The Incubator

Send us Fan MailIn this episode of Journal Club, we wrap up a marathon recording session with a deep dive into the world of neonatal neuroprognostication. Daphna reviews a systematic review and meta-analysis from Pediatric Neurology that evaluates whether combining EEG and MRI provides better answers for families of preterm infants. While MRI remains a powerful tool for structural assessment, the data suggests that adding the functional insights of EEG significantly boosts specificity, particularly when predicting severe neurodevelopmental outcomes. We discuss the importance of timing these studies and the clinical value of sleep-wake cycling as a developmental milestone at the bedside.----Combined Use of Electroencephalography and Magnetic Resonance Imaging in the Prognostication of Neurodevelopmental Outcomes in Preterm Infants - A Systematic Review and Meta-Analysis. Forrest CD, Biagioni T, Liley HG, Lai MM, Colditz PB, Ware RS, Boyd RN, Roberts JA.Pediatr Neurol. 2026 Feb;175:116-129. doi: 10.1016/j.pediatrneurol.2025.11.005. Epub 2025 Nov 13.PMID: 41337899 Support the showAs 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!

Send us Fan MailBen kicks things off with a major career update before we dive into a critical study from JAMA Network Open. We explore the predictive value of the five minute Apgar score when combined with umbilical artery pH in very preterm infants. While the Apgar score was originally designed for term babies, this analysis of the EPICE cohort reveals its enduring utility even in the smallest patients. We discuss how these two measures interact, which one "wins" when they conflict, and why the clinician assessment remains a powerful predictor of mortality and severe morbidity in the NICU.----Apgar Score Plus Umbilical Artery pH and Adverse Neonatal Outcomes in Very Preterm Infants. Ehrhardt H, Behboodi S, Maier RF, Aubert AM, Ådén U, Staude B, Draper ES, Gudmundsdottir A, Siljehav V, Varendi H, Weber T, Zemlin M, Zeitlin J; EPICE/SHIPS Research Group.JAMA Netw Open. 2026 Feb 2;9(2):e2557913.Support the showAs 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!

Send us Fan MailIs your NICU considering the shift to 24 hour in house attending coverage? In this episode of Journal Club, we explore a provocative brief communication from the Journal of Perinatology. Ben and Daphna discuss the impact of moving from home call to on site presence at UC Davis. While the change was intended to improve patient care, the data reveals a surprising 15 percent decrease in work RVUs. We examine how proactive weaning and bedside presence might actually lower billing levels under current CPT codes. Are we being penalized for doing the right thing for our patients?----From on-call to on-site: the impact of 24-hour in-house neonatology on billing patterns and physician productivity. Donohue L, Lakshminrusimha S.J Perinatol. 2026 Feb;46(2):289-292. doi: 10.1038/s41372-025-02530-8. Epub 2026 Jan 5.PMID: 41490931 Free PMC article. No abstract available.Support the showAs 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!

Send us Fan MailIn this episode of Journal Club, Ben and Daphna dive into the results of the NIRTURE trial, recently published in JAMA Network Open. Building on the lessons of SafeBoosC 3 , the NIRTURE investigators aimed to reduce the burden of cerebral hypoxia and hyperoxia in extremely preterm infants using a standardized NIRS guided treatment protocol. While the study showed a dramatic improvement in maintaining cerebral normoxia, driven largely by a reduction in hyperoxia , the clinical outcomes before discharge remained neutral. Join us as we discuss whether regional oximetry is a must have bedside tool or just another data point in search of a clear clinical benefit.  ----Cerebral Oximetry-Guided Treatment and Cerebral Oxygenation in Extremely Preterm Infants: A Randomized Clinical Trial. Jani PR, Goyen TA, Balegar KK, Maheshwari R, Saito-Benz M, Schindler T, Moore J, Merhi M, Cruz M, Song Y, McDonagh H, Luig M, Tracy M, D'Cruz D, Perdomo A, Morakeas S, Dasireddy V, Culcer M, Shingde V, Bennington K, Michalowski J, Fucek A, Querim J, Stevens S, Santanelli J, Elhindi J, Gloss B, Halliday R, Shah D, Popat H.JAMA Netw Open. 2026 Feb 2;9(2):e2557620. Support the showAs 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!

Send us Fan MailThe American Board of Pediatrics (ABP) recently announced a move toward competency-based subspecialty training that would shorten fellowships — including neonatology — from three years to two. The proposal has sent shockwaves through the training community. In this episode, Daphna sits down with three leaders from the Organization of Neonatal Perinatal Training Program Directors (ONTPD): Dr. Patrick Myers from Northwestern, Dr. Heather French from the Children's Hospital of Philadelphia, and Dr. Melissa Scala from Stanford. Together, they break down what competency-based medical education actually means in practice, why the math simply doesn't add up when applied to neonatology, and what this could mean for procedural training, scholarly activity, fellow well-being, and ultimately patient care. They also address the workforce concerns driving the ABP's proposal, share survey data from program directors across the country, and offer concrete alternative pathways forward. The message from the field is clear: the community wants to innovate — but they want a seat at the table first.Support the showAs 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!

