The Incubator

A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.

  1. 1 day ago

    #445 - 📑 Journal Club - The Complete Episode from May 30th 2026

    Send us Fan Mail Opioid withdrawal dosing, intranasal breast milk, human milk fortification in Japan, neonatal dysphagia, and vaccine policy. A full week on the Incubator Journal Club. Ben opens with the Optimized NOW trial in JAMA: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days in NOWS infants managed with Eat Sleep Console, and allowed 65% of pharmacologically treated infants to avoid scheduled opioids entirely. Daphna reviews a small RCT out of Turkey showing improved cerebral oxygenation and favorable vital sign trends after intranasal breast milk administration in preterm infants, adding to the growing tolerability data for this intervention. Ben then covers the JASMINE trial, a Phase 3 RCT in Japan showing significantly better weight gain velocity with an exclusive human milk diet in very low birth weight infants. Daphna closes with a retrospective cohort study on FEES-confirmed dysphagia in preterm infants. Of those who met criteria for evaluation, every single one had laryngeal penetration and 57% were aspirating. Ben and Eli close the week on the quiet dismantling of vaccine infrastructure in the US and what it means for the populations in your NICU. Support the show As 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!

    1hr 39min
  2. 2 days ago

    #445 - [Neo News] - 📌 Are Regulatory Roadblocks Threatening the Future of Neonatal Vaccines?

    Send us Fan Mail In this fast-paced episode of Neo News, Eli and Ben tackle the rapidly shifting landscape of vaccine regulation and economics in the US. They discuss recent political maneuvers surrounding the Vaccine Injury Compensation Program (VICP) and how expanding liability could quietly push manufacturers out of the market entirely. The hosts also examine the FDA's recent hesitation to review Moderna’s new mRNA flu vaccine, highlighting how these administrative roadblocks threaten the financial viability of developing novel vaccines—including critical immunizations for pediatric and neonatal populations. Tune in for a sharp analysis of how top-down policy changes might reshape everyday clinical practice! ---- 1) https://thehill.com/policy/healthcare/5689850-kennedy-dismisses-vaccine-advisors/ 2) https://www.washingtonpost.com/opinions/2026/01/15/rfk-jr-vaccines-autism-vicp/ 3) https://www.nytimes.com/2026/02/18/health/fda-moderna-flu-vaccine-mrna.html 4) https://www.nytimes.com/2026/02/16/health/rfk-vaccine-manufacturers.html Support the show As 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!

    20 min
  3. 3 days ago

    #445 - [Journal Club] - 📌 Are we missing dysphagia in very preterm infants before they leave the NICU?

    Send us Fan Mail How often are we missing dysphagia in our most vulnerable NICU patients? In this episode of Journal Club, Daphna reviews a retrospective cohort study from the Journal of Perinatology examining the incidence and risk factors of dysphagia confirmed by flexible endoscopic evaluation of swallowing (FEES) in very preterm and very low birth weight infants. Among infants showing persistent feeding difficulties at 38 weeks post-menstrual age, laryngeal penetration was detected in all infants who underwent FEES, and tracheal aspiration in nearly 60%. Ben and Daphna discuss whether we are naming dysphagia for what it is, whether earlier instrumental assessment could change outcomes, and what it means for families to finally understand why their baby is struggling to feed. ---- Incidence and factors associated with dysphagia in infants born very preterm or very low birth weight. Reynolds J, Suterwala M, Desai S, Chiruvolu A.J Perinatol. 2026 Apr 29. doi: 10.1038/s41372-026-02701-1. Online ahead of print.PMID: 42056238 Support the show As 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!

    19 min
  4. 4 days ago

    #445 - What Can Japan Teach Us About Treating Human Milk Fortifier as a Drug? (Part 2)

    Send us Fan Mail What does it take to turn a single struggling baby into a national standard of care? In this episode, Ben sits down with Professor Katsumi Mizuno (Showa Medical University) and Dr. Melinda Elliott (Chief Medical Officer, Prolacta Bioscience) to discuss the landmark Jasmine Trial, the first randomized controlled trial of an exclusive human milk diet (EHMD) in Japan. The results: significantly better weight and length gain, fewer antibiotic days, and improved feeding tolerance in very preterm infants. After an eight-year regulatory journey, Japan's Pharmaceuticals and Medical Devices Agency (PMDA) granted Prolacta's human milk-based fortifier PreemieFort drug-level designation, a global first, ensuring equitable, nationally reimbursed access for every preterm infant in the country. The conversation also looks ahead to the Fuji Trial and what Japan's precedent-setting decision could mean for Europe and the US. The guests joining us today have a direct financial or professional relationship with the topic being discussed in this episode. This may include employment, a consultant role, research funding relationship, or other ties to the company or product being reviewed. Support the show As 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!

