The Incubator

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30 apr.
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2025-06-01

#315 - Why Preterm Birth History Matters for Life: A Conversation with Michelle Kelly

Send us Fan Mail In this week’s episode, Ben and Daphna sit down with Michelle Kelly, Pediatric Nurse Practitioner and Associate Professor at Villanova University. Michelle is a leading voice in recognizing the lasting impact of preterm birth on long-term health. She shares insights from her co-authored article, Addressing Preterm Birth History with Clinical Practice Recommendations Across the Life Course, which outlines how a history of prematurity should inform lifelong clinical care. The conversation highlights the gap between neonatal and adult healthcare systems, and why identifying preterm birth history should be a routine part of medical assessments. Michelle also discusses practical strategies to educate families, empower survivors of prematurity, and shift provider assumptions about long-term outcomes. This episode offers a thoughtful and grounded discussion on turning early-life health factors into actionable care across the lifespan. 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!

2025-06-01

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48 min
25 APR.

#438 - 🔵 [PAS 2026] - What Would Periviable Counseling Look Like If We Let Parents Lead?

Send us Fan Mail What 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 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 apr.

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20 min
29 APR.

#440 - 🔵 [PAS 2026] - Is LISA the Future of Surfactant Delivery for Premature Babies?

Send us Fan Mail Dr. 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 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!

29 apr.

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12 min
20 APR.

#435 - On With VON - Transfusion Thresholds

Send us Fan Mail The transfusion threshold consensus is here — but practice hasn't fully caught up. In the second episode of On with VON, Ben and Daphna sit down with Dr. Roger Soll and Dr. Ravi Patel to extend the conversation from the Vermont Oxford Network Grand Rounds on evidence to practice for transfusion thresholds. The core finding across trials is consistent: lower thresholds for both packed red blood cells and platelets appear safe. The guidelines are freely available in JAMA Network Open and actionable — 11, 10, 9 grams per deciliter across the first three weeks for infants on respiratory support. So why hasn't practice shifted uniformly? The group works through the populations the trials didn't fully capture — hypoxic-ischemic encephalopathy, the most premature infants, and babies in the first week of life when intraventricular hemorrhage risk peaks. On NEC and feeding during transfusion: the data may surprise you. On transfusion volume and infusion duration: an underappreciated variable, particularly for platelets. The episode closes with practical guidance on implementing transfusion guidelines at the unit level — who needs to be in the room, how informatics tools can support decision-making, and why understanding protocol deviations matters as much as the guidelines themselves. 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 apr.

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48 min
29 APR.

#440 - 🔵 [PAS 2026] - Are We Ready for Gentle Hemodynamics the Way We Embraced Gentle Ventilation?

Send us Fan Mail Dr. 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 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!

29 apr.

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22 min
24 APR.

#437 - 🔵 [PAS 2026] - How Do We Counsel Families of Tiny Babies Without Crushing Hope or Delivering False Hope? (ft. Dr. Charles Roehr)

Send us Fan Mail Dr. Charles Roehr, neonatologist from Bristol, UK and faculty member of the Tiny Baby Collaborative, makes the case that caring for extremely preterm infants is as much about engaging families as it is about mastering the medicine. He discusses why parents of tiny babies are among the most vulnerable to enter a research conversation — often facing precipitous deliveries with little to no preparation — and what it takes for clinical teams to meet them where they are. He also addresses one of the hardest conversations in neonatology: how to counsel families around survival and neurodevelopmental outcomes when center-to-center variability is so wide, and why translating evidence from one unit to another remains one of the field's most stubborn unsolved problems. 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 apr.

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10 min
24 APR.

#437 - 🔵 [PAS 2026] - Can a Neonatal MRI Predict Long-Term Outcomes in Babies with HIE? (ft. Dr. Seetha Shankaran)

Send us Fan Mail Dr. Seetha Shankaran one of the pioneers of therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE) and longtime member of the NICHD Neonatal Research Network, reflects on a career devoted to preventing and treating neonatal brain injury. She discusses what neonatal MRI can and cannot tell us about long-term neurodevelopmental outcomes in infants with HIE, why a normal MRI does not equal a normal future, and how the pattern of brain injury on imaging should shape the counseling conversation with families. She closes with a message that no imaging study can replace: consistent, long-term follow-up remains the most important tool we have. 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 apr.

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9 min
25 APR.

#438 - 🔵 [PAS 2026] - Are We Correcting for Gestational Age Long Enough in Our Most Premature Infants? (ft. Dr. Allison Lure)

Send us Fan Mail Dr. Allison Lure, neonatologist and clinical informatics fellow, presents findings from a large primary care network spanning over 80 practices in Massachusetts on how term and preterm infants grow longitudinally after discharge. She shares why the standard practice of correcting for gestational age until two years may be sufficient for moderate and late preterm infants but falls short for babies born below 32 weeks — who may need correction extended to three years or beyond to avoid being misclassified as failing to thrive. She also sheds light on the often-overlooked growth trajectories of moderate and late preterm babies, a population rarely captured in NICU follow-up clinics, and explains what her work in clinical informatics is teaching her about how to store, structure, and extract meaningful data from the electronic health record. 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 apr.

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8 min
25 APR.

#438 - 🔵 [PAS 2026] - Can Preventing Hypotension and Using Low-Dose Steroids Change the Course of Surgical NEC? (ft. Dr. Parvesh Garg)

Send us Fan Mail Dr. Parvesh Garg, neonatologist and researcher specializing in necrotizing enterocolitis (NEC) and acute kidney injury (AKI) in preterm infants, shares more than a decade of work on two of the most understudied organ systems in the NICU. He explains why surgical NEC is an independent risk factor for long-term neurodevelopmental impairment, how aggressively managing hypotension at the time of diagnosis may protect both the brain and the kidneys, and why the severity of NEC-associated AKI should be used as a prognostic tool in counseling families. He also presents early but fascinating laboratory findings suggesting that low-dose dexamethasone — unlike high doses — may help limit intestinal epithelial loss once NEC has set in, drawing a parallel to what therapeutic hypothermia does for HIE: the event has happened, but the inflammatory cascade may still be containable. 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 apr.

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9 min
29 APR.

#440 - 🔵 [PAS 2026] - Do We Even Know What a Healthy Preterm Gut Looks Like on Ultrasound?

Send us Fan Mail Dr. 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 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!

29 apr.

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10 min

Ben and Daphna go through daily neonatal board questions. If you are studying for the upcoming neonatal boards exam or just want to keep your neonatal knowledge sharp, this is the podcast for you. This show is done in collaboration with Neonatology Review (Dr. Dara Brodsky and Dr. Camilia Martin).

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The neonatology focused podcast hosted by Dr. Ben Courchia MD & Dr. Daphna Yasova Barbeau.

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