The Incubator

Send us Fan Mail Dr. Kelly Mahaney, Assistant Professor of Pediatric Neurosurgery at Stanford and researcher focused on the role of iron in post hemorrhagic hydrocephalus, joins the podcast to challenge the traditional watch and wait approach to IVH complications. She describes Stanford’s early radiographic intervention pathway, which has reduced shunt dependency from 90% to 45% in reservoir-placed infants, explains why waiting for clinical symptoms means waiting too long, and outlines her effort to build a statewide CPQCC nested network to standardize and study early intervention practices across California NICUs. 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!

Send us Fan Mail Dr. Sanjay Sinha, interventional pediatric cardiologist, Assistant Professor of Pediatrics at CHOC and UCI, and Co-Director of the UCLA Congenital Lymphatic Imaging and Intervention Program, opens a new chapter for neonatologists on neonatal chylothorax and lymphatic disease. He explains how to recognize lymphatic mimickers at the bedside, why woody edema should raise the index of suspicion, how MR lymphangiography is reshaping diagnosis and surgical planning, and how early targeted intervention is dramatically reducing NPO time and hospital length of stay in a population that was previously managed with a prolonged watch and wait approach. 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!

Send us Fan Mail Dr. Clara Song, neonatal intensivist with Southern California Permanente Medical Group, Chair of the AAP Section on Neonatal Perinatal Medicine Executive Committee, and founding leader of the Women in Neonatology group, shares the lessons from her Cool Topics talk on quiet power and soft skills in leadership. She explores how communication, emotional intelligence, and servant leadership drive team performance more than technical expertise, breaks down the four personality types every leader needs to understand, and offers a practical framework for structuring communication so every type of team member actually receives the message. 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!

Send us Fan Mail Dr. Robin Steinhorn, Professor and Vice Dean for Children’s Clinical Services at UC San Diego and President of Children’s Specialists of San Diego, tackles one of neonatology’s most uncomfortable conversations: compensation. She breaks down how to identify reliable benchmark data, explains why neonatologists are generating more RVUs than ever while pay has not kept pace with workload complexity, addresses gender discrepancy trends in the literature, and offers practical strategies for individuals and division chiefs to use rigorous national data when advocating for fair compensation at the institutional level. 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!

Send us Fan Mail Dr. Susan Hintz, Medical Director of the Fetal and Pregnancy Health Program and Robert L. Hess Family Endowed Professor at Stanford Medicine, delivers this year’s Cool Topics keynote on collaboration, shared purpose, and the lessons learned building high risk infant follow-up infrastructure through the CPQCC. She challenges the neonatal community to move beyond the handoff to a pediatrician and think deliberately about true medical home design, including coordinated care teams, clearly defined roles across subspecialty and follow-up clinics, and better use of community based resources to support families long after NICU discharge. 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!

Send us Fan Mail Dr. Caitlin Carter, Clinical Director of Nephrology at Rady Children’s Hospital and associate clinical professor at UC San Diego, joins the podcast to challenge how neonatologists recognize and follow up on acute kidney injury. She explains why creatinine alone is insufficient, how biomarkers like NGAL can detect tubular injury before function declines, and why AKI too often disappears from the discharge summary. She also outlines published consensus guidelines on post NICU nephrology follow-up, with clear thresholds based on gestational age and AKI severity. 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!

Send us Fan Mail Dr. Tarah Colaizy, Professor of Neonatology at the University of Iowa Stead Family Children’s Hospital and Medical Director of the Mother’s Milk Bank of Iowa, challenges the one size fits all approach to nutrition in periviable infants. She shares the Iowa philosophy of individualized, principle driven feeding management, explains why rigid protocol adherence can backfire in the most immature babies, and walks through her unit’s glycerin protocol for meconium obstruction of prematurity. She also discusses the practical realities of frequent low volume lab monitoring and the importance of patience over speed in enteral feeding advancement. 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!