Send us Fan MailDr. Daniel Rauch, PAS 2026 program chair, joins Ben for a behind-the-scenes look at what it takes to pull off a conference of this scale — and what he's learned from this year's record-breaking attendance in Boston. He reflects on the sessions that packed rooms beyond capacity, from the Tiny Baby Collaborative to AI in pediatrics, and shares what's on the horizon for PAS 2027 in Minneapolis and PAS 2028 in Vancouver. He also makes the case for why PAS remains uniquely valuable for trainees and early career clinicians — not just for the science, but for the cross-disciplinary hallway conversations that become next year's publications — and highlights the steps the conference is taking to be more inclusive, from closed captioning and a first-ever Spanish language session to on-site daycare and mobility devices for attendees with ambulatory difficulties.Support the showAs 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!

Send us Fan MailDr. Benny Rossner, PGY-2 pediatrics resident and veteran physician recruiter with 15 years of experience building clinical teams across the country, joins Ben and Rupa for a candid look at the neonatology workforce from a side of the conversation trainees rarely hear. He breaks down why demand for neonatologists is rising — sicker and younger patients, a shrinking APP pipeline into high-acuity specialties, and hospitals stretching budgets on locums before finally raising permanent salaries — and why fellows coming out of training have more negotiating power than they typically realize. He also shares practical advice on contract negotiations, non-competes, and why knowing the right people still matters enormously when it comes to landing the most competitive academic or metropolitan positions.Support the showAs 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!

Send us Fan MailDr. Gabriel Altit and Daniela Villegas from the NeoCardioLab at Montreal join Ben and Rupa to reflect on a packed PAS filled with hemodynamics science — from pulmonary hypertension phenotyping to heart-brain interactions in the golden hour. Dr. Altit makes the case that just as neonatology learned to embrace gentle ventilation, it is time to think about gentle hemodynamics — intervening thoughtfully, recognizing different clinical phenotypes, and knowing when to remove interventions before they carry a price. He also previews early 3D echo data suggesting that a single clip at day 7 to 10 of life may already carry a signature predicting which babies will develop adverse cardiopulmonary outcomes by 36 weeks. Daniela shares her approach to family consent and research recruitment — sitting down, leaving papers behind, connecting families to the history of research that made current NICU care possible, and always giving them space to process before returning for an answer.Support the showAs 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!

Send us Fan MailDr. Kristen Leeman and Dr. Jonathan Levin join Ben to debrief a packed interactive session on tracheostomy timing and counseling for babies with severe bronchopulmonary dysplasia (BPD). Using iterative cases and live audience polling, they mapped the wide variability in practice across the country — finding rough consensus that tracheostomy conversations become likely around 44 to 48 weeks post-menstrual age for intubated infants and 48 to 52 weeks for those on non-invasive ventilation, with key comorbidities like pulmonary hypertension, poor growth, and neurological injury shifting the calculus significantly. Families who participated in the session delivered a powerful message: the conversation should start early, be repeated often, and be framed not as a failure but as a transition — and continuity of care, having a familiar face who knows the baby and the family, made all the difference.Support the showAs 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!

Send us Fan MailDr. Rangasamy Ramanathan, division chief at Cedars-Sinai Guerin Children's Hospital and one of neonatology's most prolific investigators, joins Ben to share what's keeping him busy — 14 active clinical trials including studies on IGF-1 for lung injury prevention, oral insulin for weight gain, and the upcoming phase three trial of aerosolized surfactant. He reflects on what has sustained his passion through decades of work, from training a third of California's neonatologists to launching Southern California's first NeuroNICU with 24-7 neurology coverage and in-house whole genome sequencing. He also previews his next innovation — the ROM Smith ventilator, designed to be manufactured and distributed at cost to resource-limited settings around the world where babies are dying for lack of a $30,000 machine he believes he can build for under $2,000.Support the showAs 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!

Send us Fan MailDr. Thais Queliz, neonatologist at Winnie Palmer Hospital in Orlando, presents ten years of data from one of the country's highest-volume programs caring exclusively for babies born at 22 to 24 weeks. She shares how survival rates for 22 and 23-weekers climbed from 40% before the Tiny Baby program launched to 67% overall — and 72% over the last two years — driven by institutional alignment, standardized protocols, and a dedicated multidisciplinary team. She also presents Golden Hour data showing a jump from 8% to 75% completion rate after implementing strict checklists and role-defined workflows that cut average admission time from nearly two hours to 54 minutes. And she previews work on prolonged empiric antibiotics in this population — extending courses based on placental pathology — which has been associated with decreased mortality in 22 and 23-weekers, echoing findings presented earlier in the conference by her fellow Dr. Gesca Borchardt.Support the showAs 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!

