic metrics and long-term outcomes in infants with BPD-associated pulmonary hypertension. Surprisingly, researchers found an almost equal distribution of pulmonary hypertension across mild, moderate, and severe BPD grades using the Jensen criteria. The hosts discuss the implications of these findings, questioning whether our traditional 36-week assessment timepoint is sufficient and if current grading criteria capture the true severity of pulmonary vascular disease in these vulnerable infants.

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Pulmonary Hemodynamics and Long-Term Outcomes in Children with Pulmonary Hypertension-Associated Bronchopulmonary Dysplasia. Austin ED, Mullen MP, Avitabile CM, Krishnan US, Rosenzweig EB, Keller RL, Kinsella JP, Yung D, Steffes L, Bates A, Elia EG, Romer LH, McGrath-Morrow S, Bernier ML, Mandl KD, Raj JU, Sleeper LA, Abman SH; Pediatric Pulmonary Hypertension Network (PPHNet) Investigators.J Pediatr. 2026 Feb;289:114869. doi: 10.1016/j.jpeds.2025.114869. Epub 2025 Oct 24.

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!