The Incubator

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In this Journal Club episode, Ben and Daphna review a systematic review and meta-analysis from JAMA Network Open questioning the clinical value of predischarge car seat tolerance screening (CSTS). Driven by data suggesting that testing does not reduce 30-day mortality or hospital readmissions, they discuss the high failure rates, varying definitions of bradycardia and desaturation, and the unintended consequence of prolonged NICU stays. They also highlight the practical reality of CSTS in ensuring parents actually have an appropriate car seat at discharge. Tune in for a critical look at whether this 1991 AAP recommendation still holds up today!

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Predischarge Car Seat Tolerance Screening in Preterm and At-Risk Full-Term Infants: A Systematic Review and Meta-Analysis. King BC, Dalvie N, Hay S, Jensen EA, Zupancic JAF.JAMA Netw Open. 2026 Feb 2;9(2):e2558197. doi:0.1001/jamanetworkopen.2025.58197.

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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 Daily Journal Club episode, Ben and Daphna review a massive Swedish national cohort study from JAMA Network Open examining early prophylactic hydrocortisone in extremely preterm infants. They discuss the targeted regimens used, differences in gestational age outcomes, and whether a blanket prophylactic approach is truly effective for preventing BPD. With impressive data covering 98% of all NICU admissions in Sweden, the hosts debate the nuances of targeting 24 to 25-weekers versus older preemies and the potential confounding impact of chorioamnionitis. Tune in for your daily snack of evidence-based medicine and insights into optimizing NICU steroid protocols!

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Early Prophylactic Hydrocortisone and Bronchopulmonary Dysplasia-Free Survival in Extremely Preterm Infants. Smedbäck V, Björklund LJ, Flisberg A, Wróblewska J, Baud O, Wejryd E, Ådén U.JAMA Netw Open. 2026 Feb 2;9(2):e2560146. doi:10.1001/jamanetworkopen.2025.60146.

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. Kelly Mahaney, Assistant Professor of Pediatric Neurosurgery at Stanford and researcher focused on the role of iron in post hemorrhagic hydrocephalus, joins the podcast to challenge the traditional watch and wait approach to IVH complications. She describes Stanford’s early radiographic intervention pathway, which has reduced shunt dependency from 90% to 45% in reservoir-placed infants, explains why waiting for clinical symptoms means waiting too long, and outlines her effort to build a statewide CPQCC nested network to standardize and study early intervention practices across California NICUs.

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. Sanjay Sinha, interventional pediatric cardiologist, Assistant Professor of Pediatrics at CHOC and UCI, and Co-Director of the UCLA Congenital Lymphatic Imaging and Intervention Program, opens a new chapter for neonatologists on neonatal chylothorax and lymphatic disease. He explains how to recognize lymphatic mimickers at the bedside, why woody edema should raise the index of suspicion, how MR lymphangiography is reshaping diagnosis and surgical planning, and how early targeted intervention is dramatically reducing NPO time and hospital length of stay in a population that was previously managed with a prolonged watch and wait approach.

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. Clara Song, neonatal intensivist with Southern California Permanente Medical Group, Chair of the AAP Section on Neonatal Perinatal Medicine Executive Committee, and founding leader of the Women in Neonatology group, shares the lessons from her Cool Topics talk on quiet power and soft skills in leadership. She explores how communication, emotional intelligence, and servant leadership drive team performance more than technical expertise, breaks down the four personality types every leader needs to understand, and offers a practical framework for structuring communication so every type of team member actually receives the message.

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. Robin Steinhorn, Professor and Vice Dean for Children’s Clinical Services at UC San Diego and President of Children’s Specialists of San Diego, tackles one of neonatology’s most uncomfortable conversations: compensation. She breaks down how to identify reliable benchmark data, explains why neonatologists are generating more RVUs than ever while pay has not kept pace with workload complexity, addresses gender discrepancy trends in the literature, and offers practical strategies for individuals and division chiefs to use rigorous national data when advocating for fair compensation at the institutional level.

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. Susan Hintz, Medical Director of the Fetal and Pregnancy Health Program and Robert L. Hess Family Endowed Professor at Stanford Medicine, delivers this year’s Cool Topics keynote on collaboration, shared purpose, and the lessons learned building high risk infant follow-up infrastructure through the CPQCC. She challenges the neonatal community to move beyond the handoff to a pediatrician and think deliberately about true medical home design, including coordinated care teams, clearly defined roles across subspecialty and follow-up clinics, and better use of community based resources to support families long after NICU discharge. 

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. Caitlin Carter, Clinical Director of Nephrology at Rady Children’s Hospital and associate clinical professor at UC San Diego, joins the podcast to challenge how neonatologists recognize and follow up on acute kidney injury. She explains why creatinine alone is insufficient, how biomarkers like NGAL can detect tubular injury before function declines, and why AKI too often disappears from the discharge summary. She also outlines published consensus guidelines on post NICU nephrology follow-up, with clear thresholds based on gestational age and AKI severity.

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. Tarah Colaizy, Professor of Neonatology at the University of Iowa Stead Family Children’s Hospital and Medical Director of the Mother’s Milk Bank of Iowa, challenges the one size fits all approach to nutrition in periviable infants. She shares the Iowa philosophy of individualized, principle driven feeding management, explains why rigid protocol adherence can backfire in the most immature babies, and walks through her unit’s glycerin protocol for meconium obstruction of prematurity. She also discusses the practical realities of frequent low volume lab monitoring and the importance of patience over speed in enteral feeding advancement.

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. Satyan Lakshminrusimha, Chair of Pediatrics and Pediatrician in Chief at UC Davis Children’s Hospital, makes a compelling case for rebranding and restructuring neonatology as a field. He argues for adopting the title of neonatal critical care physician, addresses the stark disparity between NICU revenue generation and neonatologist compensation, and outlines a step by step resuscitation framework for the field, from restoring professional identity to establishing a dedicated neonatal residency pathway and ultimately recognizing neonatology as its own independent department.

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!