    34 min
  5. 4 days ago

    #445 - [Journal Club] - 📌 Does an exclusive human milk diet improve growth in very low birth weight infants? (Part 1)

    Send us Fan Mail Japan has some of the best survival rates for extremely preterm infants in the world, yet feeding practices there look very different from what many of us are used to. In this episode of Journal Club, Ben reviews the JASMINE trial, a multicenter phase three randomized controlled trial evaluating an exclusive human milk diet compared to a standard cow milk-based diet in very low birth weight infants in Japan. Infants on an exclusive human milk diet gained weight significantly faster, reached full feeds six days sooner, and had fewer antibiotic days. Ben then sits down with first author Professor Katsumi Mizuno and Dr. Melinda Elliott, CMO of Prolacta Bioscience, to discuss the backstory and broader implications of this landmark trial. --- Growth and safety evaluation in very low birth weight infants receiving an exclusive human milk diet: a phase III randomized control trial in Japan. Mizuno K, Miyazawa T, Kondo U, Nishikubo T, Yamamoto Y, Nakano Y, Hiroma T, Ikeda K, Murase M, Jimi H, Hokuto I, Miyata M.J Perinatol. 2026 Apr 27. doi: 10.1038/s41372-026-02695-w. Online ahead of print.PMID: 42045666 Support the show As 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!

    24 min
  6. 5 days ago

    #445 - [Journal Club] - 📌 Can a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation?

    Send us Fan Mail Could putting a few drops of breast milk in a preterm infant's nose actually improve cerebral oxygenation? In this episode of Journal Club, Daphna reviews a randomized controlled trial from the European Journal of Pediatrics investigating the physiologic effects of intranasal expressed breast milk (EBM) administration in preterm infants. The study found that infants receiving 0.2 mL of fresh breast milk intranasally three times daily showed significantly higher cerebral oxygenation levels, along with more favorable trends in heart rate and respiratory rate, compared to controls. While time to full oral feeding and length of hospital stay were unchanged, the safety data is reassuring. Ben and Daphna discuss what outcomes we should even be measuring, and whether the evidence is already good enough to just do it. ---- Effect of intranasal breast milk administration on cerebral oxygenation, vital signs, and transition time to full oral feeding in preterm infants: a randomized controlled study. Yücel A, Küçükoğlu S, Konak M.Eur J Pediatr. 2026 Apr 16;185(5):272. doi: 10.1007/s00431-026-06922-6.PMID: 41986747 Support the show As 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!

    23 min
  7. 6 days ago

    #445 - [Journal Club] - 📌 Can symptom-based dosing cut hospitalization time for babies with neonatal opioid withdrawal syndrome?

    Send us Fan Mail One infant is diagnosed with neonatal opioid withdrawal syndrome every 27 minutes, and rates are rising. In this episode of Journal Club, Ben and Daphna review the Optimized NOW randomized clinical trial, a landmark multicenter study published in JAMA. The trial compared symptom-based dosing,  a single opioid dose given when a withdrawal threshold is met against the traditional scheduled opioid taper in infants managed with Eat Sleep Console. The results are striking: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days, and 65% of pharmacologically treated infants avoided scheduled opioid dosing entirely. Could this be the evidence-based approach that finally reshapes how we treat NOWS pharmacologically? ---- Symptom-Based Dosing for Neonatal Opioid Withdrawal: The OPTimize NOW Randomized Clinical Trial. Devlin LA et al HEAL Evaluation of Limited Pharmacotherapies for Neonatal Opioid Withdrawal Syndrome (HELP for NOWS) Consortium.JAMA. 2026 Apr 25:e265782. doi: 10.1001/jama.2026.5782. Online ahead of print. PMID: 42033722 Support the show As 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!

    25 min

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A weekly discussion about new evidence in neonatal care and the fascinating individuals who make this progress possible. Hosted by Dr. Ben Courchia and Dr. Daphna Yasova Barbeau.

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