Send us Fan Mail Dr. Satyan Lakshminrusimha, Chair of Pediatrics and Pediatrician in Chief at UC Davis Children’s Hospital, makes a compelling case for rebranding and restructuring neonatology as a field. He argues for adopting the title of neonatal critical care physician, addresses the stark disparity between NICU revenue generation and neonatologist compensation, and outlines a step by step resuscitation framework for the field, from restoring professional identity to establishing a dedicated neonatal residency pathway and ultimately recognizing neonatology as its own independent department. 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!

Send us Fan Mail Dr. Elizabeth Crouch, neonatologist, neuroscientist, and physician scientist at UCSF and co-host of At the Bench on The Incubator Podcast, joins Ben and Daphna live at Cool Topics to discuss palliative and comfort care in the NICU. Drawing from her research on organ donation, autopsy, and research donation after neonatal loss, Dr. Crouch shares how meaning making supports families through grief, offers practical tips for approaching these conversations with compassion and good timing, and reflects on the role of chaplains, ethics consultants, and care pathways in supporting a death with dignity. 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!

Send us Fan Mail Dr. Jochen Profit, Chair and Principal Investigator at CPQCC and Wendy J. Tomlin-Hess Endowed Professor of Pediatrics at Stanford Medicine, joins the podcast to discuss what truly separates high performing NICUs from the rest. He makes the case for process metrics over mortality as quality markers, highlighting normothermia on admission, breast milk feeding at discharge, and infection rates as deceptively simple yet deeply revealing indicators of unit culture. The conversation also explores how toxic work environments and provider burnout silently undermine quality improvement efforts. 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!

Send us Fan Mail Dr. Shmuel Zangen, Director of Neonatology at Barzilay Medical Center in Ashkelon, Israel, and former chair of the Israeli Neonatal Association, joins the podcast during his California sabbatical embedded with CPQCC. Having already led national QI collaborations targeting nosocomial infections and intraventricular hemorrhage across all 26 Israeli NICUs, he shares what he is learning about the culture, infrastructure, and methodology behind effective statewide quality improvement, and what he hopes to bring home as Israel transitions its neonatal database to the Ministry of Health. 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!

Send us Fan Mail Dr. Alexis Davis, Clinical Professor of Pediatrics at Stanford and Medical Director of the NephroNICU at Lucile Packard Children’s Hospital, makes the case that neonatology is entering a nephro era. She discusses how AKI prevention through initiatives like the BABY NINJA collaborative, fluid management strategies, and the emerging concept of the NephroNICU are reshaping how we think about kidney health in premature infants. She also addresses the complex ethical and practical considerations around dialysis and renal replacement therapy in newborns with congenital kidney failure. 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!

Send us Fan Mail Ra’Niesha Bratton, MPH, CHES, CPQCC Family Advisory Council board member and public health advocate, and Joanne Tillman, CPQCC Family Engagement Coordinator, join the podcast to discuss what genuine family centered care looks like in practice. Drawing from lived NICU experience, Ra’Niesha shares how implicit bias and cultural incompetence harm families at their most vulnerable and how structured family advisory councils can drive systemic change. The conversation also tackles peer to peer support gaps, bereavement resources, and how to access the CPQCC NICU Family Advisory Council Toolkit. 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!

Send us Fan Mail Silvia Bor, NICU mom to a 24 weeker and Family Advisory Council member for the CPQCC, makes the case for why family centered care must go beyond a philosophy and become a structured practice. She shares how involving parents in quality improvement initiatives, including the NEOBrain early skin to skin project, drives meaningful change at the bedside. She also outlines the CPQCC toolkit for building hospital level Family Advisory Councils and discusses how to identify the right parent advocates, including those whose NICU journeys ended in loss. 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!

Send us Fan Mail Recorded live at the Cool Topics in Neonatology conference, this episode features Dr. Denise Suttner, Clinical Director of the Rady Children's Hospital NICU, professor of pediatrics at UC San Diego, and director of the San Diego Regional ECMO Program. Dr. Suttner discusses the California Perinatal Quality Care Collaborative (CPQCC) as a model for statewide neonatal quality improvement, the importance of family centered communication in the NICU, and the value of state level professional organizations in advancing advocacy for neonatal healthcare funding and pediatric subspecialty reimbursement. 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!