Send us Fan MailDr. Indrani Bhattacharjee, neonatologist and POCUS program director at Tufts Medical Center in Boston, joins Ben to discuss a fascinating and largely unexplored frontier — intestinal ultrasound in healthy preterm infants. Rather than waiting for NEC to appear, her team has been systematically scanning babies born under 32 weeks every week from one week of age until eight weeks or discharge, building what may be the first normative dataset for bowel wall thickness in this population. Early findings are already challenging the standard radiological definitions, showing that extremely preterm babies have thinner bowel walls than current benchmarks would classify as normal — raising the question of whether definitions derived from term or older patients have ever been appropriate for our tiniest babies. The publication is forthcoming in the European Journal of Pediatrics.Support the showAs 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!

Send us Fan MailDr. Surabhi Aggarwal, neonatologist at Stony Brook University, joins Ben and Rupa to share five years of experience building a LISA — Less Invasive Surfactant Administration — program from the ground up at her institution. She walks through the obstacles of getting IRB approval, gaining clinical buy-in from colleagues comfortable with intubation, and how the introduction of video laryngoscopy was the turning point that finally got the practice off the ground. She shares early results showing that 30% of eligible babies received surfactant via LISA rather than intubation, discusses the technical nuances of catheter placement and confirmation, and weighs in on the emerging SALSA technique using an LMA — with a candid admission that she may be a little biased. She also highlights her work with MidCan, the AAP mid-career neonatologist group supporting clinicians between seven and seventeen years post-training.Support the showAs 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!

Send us Fan MailDr. Arpitha Chiruvolu, neonatologist and infant nutrition researcher, joins Ben to share three posters from this year's PAS covering two of her core research interests. She presents pilot data on using Prolacta human milk cream as an alternative to dextrose gel for treating asymptomatic neonatal hypoglycemia — highlighting the well-known limitations of dextrose gel including inconsistent dosing, poor tolerance, and the way it interferes with breastfeeding immediately after administration. In 25 babies treated with cream, blood glucose rose from a median of 36 to 56 mg/dL, only one baby required NICU admission, and nurses and families loved it. She also shares her center's experience with probiotics in extremely low birth weight infants — where NEC rates dropped significantly with no cases of probiotic sepsis — and raises the urgent question of what is happening to NEC rates now that probiotics have been pulled from use in the US.Support the showAs 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!

Send us Fan MailDr. David Sas, pediatric nephrologist at Mayo Clinic, joins Ben to discuss primary hyperoxaluria type 1 — a rare but devastating genetic disease where the liver overproduces oxalate, flooding the kidneys with crystals and leading to end-stage kidney failure in roughly 60% of patients, historically requiring both a liver and kidney transplant. He presents 60-month long-term extension data on Lumasiran, an siRNA-based therapy that suppresses oxalate production at its source — showing that urinary oxalate drops rapidly within the first three months and stays down with quarterly injections, potentially changing the trajectory of this disease forever. He also issues a direct call to urologists and nephrologists everywhere: if your patient has recurrent calcium oxalate stones, check a 24-hour urine — because primary hyperoxaluria is almost certainly being missed.Support the showAs 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!

Send us Fan MailDr. Kyle Willsey, pediatric critical care transport director at Cedars-Sinai, joins Daphna to discuss one of the least standardized corners of pediatric and neonatal medicine — critical care transport. With children's hospitals closing across the country and tertiary centers absorbing more of the patient load, the demand for safe, well-trained transport teams is growing at the same time that national standards remain nearly nonexistent. He shares the challenges of building a transport program from the ground up, presents early pilot data using the NASA Task Load Index to measure the subjective cognitive burden on transport nurses and respiratory therapists, and makes an open call for collaboration with anyone else navigating the same uncharted territory — because the transport leg of a critically ill child's journey should never be an afterthought.Support the showAs 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!

Send us Fan MailDr. Emily Wassmer, researcher at Children's Hospital of Philadelphia, presents findings from one of the first studies to examine gaming addiction in young children ages 5 to 12 with ADHD diagnoses. Using a newly developed caregiver-report screening tool based on DSM-5 criteria for internet gaming disorder, she found that inattention — more than hyperactivity, anxiety, depression, or autism symptoms — was the factor most strongly associated with meeting criteria for gaming addiction, mirroring patterns seen in adolescent research. Perhaps most striking was the parenting finding: each additional negative parenting behavior, such as yelling or losing one's temper, tripled the child's risk of gaming addiction — suggesting that evidence-based parent training programs already used in ADHD populations may be one of the most promising avenues for intervention.Support the showAs 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!

