The Incubator

Send us Fan Mail Three third-year fellows present diverse research at Hot Topics. Juhi from University of Illinois in Chicago demonstrates lung ultrasound's potential to predict respiratory support duration in 30+ week infants, with first six-hour exams showing strongest correlation—suggesting possible replacement for admission chest x-rays. Tanima from Boston Children's applies large la...

Send us Fan Mail Dr. Jeffrey Gould and Dr. David Stevenson recount founding California Perinatal Quality Care Collaborative (CPQCC) in the mid-1990s, transforming California's fragmented perinatal care system. Initial success required organizational development expertise—not just databases—to transform stakeholders into partners by identifying mutual value. They created California Association...

Send us Fan Mail Dr. Elizabeth Foglia, University of Pennsylvania/Children's Hospital of Philadelphia and scientific PI for AAP's DRIVE (Delivery Room Intervention and Evaluation) Network, discusses building a 3,000-hospital US collaboration to understand real-world delivery room practices. Despite robust evidence supporting supraglottic airways for PPV in infants 34+ weeks, surveys show...

Send us Fan Mail  In this episode of The Incubator Podcast, recorded live at Hot Topics in Neonatology in Washington, DC, we sit down with Dr. Daniele De Luca, Chief of Pediatric and Neonatal Critical Care at AP-HP Paris-Saclay University and leader of one of Europe's largest NICUs. Dr. De Luca discusses the groundbreaking Lancet Child & Adolescent Health Commission on the Future of Neona...

Send us Fan Mail Dr. Matthew Laughon, Professor at University of North Carolina and NICHD Neonatal Research Network investigator, presents the landmark PDA Management Trial comparing expectant management versus active medical treatment (indomethacin, ibuprofen, or acetaminophen). The trial stopped early due to futility and safety concerns—mortality exceeded 10% in the treatment group versus 4% wit...

Send us Fan Mail Nicole and Maureen from Lactalogics present innovative donor human milk processing using gentle ultra-high temperature pasteurization—exposing milk to heat for only 10 seconds versus 30-40 minutes with traditional methods. Their tube-in-tube system (milk and steam traveling opposite directions) maintains safety by eliminating pathogens while better preserving inherent nutrients. P...

Send us Fan Mail Dr. Michael Narvey, neonatologist and Vice President of Canadian Pediatric Society, challenges the validity of pre-discharge car seat testing. After leading Canadian work resulting in nationwide abandonment of the test in 2016, he argues the test doesn't represent real-world conditions (potholes, movement) and lacks evidence demonstrating it saves lives from apnea or desatura...

Send us Fan Mail Dr. Elaine Boyle, Professor of Neonatal Medicine at University of Leicester, presents the SURFON trial evaluating early surfactant versus expectant management in 34-38 week infants with respiratory distress. This pragmatic trial enrolled infants requiring 30-45% oxygen or non-invasive support. Primary outcomes showed no difference in hospital length of stay or progression to sever...

Send us Fan Mail Dr. Shalini Ojha, Professor of Neonatal Medicine at University of Nottingham, presents the Feed One trial examining full enteral feeding (60 mL/kg/day) from day one versus gradual advancement in 30-32 week infants. While the primary outcome of hospital length of stay showed no difference (median 32 days), full feeding significantly reduced parenteral nutrition use, IV cannulations...

Send us Fan Mail Three first-year fellows from University of Virginia—Jamie, Megan, and Brianne—share their Hot Topics conference experience. Despite being early in training, they engage deeply with cutting-edge research across diverse interests: POCUS and hemodynamics (Jamie), ENT non-surgical interventions (Brianne), and neurodevelopmental outcomes with Tiny Baby projects (Megan). They value lea...

Send us Fan Mail Dr. Pankaj Agrawal, Division Chief of Neonatology at University of Miami, discusses rapid genomic advances—from six-month diagnostic timelines in 2000 to same-day sequencing today. While current practice targets phenotype-based testing for unexplained conditions or dysmorphic features, Agrawal advocates moving toward universal NICU sequencing to identify previously unrecognized co...

Send us Fan Mail Dr. Kavya Rao from University of Buffalo discusses quality improvement initiatives following completion of her master's in QI. Her team successfully implemented antibiotic stewardship by safely discontinuing antibiotics at 24 hours for early onset sepsis in clinically well infants with negative blood cultures, initially studying all gestational ages with plans for subset anal...

Send us Fan Mail Dr. Ariel Salas, recent R01 recipient, discusses challenging traditional feeding volume targets in preterm infants. His multi-center trial compares 180-200 versus 140-160 mL/kg/day volumes, examining body composition changes rather than weight alone. Salas emphasizes targeting fat-free mass gains over simple weight gain, as this component associates with better long-term neurodeve...

