The Incubator

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In the final episode of our Rethinking Phototherapy series, Ben speaks with Steve Falk, Chief Engineer of the Maternal Infant Care Strategic Business Unit at GE Healthcare. With more than three decades of engineering leadership, Steve has been instrumental in the development of landmark neonatal technologies, including the Giraffe Omnibed and Panda platforms.

This conversation highlights the critical role of engineering in making phototherapy precise, reliable, and safe. Steve explains how advances in LED technology have transformed phototherapy devices, ensuring consistent irradiance and long product life. He describes how engineers translate clinical needs—wavelength, intensity, surface coverage, and distance—into product requirements, and how rigorous usability testing with clinicians shapes intuitive bedside tools. The discussion also explores innovation on the horizon, from refining intermittent phototherapy strategies to integrating technologies that simplify care and support earlier discharge.

Listeners will gain a behind-the-scenes perspective on how engineering teams think about phototherapy as a true pharmacotherapy, and how collaboration between clinicians and industry can directly improve outcomes for newborns and families. This episode closes the series by reminding us that innovation in neonatal care happens not only in clinical practice, but also in the design labs where these essential tools are created.

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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 happens when we challenge our long-standing assumptions about phototherapy in the NICU? In this special installment of our Rethinking Phototherapy series, Ben and Daphna are joined by Dr. Deepak Manhas to examine one of the most complex questions: how should we manage hyperbilirubinemia in preterm infants?

Unlike term babies, preemies face unique risks—shorter red blood cell lifespan, immature bilirubin conjugation, lower albumin binding, and increased blood-brain barrier permeability—all of which make them more vulnerable to bilirubin-induced neurologic dysfunction. This conversation explores why traditional guidelines cannot simply be applied to preterm infants and why clinicians often initiate phototherapy earlier.

Dr. Manhas discusses the creation of gestation-specific treatment charts, the challenges and dangers of exchange transfusion in this fragile population, and the uncertain role of therapies such as IVIG, albumin, and phenobarbital. The team also unpacks practical issues: what “double phototherapy” should really mean, how to order irradiance and body surface area coverage with precision, and the role of bili blankets in promoting family bonding.

By situating this discussion in the broader Rethinking Phototherapy series, the episode highlights both the progress and the unanswered questions in caring for preterm infants.

📖 Reference: Pathogenesis and Management of Indirect Hyperbilirubinemia in Preterm Neonates Less Than 35 Weeks: Moving Toward a Standardized Approach (NeoReviews)

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 the second installment of our Rethinking Phototherapy series, Ben and Daphna welcome Dr. Daniel Rauch, Professor of Pediatrics at the Hackensack Meridian School of Medicine and Division Chief of Pediatric Hospital Medicine and General Academic Pediatrics at Joseph Sanzari Children’s Hospital. Dr. Rauch co-authored the AAP technical report on phototherapy and brings a unique perspective on how light therapy should be understood and applied in clinical practice.

This conversation reframes phototherapy as a true pharmacotherapy—an intervention that must be delivered in precise doses with attention to wavelength, irradiance, body surface exposure, and treatment duration. Dr. Rauch explains why more light is not always better, how technology has evolved from “easy-bake oven” style lamps to modern LED systems, and why maximizing body surface exposure often matters more than piling on extra light banks. The discussion also touches on cycling strategies, the value and limitations of transcutaneous monitoring, and the potential of home phototherapy to reduce unnecessary hospitalizations while supporting family bonding.

Listeners will gain practical insights into the art and science of phototherapy: how to optimize treatment, minimize harm, and communicate clearly with families navigating jaundice management.

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 The Incubator Podcast, Ben and Daphna sit down with Dr. Alex Kemper, Division Chief of Primary Care Pediatrics at Nationwide Children’s Hospital and Editor-in-Chief of Pediatrics. Dr. Kemper served as chair of the American Academy of Pediatrics subcommittee that authored the 2022 revision of the neonatal hyperbilirubinemia guidelines.

Together, they explore the motivations behind revisiting the 2004 guideline, the major changes introduced, and how these revisions are shaping clinical care. Dr. Kemper explains why treatment thresholds for phototherapy were raised, the careful balance between avoiding unnecessary interventions and preventing kernicterus, and the rationale for moving away from the risk stratification nomogram. The discussion highlights phototherapy as an effective but not benign therapy—one that can disrupt bonding, prolong hospitalization, and create family stress when overused.