Send us Fan MailDr. Lily Lou joins Daphna and Rupa to reflect on this year's Silverman Lecture at PAS — the annual honorary lecture of the AAP Section on Neonatal Perinatal Medicine — delivered by Dr. John Ioannidis of Boston, who turned the lens of research methodology back on the research community itself. Drawing on meta-analyses of meta-analyses, he offered ten provocations about how neonatology studies its own practice: are we studying the right populations, asking about race and ethnicity appropriately, and publishing the right amount? Dr. Lou also makes a heartfelt call for trainees to prioritize these foundational lectures alongside the practical career-building sessions, arguing that understanding the history and philosophy of how neonatology does science is just as important as learning how to get published.Support the showAs 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!

Send us Fan MailDr. Satyan Lakshminrusimha, pediatric chair and neonatologist, joins Ben hot off the ONTPD meeting to share his perspective on the ABP fellowship reform debate — and it's more nuanced than a simple yes or no to a two-year fellowship. He argues that the real problem is a six-year training pipeline that is driving medical students away from pediatric subspecialties under crushing debt, and that the solution for procedure-heavy specialties like neonatology is not to shorten fellowship but to truncate the pediatric residency to two years — following the precedent already set by pediatric neurology. He also makes the case that the workforce crisis is ultimately an entry ticket problem: before debating fellowship length, we need to convince more medical students to choose pediatrics in the first place, and more pediatric residents to choose subspecialty training before it's too late.Support the showAs 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!

Send us Fan MailDr. Nathan Sundgren, neonatologist and NRP educator at Texas Children's Hospital, joins Ben to discuss one of the most deceptively difficult skills in neonatal resuscitation — effective bag mask ventilation. He shares findings from a fellowship training study showing that respiratory function monitor feedback improves ventilation technique equally well across all three device types, and tackles the harder question of why that same technology has yet to show clinical benefit in the delivery room — pointing to human factors, cognitive overload, and the need for a dedicated respiratory coach role rather than a better device alone. He also reflects on the evolution of team leadership in neonatal resuscitation, why doing a procedure and leading a team simultaneously is impossible, and where people can find his free educational content on YouTube at Texan Neo-Ed.Support the showAs 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!

Send us Fan MailDr. Matthew Saxonhouse, neonatologist at Atrium Health, joins Ben to discuss two initiatives designed to fill the gaps that traditional conferences often leave behind. The first is Neonatal Insights, a biennial meeting returning January 29-31, 2027 in Houston — both in person and virtual — where controversial topics like the new hypoglycemia guidelines, cord blood transfusions, optimal caloric targets for growing infants, and wasteful NICU practices are presented from all sides with the explicit goal of reaching a working consensus. The second is Neonatal Insider, a monthly virtual series combining physiology and current evidence on hot topics, now opening its five-year archive to subscribers. He also reflects on why education that presents competing perspectives honestly is one of the most valuable things neonatology can offer its community.Support the showAs 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!

Send us Fan MailDr. Mitchell Goldstein, neonatologist at Loma Linda University and editor-in-chief of Neonatology Today, joins Ben to share the story behind one of neonatology's most accessible and wide-reaching publications — a peer-reviewed, open-access journal with 25,000 monthly readers worldwide, no publication fees, no page limits, and no color charges. He explains the philosophy behind the Academic True Open Model that guides the journal, why author development and rapid peer review turnaround of as little as 72 hours set it apart, and how the journal has used platforms like LinkedIn to find voices that traditional publishing would never have reached. He also highlights the 39th International Gravens Conference on the Physical and Developmental Environment of the High-Risk Infant, taking place June 16-18 in South Bend, Indiana — use code Special10 for 10% off registration.Support the showAs 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!

Send us Fan MailDr. Jayasree Nair, neonatal resuscitation expert, joins Ben to reflect on one of the most humbling realities in neonatology — nearly everything we know about epinephrine use in extensive neonatal resuscitation comes from animal studies, adult data, or pediatric populations, not neonates. She explains why the pyramid of resuscitation research narrows dramatically as you move toward chest compressions and epinephrine, why randomized controlled trials in this space may never be fully achievable, and why collaborative registries like the DRIVE network offer one of the most promising paths forward. She also shares her experience piloting the new NRP NICU resuscitation module and reflects on how the two-year fellowship debate ultimately circles back to the same root problem: the financial sustainability of a career in academic pediatrics.Support the showAs 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!

