The Incubator

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This episode features Dr. Sofia Isabel Perazzo (Children’s National Hospital) and Dr. Rakesh Rao (St. Louis Children’s Hospital) discussing a CHNC Explore analysis of intestinal stricture formation following surgical necrotizing enterocolitis (NEC). Using 15 years of CHND data, they examined over 2,400 surgical NEC cases, finding an overall stricture incidence of about 31%, with striking inter-center variability (24–38%). Lower gestational age, stoma creation, and combined drainage-laparotomy increased risk, while peritoneal drainage was protective. Hispanic ethnicity was associated with lower risk. Although their predictive model (AUC 0.67) was modest, the findings offer valuable benchmarks for parent counseling, quality improvement, and hypothesis generation.

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In this episode Dr. Murali Premkumar (Texas Children’s) presents an Explore/CHNC analysis of stricture formation after surgical NEC using 2010–2024 CHND data (2,411 surgical NEC infants). Overall CHNC stricture incidence ≈31% with marked inter-center variability (adjusted center rates ~24–38%). Multivariable analysis identified lower gestational age and stoma/laparotomy as associated with higher stricture risk, while initial peritoneal drainage associated with lower risk; Hispanic ethnicity showed lower unadjusted risk. A predictive model yielded AUC 0.67, highlighting missing variables (antibiotic duration, feeding practices). Practical implications: use these benchmarks to counsel families, generate hypotheses, and target QI by studying low-risk centers.

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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 episode features Dr. Sarah Swenson (Children’s Nebraska), Dr. Cara Solness, PhD (Children’s Nebraska), and Dr. Desiree Leverette (Emory/Children’s Healthcare of Atlanta) discussing equitable approaches to parental mental health screening in the NICU. They highlight that traditional programs often screen only mothers for depression, missing significant distress among non-gestational parents, especially fathers. Universal screening identified five times more affected partners, improving opportunities for support. The guests underscore the developmental importance of including all caregivers, the need to address stigma and fears of CPS involvement, and the value of trauma-informed communication. They advocate for integrated NICU psychologists and tailored, equity-focused interventions, including telehealth and culturally responsive materials.

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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 episode features Joshua Hess, MSN, RN discussing strategies to encourage more nurses to attend neonatal conferences where interdisciplinary collaboration drives meaningful quality improvement. Hess highlights how nurse involvement ensures clinical decisions reflect bedside realities, especially in managing conditions like BPD. He describes his unit’s culture of first-name, physician-nurse partnership and how institutional support and presenting a poster helped him attend. He also shares his team’s safe sleep quality initiative, which standardized education, created an order for “safe sleep readiness,” and significantly reduced unsafe sleep environments. Hess encourages NICUs to empower nurses as conference participants, educators, and change leaders.

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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, Dr. Marina Metzler (St. Louis Children’s) shares her experience as a mentored fellow within the CHNC network, focusing on her project investigating genetic diagnoses in neonates with hypoxic-ischemic encephalopathy (HIE). She discusses the application and mentorship process, the support available from statisticians and CHNC collaborators, and early findings showing that infants with genetic conditions often experience longer NICU stays, more ventilator support, and greater feeding challenges. Dr. Metzler highlights the potential for genetic testing to refine diagnosis, guide care, and inform families, while emphasizing the need for larger datasets and multi-center collaboration to advance understanding in this complex population.

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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 episode reflects on key themes emerging from day two of the 2025 CHNC Symposium. Hosts highlight ongoing work within CHNC focus groups, including defining emergent neonatal transport criteria and improving care pathways for infants with intestinal failure. They emphasize the pivotal role of family partners in research and quality improvement, noting the need to reduce financial and logistical barriers that limit caregiver participation at conferences. The discussion also underscores the growing recognition of parental mental health as central to infant outcomes, encouraging universal screening and structured support. Overall, the episode calls for intentional collaboration across disciplines and with families to drive meaningful neonatal care improvement.

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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 episode features Dr. Carolina Adams (Emory) and Dr. Faizah Bhatti (Oklahoma Children’s Hospital) discussing findings from the CHNC Retinopathy of Prematurity (ROP) Focus Group. Their survey of pediatric ophthalmologists across U.S. centers revealed wide variability in screening practices, communication with neonatologists, sedation protocols, and anti-VEGF dosing. Many clinicians continue using higher bevacizumab doses despite emerging evidence supporting dose reduction. The guests emphasize the need for consistent, collaborative protocols, especially for infants outside standard screening criteria and extremely premature infants now surviving earlier gestational ages. They preview upcoming technology, including handheld NICU-compatible OCT devices, that may enhance early detection, shared decision-making, and long-term visual outcomes.

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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, Dr. Katie Huff (Cincinnati Children’s) and Dr. Pritha Nayak (Dallas Children’s) discuss the work of the CHNC Intestinal Failure Focus Group. They highlight the unique challenges of managing neonates post-NEC, including TPN, nutrition, and long-term outcomes. The group’s recent survey revealed significant variability across centers, including the presence of dedicated intestinal rehab teams and approaches to outpatient follow-up. Future efforts will focus on neurodevelopmental support, optimizing feeding practices, and standardizing criteria for discharge on TPN. This work demonstrates how descriptive, collaborative research within CHNC can spark new hypotheses and improve outcomes for this complex neonatal population.

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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, neonatologists Dr. Megan Paulsen (Children’s Minnesota) and Dr. Sarah Swenson explore strategies for supporting parental mental health in the NICU, emphasizing universal screening for depression, anxiety, and trauma. They highlight the critical impact of parental well-being on infant neurodevelopment, family stability, and long-term quality of life. Drawing on personal and professional experience, Dr. Paulson shares her journey as a NICU parent, illustrating gaps in current care. Practical recommendations include integrating psychologists and social workers into NICU teams, implementing structured follow-up, and advocating for system-level changes to ensure equitable, sustained mental health support for 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 episode, Dr. Jacqueline Evans, Dr. Theresa Grover, and Dr. Karna Murthy provide an update on the Children’s Hospitals Neonatal Consortium (CHNC), highlighting its growth to 52 centers and over 375,000 infants in the registry. They discuss the symposium’s expansion, multi-center quality improvement collaboratives, and focus groups that enable data-driven research and clinical innovation. Emphasis is placed on leveraging the registry for rare disease insights, supporting career development, and fostering collaboration across institutions. Practical takeaways include opportunities for hospitals to join CHNC, engage with focus groups, and utilize registry data for research, QI, and improved neonatal patient care 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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