Send a text In this episode, we sit down with Dr. Jessica Shui, attending neonatologist at Mass General for Children, to explore the game-changing potential of Electrical Impedance Tomography (EIT) in the NICU. We dive into her recent paper in the Journal of Perinatology on using non-invasive EIT to identify optimal PEEP in infants with severe bronchopulmonary dysplasia. Dr. Shui explains how this real-time, radiation-free technology allows clinicians to visualize lung mechanics, dynamically titrate ventilator settings, and confidently reduce PEEP without risking atelectasis. Join us as we discuss moving beyond blind adjustments and stepping into the future of personalized neonatal respiratory care. 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!

Send a text The PDA debate has a new data point. TREOCAPA, a phase 3 multicenter European RCT, tested prophylactic acetaminophen in infants born at 23 to 28 weeks. The ductus closed more reliably. Whether that translated into better survival without severe morbidity at 36 weeks is where the conversation gets interesting. Also this week: a large multicenter cohort study puts real numbers on diazoxide use across US NICUs and the pulmonary hypertension risk that has driven so much practice variation. The NeoDry trial tests whether drying very preterm infants before plastic wrapping improves normothermia at admission, with results that are a good reminder of why we run trials. And a retrospective from NYU raises the question of whether standard caffeine dosing in the most premature infants is leaving something on the table. The episode closes with Ben and Eli on Florida’s infant formula heavy metal report and why publishing findings without methods may be as much a public health problem as the data itself. 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!

Send a text In this Neo News episode, Ben and Eli dive into the recent controversial announcement from the state of Florida regarding heavy metals and pesticides found in infant formulas. They discuss the implications of releasing testing data without transparent methodology or clinical context, especially for unregulated or recalled brands like ByHeart and Similac Soy Isomil. How should NICU clinicians counsel parents who want to bring their own formulas from home? Tune in as they unpack the regulatory loopholes, the evolving public health initiatives, and the ongoing challenge of navigating unverified reports in neonatal care! ---- https://www.miamiherald.com/news/politics-government/article314266407.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!

Send a text In this episode of Journal Club, Ben and Daphna review a retrospective cohort study exploring the effects of higher caffeine maintenance dosing on BPD and neurodevelopmental outcomes. They discuss the transition from the standard CAP trial doses to higher regimens for infants born at or before 28 weeks gestation. Does an average daily dose of over six milligrams per kilogram reduce severe BPD or improve Bayley cognitive scores at six months? Tune in as they debate the safety, clinical implications, and their own unit's practices regarding caffeine management in the NICU! ---- Effects of higher caffeine dosing on rates of bronchopulmonary dysplasia and neurodevelopmental outcomes. Fleishaker S, Kazmi SH, Mavrogiannis N, Street H, Ravuri H, Moinuddin T, Pierce K, Verma S.J Perinatol. 2026 Feb 23. doi: 10.1038/s41372-026-02593-1. Online ahead of print.PMID: 41731043 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!

Send a text In this Journal Club episode, Ben and Daphna review the eye-opening results of the NeoDry Trial recently published in JAMA Network Open. They explore the clinical rationale of whether drying very preterm infants before applying a plastic wrap in the delivery room improves rates of normothermia upon NICU admission. While the intervention did not significantly improve temperatures, it unexpectedly revealed an alarming increased mortality risk for the smallest neonates. Tune in as they break down the study's design, discuss the potential causes for this stark safety signal, and highlight the ongoing challenge of maintaining thermoregulation for our most vulnerable preemies! ---- Drying Very Preterm Infants Before Plastic Wrapping at Birth: A Randomized Clinical Trial. Cavallin F, Doglioni N, Risso FM, Monari CB, Aversa S, Troiani S, Battajon N, Moschella S, Villani PE, Vedovato S, Maiorca D, Frezza S, Lista G, Laforgia N, Mondello I, Sibona I, Staffler A, Pratesi S, Paviotti G, De Bernardo G, Lama S, Miselli F, Bua J, Gitto E, Pesce S, Baraldi E, Trevisanuto D; NEODRY Trial Group.JAMA Netw Open. 2026 Mar 2;9(3):e2556902. doi: 10.1001/jamanetworkopen.2025.56902. 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!