Send us Fan MailChristie Lawrence, clinical nurse specialist at Rush University Medical Center, joins Ben to discuss sudden unexpected infant death (SUID) — the updated term that encompasses all sleep-related infant deaths, including what was formerly called SIDS. In Cook County alone, an infant dies every week from SUID, with Black infants dying at 14 times the rate of white infants — a disparity far exceeding the already alarming national figure of three times. She explains why shifting the language from the mysterious "SIDS" to the more concrete word "suffocation" is not about being harsh but about giving families something they can actually understand and act on — and why meeting families where they are, involving the whole family unit, and addressing real barriers to safe sleep is the only way to move the needle on a problem that has been hiding in plain sight.Support the showAs 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!

Send us Fan MailDr. Elisabeth Kuhn, researcher focused on hospital operations, presents findings from a mixed-methods study examining how US children's hospitals measure and respond to capacity strain — the point at which demand for care outpaces the ability to deliver it safely. In a survey of 45 tertiary children's hospitals, 43 reported experiencing capacity strain in the past year, underscoring just how widespread and persistent the problem has become since the triple-demic brought it into sharp focus. She argues that current metrics like occupancy rates and boarding times fail to capture the real clinical experience of strain — which is driven by acuity and complexity, not just bed counts — and calls for better measurement tools tied directly to patient outcomes, alongside broader policy change to address what no amount of internal reshuffling can fully solve.Support the showAs 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!

Send us Fan MailKimberly Novod, community health advocate, founder of Sol's Light, and fierce voice for health equity, joins Ben for a conversation about what it actually means to build trust between hospitals and the communities they serve. Drawing on her experience in New Orleans — where the prematurity rate sits at 14% and environmental factors like air, water, and soil quality in areas like Cancer Alley drive devastating birth outcomes — she makes the case that health equity cannot be achieved within hospital walls alone. She calls on institutions to stop designing solutions without asking the people they're meant to serve, to share research findings back with the communities that participated in them, and to invest meaningfully in family partners who reflect the full spectrum of lived experience — not just the ones with the rosiest stories to tell.Support the showAs 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!

Send us Fan MailDr. Brandon Hadfield and Dr. Debora Abimana join Ben for a conversation that brings the incubator's global neonatology work full circle — from the founding of Rwanda's first neonatology fellowship program to seeing its first trainee present scholarly work at PAS. Dr. Abimana shares findings from her research on healthcare provider attitudes toward donor human milk in Rwandan NICUs, where the concept is largely welcomed but faces cultural concerns around infants adopting the characteristics of their donor — a barrier the team hopes to address through targeted community education. She also paints a vivid picture of the need: NICUs without TPN, near-universal breastfeeding rates driven by necessity rather than choice, and critically ill mothers who simply cannot produce enough milk for their premature babies in those first crucial hours.Support the showAs 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!

Send us Fan MailDr. Zubair Aghai, neonatologist at Thomas Jefferson University in Philadelphia, presents results from one of the largest neonatal trials ever conducted — enrolling 3,448 late preterm and term infants across India to test whether umbilical cord milking in non-vigorous newborns reduces death or moderate-to-severe HIE. With over 100,000 deliveries screened and real-time data collected by research staff present at every delivery around the clock, the primary outcome showed no short-term harm from cord milking — and a secondary signal of reduced infection risk, possibly driven by the immunoglobulins transferred with the extra blood. He also explains why non-vigorous babies stand to gain the most from this simple ten-second intervention, and previews two-year neurodevelopmental follow-up data still to come.Support the showAs 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!

Send us Fan MailDr. Ryan McAdams guest hosts alongside the NeoMind AI team — Dr. Ameena Husain, Dr. Kristyn Beam, Dr. Brynne Sullivan, and Dr. Zach Vesoulis — to recap their third annual pre-conference AI workshop at PAS, including a live predictive modeling bake-off using the Epic Cosmos database to predict late-onset sepsis in nearly 100,000 preterm infants. The group discusses where AI stands today in neonatology — from using large language models to reduce administrative burden and improve family communication, to Epic's growing investment in neonatal-specific tools — and makes an honest case for what clinicians should start doing now and what still requires caution. They close with an open invitation to join NeoMind AI, a growing community of neonatologists, data scientists, and researchers working to ensure the NICU is not left behind as this technology reshapes medicine.Support the showAs 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!

Send us Fan MailDr. Melissa Zhou, researcher at the Developing Brain Institute at Children's National, joins Daphna to discuss functional MRI and what it reveals about how preterm brains are building connections during the NICU stay. Using functional connectivity — measuring how different brain regions communicate with each other over time — her team compares preterm infants to healthy in utero fetuses scanned as early as 20 weeks, finding that the ex utero preterm brain actually looks more mature in terms of connectivity, suggesting the NICU environment itself accelerates certain aspects of brain development. She shares why extremely and very preterm infants show a distinctly different pattern of connectivity compared to moderately preterm babies who seem to bounce back more quickly, and why the team's next goal is to use these early functional findings to predict which babies will struggle with neurodevelopmental outcomes at 36 months — and which ones will be just fine.Support the showAs 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!

