The Incubator

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What if the smallest patients finally had a diaper designed just for them? For years, NICUs have struggled to find appropriately sized diapers for extremely premature infants, often resorting to makeshift solutions that compromised skin integrity and care quality. That changes now. In this breaking news episode, Ben sits down with Harry McCusker, Director of Research and Development for North America Pampers Diapers, to discuss the groundbreaking launch of the Pxxs diaper—the world's smallest commercially available diaper, specifically engineered for micropreemies born as early as 21-23 weeks gestation. Weighing less than a nickel and designed with input from NICU professionals worldwide, the Pxxs addresses critical challenges in skin protection, fluid management, and developmental care for our most vulnerable patients. Join us as we explore how this innovation represents more than just a smaller diaper—it's Pampers' commitment that every preemie deserves products designed with their unique needs in mind.

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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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Could a simple blood test help identify chronic pulmonary hypertension when echo access is limited? This week on The Incubator Podcast, Ben and Daphna explore this question and others relevant to daily NICU practice. A Toronto study examines NT-proBNP as a practical diagnostic tool in extremely preterm infants.

They also examine a puzzling finding from Italy and Belgium: despite near-universal antibiotic use in neonates with HIE undergoing cooling, actual culture-positive sepsis rates are surprisingly low. What does this mean for our approach to empiric antibiotics?

Ben presents Norwegian data showing that serial physical exams cut antibiotic exposure in half for term and late preterm infants—without compromising safety. Daphna follows with research connecting NICU capacity strain to patient outcomes, underscoring why adequate staffing isn’t just about comfort, but about survival.

The episode concludes with Ben, Daphna, and Eli discussing the recent CDC changes to Hepatitis B birth dose recommendations. With federal guidance now diverging from AAP recommendations, how do we navigate conversations with families? They explore transmission risks parents may overlook and share approaches to shared decision-making when expert opinions conflict. 

A full week of neonatal medicine research and real-world clinical challenges, all in one episode

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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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This week on Neo News, we tackle the recent and controversial divergence between CDC and AAP guidelines regarding the birth dose of the Hepatitis B vaccine. With the CDC now recommending a deferred schedule for infants of Hepatitis B-negative mothers, we explore the clinical implications, the risks of vertical transmission, and the challenge of navigating discordant public health advice. We discuss how to handle shared decision-making in an era of waning vaccine confidence and why the "birth dose" remains a critical safety net in a community setting. Join us as we break down the data behind the headlines.

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American Academy of Pediatrics. (2025, December 15). AAP: CDC decision on universal birth dose of hepatitis B vaccine irresponsible and purposely misleading. AAP News. https://publications.aap.org/aapnews/news/33980/AAP-CDC-decision-on-universal-birth-dose-of?searchresult=1?autologincheck=redirected

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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 episode of Journal Club, Ben and Daphna review a retrospective cohort study from the Journal of Perinatology examining the association between NICU capacity strain and neonatal outcomes. We discuss how high census and acuity on admission day correlate with increased mortality and morbidity when adjusted for hospital and patient factors. Join us as we explore why being "slammed with admissions" is more than just a badge of honor—it’s a critical safety metric for our patients.

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The association of NICU capacity strain with neonatal mortality and morbidity. Salazar EG, Passarella M, Formanowski B, Rogowski J, Edwards EM, Halpern SD, Phibbs C, Lorch SA.J Perinatol. 2025 Dec;45(12):1801-1808. doi: 10.1038/s41372-025-02449-0. Epub 2025 Oct 20.PMID: 41116036 Free PMC article.

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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 episode of The Incubator Podcast, Ben and Daphna review a pivotal population-based study from Norway examining a new approach to Early-Onset Sepsis (EOS). The hosts discuss whether serial physical examinations can safely replace routine antibiotic prophylaxis in at-risk term and late-preterm infants. With antibiotic exposure often far exceeding sepsis incidence, this study offers compelling data for a "less is more" strategy. Tune in as Ben and Daphna explore the safety, efficacy, and bedside implications of substituting automatic treatment with structured clinical monitoring—and what this means for reducing unnecessary interventions in the NICU.

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Serial physical examination to reduce unnecessary antibiotic exposure in newborn infants: a population-based study. Vatne A, Eriksen BHH, Bergqvist F, Fagerli I, Guthe HJT, Iversen KV, Ud Din FS, van der Weijde J, Kvaløy JT, Rettedal S.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 19:fetalneonatal-2025-329639. doi: 10.1136/archdischild-2025-329639. Online ahead of print.PMID: 41260908

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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 episode of Journal Club, Ben and Daphna dive into a multicenter retrospective study from the European Journal of Pediatrics questioning the necessity of universal empiric antibiotics in neonates undergoing therapeutic hypothermia for HIE. Comparing Italian and Belgian cohorts, the team discusses the reality of a 111 Number Needed to Treat (NNT) for a single case of culture-proven sepsis. From the diagnostic challenges of overlapping clinical markers to the fascinating "asymptote" of postnatal leukocyte trends, we explore whether it's time to shift from routine to selective antibiotic use in our most complex patients.