Listeners will gain insight into the complexities of evidence review, the challenges of consensus-building over eight years of work, and the importance of shared decision-making and reliable follow-up after discharge. This conversation not only demystifies the new guidelines but also reframes the way clinicians think about jaundice management, risk stratification, and the broader impact on families.

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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 discussion, Dr. Hevil Shah (Cook Children’s Hospital) and Dr. Julie Lindower (UI Children’s) highlight the work of the CHNC Focus Group on Extremely Preterm Infants, centered on babies born between 21–23 weeks’ gestation. They share insights from a workshop on precision care, emphasizing lessons from Iowa’s long-term data showing improved survival and neurodevelopmental outcomes. The conversation explores variability in resuscitation and counseling practices across centers, and the importance of unified messaging among care teams. The group’s next steps include publishing survey results and strengthening collaborations—particularly with the nutrition focus group—to advance standardized, evidence-based care for the most premature newborns.

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 keynote discussion, Dr. Natasha Henner (Lurie Children’s Hospital) examines how evolving reproductive policies are reshaping neonatal practice, from counseling at the limits of viability to supporting families after restrictive abortion laws. She discusses rising NICU admissions for infants with congenital differences, ethical tensions around “life-limiting” diagnoses, and gaps in perinatal hospice and home care resources. Dr. Henner emphasizes the need for shared frameworks among neonatologists, obstetricians, and palliative care teams, as well as simulation-based training to navigate moral distress and complex communication. Her call to action: welcome these difficult conversations to improve compassionate, coordinated family-centered care.

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 keynote conversation, Dr. Amy Baughcum, PhD (Nationwide Children’s), Dr. Elizabeth Fischer, PhD (Children’s Wisconsin), and Dr. Lamia Soghier, MD, MeD, MBA (Children’s National) discuss building comprehensive perinatal mental health support systems that span from prenatal diagnosis to life after NICU discharge. Drawing inspiration from Dr. Joanna Cole’s fetal psychology model at CHOP, they emphasize early screening, interdisciplinary collaboration, and embedding psychologists or social workers within NICU teams. The speakers highlight strategies to normalize emotional distress, empower families to seek help, and align institutional priorities with psychosocial care. Their shared message: supporting parental mental health is essential, evidence-based, and foundational to optimal infant outcomes.

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 episode addresses NICU staff mental health with Dr. Chavis Patterson, PhD (Children’s Hospital of Philadelphia). He reviews common problems—toxic stress, compassion fatigue, irritability, sleep disturbance—and practical mitigation strategies: brief micro-practices (five-minute arrival/departure routines), peer debriefs (e.g., “pink flags”), unit multidisciplinary check-ins, and institutional resources such as employee assistance programs and embedded NICU psychologists. Patterson stresses normalizing emotional responses, reducing stigma around seeking psychotherapy, and building structural supports by advocating for funded on-unit psychology positions. Immediate actions: start regular team debriefs, map local mental-health resources, pilot embedded psychology coverage, and lead institutional advocacy to make staff mental health standard NICU practice.

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 keynote episode features Dr. Jennifer Sucre (Vanderbilt University Medical Center), whose research bridges bedside observation and molecular biology to uncover why some preterm infants develop severe bronchopulmonary dysplasia (BPD) while others recover. Through innovative live imaging of lung development and mouse and human tissue models, her lab discovered that capillary “guidance” signals—semaphorins—are crucial for lung repair and resilience. Loss of these pathways marks irreversible injury. Dr. Sucre emphasizes “bedside-to-bench” science, finding lessons from resilient infants to inform therapy. Clinically, she urges providers to recognize individual resilience, foster hopeful communication with families, and envision a future where BPD is preventable—not inevitable.

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 episode features Dr. Giulia Lima (Boston Children’s Hospital), a CHNC Mentored Fellow, discussing risk factors for morbidity and mortality among preterm infants with congenital heart disease (CHD) using data from over 11,000 NICU admissions. Surprisingly, older gestational age did not predict improved survival once infants survived beyond three days. Major mortality predictors included surgical NEC, bloodstream infection, trisomy 21, airway anomalies, and compromised systemic output lesions. Multiple gestation appeared protective, though reasons remain unclear. Dr. Lima highlights the importance of standardized prenatal steroids, care coordination, and exploring socioeconomic and ethnic disparities to improve outcomes in this uniquely vulnerable CHD population.

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!