Send us Fan MailDr. Kevin Cook, researcher at the Developing Brain Institute at Children's National, joins Daphna to discuss functional MRI and what it reveals about how preterm brains are building connections during the NICU stay. Using functional connectivity — measuring how different brain regions communicate with each other over time — his team compares preterm infants to healthy in utero fetuses scanned as early as 20 weeks, finding that the ex utero preterm brain actually looks more mature in terms of connectivity, suggesting the NICU environment itself accelerates certain aspects of brain development. He shares why extremely and very preterm infants show a distinctly different pattern of connectivity compared to moderately preterm babies who seem to bounce back more quickly, and why the team's next goal is to use these early functional findings to predict which babies will struggle with neurodevelopmental outcomes at 36 months — and which ones will be just fine.Support the showAs 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!

Send us Fan MailDr. Gesca Borchardt, third-year neonatology fellow at Winnie Palmer Hospital, presents findings from a retrospective study of 296 infants born under 25 weeks examining whether extending empiric antibiotic use beyond 72 hours reduces mortality in this vulnerable population. She shares why her unit moved to a seven-day antibiotic course for babies with placental pathology positive for chorioamnionitis — and what they found when they looked at the data. At 22 and 23 weeks, longer antibiotic courses were associated with a statistically significant decrease in mortality. At 24 weeks, no difference was seen. One puzzling finding clouds the picture however: an increased incidence of spontaneous intestinal perforation in the prolonged antibiotic group — a signal the team is still trying to understand and that the wider community will want to watch closely.Support the showAs 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!

Send us Fan MailDr. Katie Ottolini, researcher at the Developing Brain Institute at Children's National in Washington DC, presents findings from a longitudinal MRI study comparing brain growth trajectories in preterm infants to healthy fetuses — scanning as early as 25 weeks and through term corrected age. Even in preterm babies with no significant brain injury and appropriate growth at birth, brain volumes were already smaller by the first MRI at around two weeks of life. She shares which regions are most vulnerable, why the amygdala-hippocampus shows a distinct window of impaired growth beginning after 32 weeks that may represent an opportunity for intervention, and why the goal for neonatology must now shift from neuroprotection alone to what she calls neuropromotion — actively supporting optimal brain development through nutrition, sleep, and other targeted interventions.Support the showAs 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!

Send us Fan MailDr. Lori Devlin, neonatologist and principal investigator of the Optimize Now trial, shares results from the first multicenter randomized trial comparing symptom-based opioid dosing to scheduled opioid tapers in babies with neonatal opioid withdrawal syndrome (NOWS). Published in JAMA on the day of this recording, the trial found that symptom-based dosing reduced medical readiness for discharge by an additional 2.1 days — and that 65% of babies who would traditionally have been placed on a scheduled opioid taper never needed one at all. She also previews the next trial in this series, TREAT Now, which will compare buprenorphine versus morphine for babies who do require pharmacologic treatment, and reflects on how far the field has come since Eat Sleep Console first changed the way we think about caring for this population and their families.Support the showAs 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!

Send us Fan MailDr. John Feister, neonatologist and health equity researcher at Cincinnati Children's Hospital, presents two studies that challenge us to look beyond the bedside. The first reveals that NICU babies whose families prefer a language other than English have nearly double the in-hospital mortality rate of English-speaking families — a difference that persisted even after adjusting for medical and sociodemographic risk factors, and one he suspects is driven in part by barriers to family advocacy and end-of-life communication. The second introduces the concept of medical-financial partnerships, and specifically a hospital-based free tax preparation clinic that helped NICU and hospital families claim thousands of dollars in refundable tax credits — with 90% of participants reporting that the service improved their trust in their medical team.Support the showAs 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!

Send us Fan MailDr. Ravi Jhaveri, infectious disease physician at Lurie Children's Hospital in Chicago, joins Daphna for a conversation spanning two underappreciated threats in pediatrics. On hepatitis C, he shares that up to 90% of perinatally exposed infants never get tested despite clear guidance — and makes the case for point-of-care, heel-stick based testing that meets families where they are rather than relying on follow-up that often never happens. On long COVID, he reframes the vaccine conversation away from acute illness and toward something families actually care about: protecting their child's ability to show up for the things that matter most to them — sports, dance, school — since even mild or repeat COVID infections can double the risk of debilitating long COVID symptoms.Support the showAs 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!

