The Incubator

Send us a textIn 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.----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: 41260908Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textIn 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.----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: 41275063Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textIn 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.----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: 41233504Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Eli, a regular contributor with a focus on neonatal policy and legal aspects, joins the conversation on recent neonatal care studies. They discuss a JAMA trial showing expectant management could improve survival in preterm infants with PDA. The outcomes of 21-week gestation infants are reviewed, revealing survival strategies that challenge earlier practices. Eli also highlights the implications of a $32 million NEC settlement, sparking a discussion on informed consent for nutritional care, fostering better communication in NICUs.

Send us a textIn 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.----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 showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textIn 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.----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: 41086871Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textBen and Daphna review the ICAF randomized clinical trial evaluating extended caffeine therapy in preterm infants and its impact on intermittent hypoxia through 41 weeks postmenstrual age. They discuss the study design, oximetry outcomes across multiple saturation thresholds, inflammatory biomarkers including TNF-α, and clinically relevant safety signals such as oxygen restart rates, length of stay, and weight gain. The conversation focuses on what intermittent hypoxia may mean for ongoing risk, and whether a targeted subgroup of infants might benefit from extending caffeine beyond traditional stopping points.----Intermittent hypoxia and caffeine in infants born preterm: the ICAF Randomized Clinical Trial. Eichenwald E, Corwin M, McEntire B, Knoblach S, Limperopoulos C, Kapse K, Kerr S, Heeren TC, Ikponmwonba C, Hunt CE; ICAF Study Group.Arch Dis Child Fetal Neonatal Ed. 2025 Nov 24:fetalneonatal-2025-329230. doi: 10.1136/archdischild-2025-329230. Online ahead of print.PMID: 41285561Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textIn this Journal Club episode, Ben and Daphna review a salient study from JAMA Network Open examining outcomes of infants born at 21 weeks’ gestation at the University of Iowa. They walk through resuscitation practices, early physiologic challenges, survival trends, and short-term developmental outcomes, while placing the data in the broader context of shifting limits of viability. The discussion highlights both cautious optimism and the many unanswered questions that remain as neonatology continues to push the boundaries of what is possible.----Outcomes of Infants Born at 21 Weeks' Gestational Age. Hyland RM, Mat HD, Boly TJ, Thomas BJ, Stanford AH, Harmon HM, Bermick JR, Davila RC, Colaizy TT, Dagle JM, Klein JM, Greiner AL, Bell EF, McNamara PJ; University of Iowa Neonatology Program.JAMA Netw Open. 2025 Dec 1;8(12):e2548211. doi:10.1001/jamanetworkopen.2025.48211.PMID: 41385227 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textIn this Journal Club episode, Ben and Daphna review a major randomized clinical trial published in JAMA comparing expectant management with active pharmacologic treatment of patent ductus arteriosus in preterm infants. They walk through the trial design, inclusion criteria, and outcomes, highlighting the unexpected survival difference favoring expectant management despite similar rates of bronchopulmonary dysplasia. The discussion explores the implications for bedside decision-making, the limitations of PDA-focused strategies, and the need for a more physiologic, patient-centered approach to ductal management in extremely preterm infants.----Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants: The PDA Randomized Clinical Trial. Laughon MM, Thomas SM, Watterberg KL, Kennedy KA, Keszler M, Ambalavanan N, Davis AS, Slaughter JL, Guillet R, Colaizy TT, Cotten CM, Dhawan MA, Bose CL, Talbert J, Smucny S, Benitz WE, Rysavy MA, Ohls RK, Baserga MC, DeMauro SB, Jaleel M, Jackson WM, Carlo WA, Puopolo KM, Hibbs AM, Katheria A, Sánchez PJ, D'Angio CT, Patel RM, Johnson BA, Chock VY, Bhatt AJ, Merhar SL, Moore R, Laptook AR, Ghavam S, Fuller J, Vyas-Read S, Kicklighter SD, Steinbrekera B, Anderson K, Reynolds AM, Wyckoff MH, Montoya C, Das A, Do B, Chang S, Higgins RD, Walsh MC; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA. 2025 Dec 9:e2523330. doi: 10.1001/jama.2025.23330. Online ahead of print.PMID: 41364689Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!

Send us a textAs 2025 comes to a close, Ben and Daphna reflect on a year of growth, community, and evolution for The Incubator Podcast. In this end-of-year wrap-up, they preview major changes coming in 2026, including new standalone podcast feeds, expanded journal club content, CME opportunities, and exciting partnerships with organizations like the Vermont Oxford Network and PAS. They also share what’s ahead for the Delphi Conference and offer a candid look at their personal and professional goals for the year ahead. Thank you for being part of this extraordinary neonatal community. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. 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!