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Antibiotic use in neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia: time to rethink universal empirical treatment. De Rose DU, Piersigilli F, Auriti C, Campi F, Cortazzo V, Samaey A, Carkeek K, Martini L, Maddaloni C, Santisi A, Ronci S, Iacona G, Bersani I, Savarese I, Danhaive O, Cilio MR, Bernaschi P, Dotta A, Ronchetti MP.Eur J Pediatr. 2025 Nov 22;184(12):781. doi: 10.1007/s00431-025-06652-1.PMID: 41275063

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 Journal Club episode of the Incubator Podcast, Ben Courchia and Daphna Yasova-Barbeau review a study from the Journal of Perinatology evaluating NT-proBNP as a diagnostic tool for chronic pulmonary hypertension in extremely preterm infants. The discussion walks through the clinical burden of pulmonary hypertension in babies with bronchopulmonary dysplasia, the limitations of echocardiography, and the appeal of accessible biomarkers. Using data from a SickKids Toronto cohort, the hosts unpack sensitivity, specificity, cutoff values, and real-world applicability, while exploring how NT-proBNP could support screening, risk stratification, and bedside decision-making in everyday NICU practice.

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Can N-terminal pro-brain natriuretic peptide accurately diagnose chronic pulmonary hypertension among extremely low gestational age neonates: A Retrospective Cohort Study. Garcia-Gozalo M, Jain A, Weisz DE, Jasani B.J Perinatol. 2025 Nov 13. doi: 10.1038/s41372-025-02462-3. Online ahead of print.PMID: 41233504

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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This week on The Incubator Podcast, Ben and Daphna review several recent studies in neonatal care. They start with a JAMA trial comparing expectant versus active PDA management in preterm infants, noting a survival signal favoring expectant care and discussing how this fits within current practice. They then review outcomes of 21-week gestation infants from the University of Iowa, focusing on resuscitation strategies and survival at the limits of viability.

The conversation continues with the ICAF trial, examining whether extending caffeine therapy through 41 weeks postmenstrual age meaningfully reduces intermittent hypoxia and for which infants this may matter. A large national cohort study on antenatal corticosteroids between 21 and 24 weeks gestation is also discussed, highlighting practice variation and implications for counseling.

The episode closes with a Neo News segment on legal liability in the NICU following a recent $32 million NEC settlement. Ben, Daphna, and Eli consider informed consent around nutritional care and how evolving legal pressures may influence communication and clinical decision making.

This compilation brings together research and policy discussions from the week in a single long-form episode.

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, Daphna, and Eli tackle the complex and emotionally charged landscape of legal liability in the NICU. Following a recent $32 million settlement involving necrotizing enterocolitis (NEC) and cow's milk-based formula, the team debates the future of informed consent for routine nutritional care. They explore how legal precedents may force neonatologists to replace bedside counseling with transactional forms, potentially eroding trust and complicating evidence-based practice. Join us as we discuss how to balance transparency, parental autonomy, and the reality of risk in the pursuit of better outcomes for our tiniest patients.

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WTNH News 8. (2025, December 15). Parents, attorneys emphasizing importance of informed consent to NICUs following baby’s death at Yale New Haven Hospital. WTNH. https://www.wtnh.com/news/connecticut/new-haven/parents-attorneys-emphasizing-importance-of-informed-consent-to-nicus-following-babys-death-at-yale-new-haven-hospital/

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 Journal Club episode, Ben and Daphna review a large national cohort study examining the association between antenatal corticosteroid exposure and survival in extremely preterm infants born between 21 and 24 weeks’ gestation. They discuss biologic plausibility, practice variation, and the challenges of interpreting retrospective data, while focusing on how these findings may inform counseling and shared decision-making at the margins of viability.

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The Effects of Antenatal Corticosteroids on Extremely Premature Neonates Born between 21 and 24 Weeks. Yao R, Tritch N, Vedhanayagam K, Ali N, Reimche-Vu H, Gedestad I, Karageuzian S, Contag S.Am J Perinatol. 2025 Nov 6. doi: 10.1055/a-2722-8107. Online ahead of print. PMID: 41086871

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!