Send us Fan MailDr. Sharon Levy, director of the Division of Addiction Medicine at Boston Children's Hospital, joins Daphna for a wide-ranging conversation on adolescent substance use. She shares data showing a sudden spike in nicotine exposure among teens in treatment for substance use disorders — likely driven by larger vape devices and cooling agents that eliminate the burn sensation — and introduces one of the most novel concepts in addiction medicine: a vaccine that would create antibodies against fentanyl, blocking its effect at the meningeal level before it reaches the brain. She also presents findings on why current surveillance questions fail to capture how teens actually talk about drug use, and why kids who need treatment most are paradoxically the ones most likely to answer screening questions honestly.Support the showAs 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!

Send us Fan MailDr. Jonathan Flyer, pediatric and fetal cardiologist at the University of Vermont, presents findings from a Vermont Oxford Network analysis of over 11,000 extremely low birth weight infants examining whether the method of patent ductus arteriosus (PDA) closure — transcatheter device versus surgical ligation — makes a difference for neurodevelopmental outcomes at 18 to 24 months. The answer: no difference between the two techniques on Bayley-4 cognitive, language, and motor scores. The more sobering finding is that both groups scored well below the normative mean of 100, sitting in the high 70s to low 80s — a reminder of just how much ground this population has to cover. He also makes a case for centering the counseling conversation not on technique but on what each center does best, and what families actually care about most: their child's brain.Support the showAs 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!

Send us Fan MailDr. Brandon Tucker and Dr. Jenelle Ferry share two studies tackling some of the most pressing challenges in the care of extremely low birth weight infants. Dr. Tucker presents a quality improvement initiative examining whether switching from PRN glycerin suppositories to scheduled glycerin enemas every 12 hours reduces feeding intolerance and spontaneous intestinal perforation in babies under 1,000 grams — with early results trending in the right direction. Dr. Ferry then shares findings from a meta-analysis of 14 studies and nearly 4,700 babies showing that an exclusive human milk diet is associated with a roughly 20% reduction in the odds of death — a finding that reached statistical significance when RCTs and observational cohorts were pooled together, and one that carries real weight for units still weighing the evidence on human milk-based nutrition.Support the showAs 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!

Send us Fan MailDr. John James Parker, internist, pediatrician, and researcher at Northwestern University and Lurie Children's Hospital, joins Daphna and Rupa for a conversation about one of the most overlooked players in family-centered care — fathers. He shares why paternal stress in the NICU and postpartum period often peaks later than maternal stress, why discharge instructions routinely go home with only one parent, and how a few small changes — making eye contact with dad, asking him a question, giving him a specific task — can fundamentally shift how engaged fathers feel in their child's care. He also reflects on the inaugural Fathers in Pediatrics special interest group at PAS, and makes the case that thinking about the whole family unit, including the mental and physical health of every caregiver, is not a nice-to-have but a core part of caring for the child.Support the showAs 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!

Send us Fan MailDr. Christina Rojas, from Lurie Children's Hospital, presents findings from a multi-center study across eight hospitals examining how often hospitalized patients and families receive communication touchpoints from their care team — and whether that differs based on preferred language. Across more than 30 languages represented in the study, families who preferred a language other than English experienced significantly fewer room visits, less direct communication when staff did enter the room, and a 55% gap in language-concordant interactions. She discusses what this means for patient safety — since missed touchpoints are missed opportunities to catch medication errors and address family concerns — and makes the case that interpreter access needs to stop being an extra step and start being the cultural default built into every care process.Support the showAs 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!

Send us Fan MailDr. Ayesha Khalid, resident at Marshall University, presents findings from a large meta-analysis pooling data from eight national registries across Europe — covering 2.5 million pregnancies — to examine whether prenatal acetaminophen exposure is truly linked to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) in children. She shares why the association with ASD largely disappears when accounting for heterogeneity and confounders, why the previously reported link with ADHD appears significantly smaller than what has been published, and why publication bias may have inflated the estimates we have been working from. She also addresses the critical limitation that no patient-level dose or timing data was available, why the risk-benefit calculation around fever control in pregnancy complicates any simple recommendation, and what kind of studies — ideally sibling-controlled designs like those done in Sweden — would be needed to actually settle this question.Support the showAs 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!

Send us Fan MailDr. Lyubina Yankova, hospitalist at Yale, presents findings from a large retrospective multi-center analysis across 106 sites examining whether the combination of procalcitonin and C-reactive protein (CRP) can match or outperform the inflammatory marker combinations currently recommended by the 2021 AAP guidelines for risk-stratifying febrile infants between 8 and 60 days of age. She shares why this combination showed similar sensitivity but higher specificity for detecting invasive bacterial infections — meaning fewer false positives, fewer unnecessary lumbar punctures, and fewer unnecessary antibiotics. She also addresses the limitations of retrospective data, why preterm infants were excluded from this analysis and what future research in that population might look like, and what it would take for guideline committees to feel confident enough to incorporate this combination into routine practice.Support the showAs 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!