Send us Fan Mail Julie Raskin, representing Congenital Hyperinsulinism International (CHI), advocates for universal newborn glucose screening following her son's brain injury from undiagnosed hyperinsulinism in 1996. Registry data reveals 28% of affected infants lack traditional risk factors (abnormal birth weight), and even high-risk babies are often discharged inappropriately. CHI's &q...

Send us Fan Mail Dr. Edgardo Szyld from Indiana University presents the PLANT study evaluating 20 minutes of prophylactic CPAP for late preterm infants (34-36+6 weeks) born via cesarean section. This population represents 70% of US preterm births and experiences five times higher respiratory distress rates with cesarean delivery. The pragmatic pilot enrolled 100 patients, demonstrating reduced NIC...

Send us Fan Mail Dr. Ravi Patel, Professor at Emory University and Chair of the Georgia Perinatal Quality Collaborative, examines the tension between quality improvement and evidence-based medicine. He argues NICUs should prioritize high-certainty interventions (antenatal steroids, delayed cord clamping) rather than standardizing practices based on low-certainty evidence. Using tools like GRADE to...

Send us Fan Mail Dr. Divya keerthy (New York Presbyterian Queens/Weill Cornell Medicine) and Dr. Katherine Nyman (UCSD/Rady Children's, San Diego) discuss their Hot Topics conference experience. Keerthy presents research on prenatal polycyclic aromatic hydrocarbon exposure measured via backpack monitors and silicone wristbands during the third trimester. Her longitudinal study tracked infant...

Send us Fan Mail Dr. Louise Owen from Royal Women's Hospital Melbourne presents the AEROPLANE trial comparing 21% versus 30% oxygen for 32-35 week infants at birth. This understudied cohort represents 80% of preterm births globally. Using cluster randomization with waived consent, the trial captured real-world practice across centers. Infants receiving 30% oxygen required less delivery room i...

Send us Fan Mail Dr. Clara Song, Chair of the AAP Section on Neonatal-Perinatal Medicine, discusses urgent workforce challenges facing neonatology. With average neonatologist age around 50-55 and stable fellowship applications despite growing positions, the field faces potential shortages. The section launched initiatives addressing fair compensation, including a new website comparing negotiated c...

Send us Fan Mail Dr. Katherine P Callahan, neonatologist and bioethicist at Children's Hospital of Philadelphia, discusses the complexity of genetic testing in neonatal care. While the NICU serves as a launch point for genetic technologies due to high prevalence of genetic disease, genetic information is often ambiguous or uncertain rather than straightforwardly diagnostic. Variants of uncert...

Send us Fan Mail In this episode, Mandy Daly shares her profound journey as a NICU parent and her advocacy work through the Irish Neonatal Health Alliance (INHA). She discusses the emotional challenges faced by parents of preterm infants, the importance of family-centered care, and the need for systemic changes in neonatal healthcare. Mandy emphasizes the significance of building support networks,...

Send us Fan Mail In this episode of NeoNews, the team returns from a brief hiatus with a refreshed format and a packed review of neonatal stories dominating recent headlines. Eli, Ben, and Daphna open with updates on RSV prevention, highlighting new MMWR data showing significant gaps in nirsevimab and maternal vaccine uptake—despite strong evidence and renewed availability. They discuss how supply...

Send us Fan Mail In the final episode of our Rethinking Phototherapy series, Ben speaks with Steve Falk, Chief Engineer of the Maternal Infant Care Strategic Business Unit at GE Healthcare. With more than three decades of engineering leadership, Steve has been instrumental in the development of landmark neonatal technologies, including the Giraffe Omnibed and Panda platforms. This conversation hig...

Send us Fan Mail What happens when we challenge our long-standing assumptions about phototherapy in the NICU? In this special installment of our Rethinking Phototherapy series, Ben and Daphna are joined by Dr. Deepak Manhas to examine one of the most complex questions: how should we manage hyperbilirubinemia in preterm infants? Unlike term babies, preemies face unique risks—shorter red blood cell...

Send us Fan Mail In the second installment of our Rethinking Phototherapy series, Ben and Daphna welcome Dr. Daniel Rauch, Professor of Pediatrics at the Hackensack Meridian School of Medicine and Division Chief of Pediatric Hospital Medicine and General Academic Pediatrics at Joseph Sanzari Children’s Hospital. Dr. Rauch co-authored the AAP technical report on phototherapy and brings a unique per...