Send us Fan MailDr. Ofer Levy, director of the Precision Vaccines Program at Boston Children's Hospital and member of the FDA's Vaccines and Related Biologic Products Advisory Committee, makes the case that vaccines must be tailored to the immune system of the person receiving them — and that immune system changes dramatically from the moment of birth through old age. He explains why preterm infants, who represent 11% of births worldwide, carry an increased risk of infection-related hospitalization all the way through age 18, and why almost no investment has been made in understanding how to optimally immunize them. He also discusses the FDA Modernization Act 2.0, which is shifting vaccine development away from animal models toward human in vitro modeling and systems biology, and reflects on what precision vaccinology could mean for rebuilding public trust in a deeply polarized conversation — not by dismissing concerns, but by taking vaccine safety science more seriously than ever before.Support the showAs 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!

Send us Fan MailDr. Anup Katheria, one of the world's leading researchers in umbilical cord management, joins Daphna to share the latest data on deferred cord clamping and cord milking across gestational ages. He presents new two-year follow-up findings showing that while cord milking remains a reasonable alternative to immediate cord clamping, delayed cord clamping still carries a measurable advantage in Bayley scores for motor and language — even in babies between 28 and 32 weeks where short-term outcomes looked identical. He also breaks down the practical decision tree for vigorous versus non-vigorous babies at different gestational ages, shares his vision for involving obstetricians more actively in that critical first minute of life, and previews an upcoming large-scale Neonatal Research Network trial testing 100% oxygen delivery during the cord clamping window. He closes with a call to move away from traditional composite outcomes in neonatal trials toward ranked ordinal outcomes that better reflect what actually matters to families.Support the showAs 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!

Send us Fan MailDaphna is back for day two of PAS 2026 in Boston, joined in the booth by Christa and Rupa. More episodes coming all day — and if you're at the conference, stop by and say hi.Support the showAs 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!

Send us Fan MailDr. Bridget Young, researcher at the University of Rochester, shares early but promising work on using freeze-dried mother's own breast milk — including a skim milk fraction — as a fortifier for human milk feeds in the NICU. She explains why milk variability makes accuracy the central challenge in this approach, how her team validated a method using macronutrient analysis to consistently hit a target caloric density of 28 kcal per ounce, and why the skim milk fraction in particular can deliver a protein content that rivals commercial bovine fortifiers. She also introduces the concept of mother's own breast milk cream — a centrifuge-derived calorie booster that families in her unit have found deeply empowering — and lays out honestly what it would take to bring lactoengineering from a research setting into routine clinical practice.Support the showAs 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!

Send us Fan MailFrom lumbar punctures to mitochondrial recycling, this booth interview from PAS 2026 covers a lot of ground. Ben and Daphna sit down with Dr. Ioanna Kotsopoulou from Mass General to discuss two distinct but equally compelling topics. First, a quality improvement project that took ultrasound-guided LP use from 12 to 73 percent and first attempt success from 32 to 68 percent. Then a pivot to basic science: impaired mitophagy in pulmonary hypertension, and whether dysfunctional mitochondrial recycling in cardiomyocytes may be contributing to the cardiac phenotype we see in these patients. A wide-ranging conversation with something for every neonatologist.Support the showAs 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!

Send us Fan MailDr. Nathan Kupperman and Dr. Brett Bernstein, lead investigators on a landmark international pooled analysis published in JAMA, present the most comprehensive evidence to date on whether a lumbar puncture can be safely avoided in febrile infants under one month of age. Using a simple three-criteria rule — negative urinalysis, procalcitonin of 0.5 or below, and absolute neutrophil count of 4,000 or below — across more than 2,500 prospectively collected cases from multiple international cohorts, the rule did not miss a single case of bacterial meningitis. They explain what this means for shared decision-making with families, why the number needed to perform a lumbar puncture to identify one case of bacterial meningitis is now vanishingly close to infinity for low-risk infants, and why implementing this approach requires a multidisciplinary coalition across emergency medicine, infectious disease, and inpatient teams before any individual physician changes their practice.Support the showAs 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!

Send us Fan MailWhat does it actually feel like to be told your 22-week baby has no chance — before anyone asks what you want? In this booth interview recorded live at PAS 2026, Ben and Daphna sit down with two NICU parents, Christelle and Reem, both of whom delivered at the limits of viability. They share candid, at times difficult accounts of prenatal counseling experiences where they felt dismissed, pressured, and unheard — and what it would have taken to make those conversations feel human. This episode is a reminder that listening is not a soft skill. It is the clinical skill.Support the showAs 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!