The Incubator - podcast cover

The Incubator

Ben Courchia & Daphna Yasova Barbeauβ€’www.the-incubator.org

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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Episodes

#446 - Is Bedside Transcatheter PDA Closure Ready for Your NICU?

Send us Fan Mail What if closing a PDA could be done at the bedside in under 10 minutes, without transporting a fragile preterm infant to the cath lab? Dr. Shyam Sathanandam, Chief of Cardiovascular Medicine at Nicklaus Children's Heart Institute, joins us to discuss the evolution of transcatheter PDA closure in extremely preterm infants. We cover how bedside procedures protect the most vulnerable neonates, which infants are most likely to benefit from closure, the learning curve and complicatio...

Jun 01, 2026β€’48 minβ€’Season 5Ep. 123

#445 - πŸ“‘ 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...

May 30, 2026β€’1 hr 39 minβ€’Season 5Ep. 122

#445 - [Neo News] - πŸ“Œ 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 fin...

May 29, 2026β€’20 minβ€’Season 5Ep. 121

#445 - [Journal Club] - πŸ“Œ 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 in...

May 28, 2026β€’19 minβ€’Season 5Ep. 120

#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 ...

May 27, 2026β€’34 minβ€’Season 5Ep. 119

#445 - [Journal Club] - πŸ“Œ 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 fas...

May 27, 2026β€’24 minβ€’Season 5Ep. 118

#445 - [Journal Club] - πŸ“Œ 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 oxygenat...

May 26, 2026β€’23 minβ€’Season 5Ep. 117

#445 - [Journal Club] - πŸ“Œ 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-bas...

May 25, 2026β€’25 minβ€’Season 5Ep. 116

#444 - Can a Beanie Protect NICU Infants from Harmful Noise While Keeping Them Connected to Their Parents?

Send us Fan Mail The NICU is one of the loudest environments a newborn will ever experience, yet it is also where the most vulnerable infants spend their earliest, most developmentally critical days. In this Tech Tuesday episode, Ben and Daphna sit down with Gabby Daltoso and Sophie Ishiwari, co-founders of the Sonura Beanie. Their device tackles two pressing NICU challenges at once: harmful noise exposure and disrupted parental connection. By embedding a low-pass filtration system tuned to the ...

May 22, 2026β€’21 minβ€’Season 5Ep. 115

#443 - Could NeoGuide Be the Answer to the NICU’s Variability Problem?

Send us Fan Mail Every neonatologist has built a protocol or written a guideline, and most have done it completely alone. In this episode, Ben sits down with Dr. Christina Muffy Sollinger (UC Davis) and Dr. Sarvin Ghavam (CHOP), the co-founders of NeoGuide, a national collaborative dedicated to connecting clinicians around the shared work of clinical guidelines and practice pathways. Born from a single email that broke a listserv and generated over 120 responses overnight, NeoGuide has grown int...

May 18, 2026β€’44 minβ€’Season 5Ep. 114

#442 - πŸ“‘ Journal Club - The Complete Episode from May 16th 2026

Send us Fan Mail Cerebral oxygenation, staffing economics, delivery room scoring, neurodevelopmental prognostication, and public health β€” a full week on the Incubator Journal Club. Ben walks through the NIRTURE trial, a single-device RCT testing cerebral oximetry-guided care in infants born under 29 weeks. The intervention dramatically reduced the burden of cerebral hypoxia and hyperoxia compared to standard care. Secondary clinical outcomes were neutral and neurodevelopmental follow-up is still...

May 16, 2026β€’1 hr 25 minβ€’Season 5Ep. 113

#442 - [Neo News] - πŸ“Œ What Is the Ripple Effect of Defunding Disease Surveillance?

Send us Fan Mail In this episode of Neo News, Ben and Eli tackle the recent, quietβ€”but massiveβ€”public health funding cuts implemented by the Department of Health and Human Services. With $600 million pulled back from four targeted states and additional CDC block grants eliminated, they discuss the severe domestic implications for local health departments, HIV/STI surveillance, and lead poisoning prevention. They also zoom out to examine the global health consequences of the US withdrawing from t...

May 15, 2026β€’21 minβ€’Season 5Ep. 112

#442 - [Journal Club] - πŸ“Œ Does combining EEG and MRI improve neurodevelopmental prognostication in preterm infants?

Send us Fan Mail In 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, particul...

May 14, 2026β€’13 minβ€’Season 5Ep. 111

#442 - [Journal Club] - πŸ“Œ Is a low Apgar score more concerning than a low umbilical pH in preemies?

Send us Fan Mail Ben 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 t...

May 13, 2026β€’22 minβ€’Season 5Ep. 110

#442 - [Journal Club] - πŸ“Œ Does 24 hour in house staffing decrease physician productivity metrics?

Send us Fan Mail Is 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 le...

May 12, 2026β€’18 minβ€’Season 5Ep. 109

#442 - [Journal Club] - πŸ“Œ Does NIRS guided treatment improve clinical outcomes for extremely preterm infants?

Send us Fan Mail In 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 ou...

May 11, 2026β€’22 minβ€’Season 5Ep. 108

#441 - Is Two Years Enough? Fellowship Directors Respond to the ABP’s Proposed Training Overhaul

Send us Fan Mail The American Board of Pediatrics (ABP) recently announced a move toward competency-based subspecialty training that would shorten fellowships β€” including neonatology β€” 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 Phil...

May 10, 2026β€’47 minβ€’Season 5Ep. 107

#440 - πŸ”΅ [PAS 2026] - What Goes Into Planning the Biggest Pediatric Conference in the World?

Send us Fan Mail Dr. 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 β€” 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 f...

Apr 29, 2026β€’12 minβ€’Season 5Ep. 106

#440 - πŸ”΅ [PAS 2026] - Is the Neonatology Job Market About to Shift Dramatically in Fellows' Favor?

Send us Fan Mail Dr. 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 β€” sicker and younger patients, a shrinking APP pipeline into high-acuity specialties, and hospitals stretching budgets on locums before finally raising permane...

Apr 29, 2026β€’12 minβ€’Season 5Ep. 105

#440 - πŸ”΅ [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 β€” 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 β€” intervening thoughtfully, recognizing different clinical phenotypes, and knowing when to remove intervent...

Apr 29, 2026β€’22 minβ€’Season 5Ep. 104

#440 - πŸ”΅ [PAS 2026] - When Is the Right Time to Talk to a Family About a Tracheostomy for BPD?

Send us Fan Mail Dr. 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 β€” 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 vent...

Apr 29, 2026β€’13 minβ€’Season 5Ep. 103

#440 - πŸ”΅ [PAS 2026] - What Does It Take to Build a World-Class NICU From the Ground Up?

Send us Fan Mail Dr. 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 β€” 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 ...

Apr 29, 2026β€’12 minβ€’Season 5Ep. 102

#440 - πŸ”΅ [PAS 2026] - How Did One NICU Take 22-Weeker Survival From 12% to 72%?

Send us Fan Mail Dr. 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 β€” and 72% over the last two years β€” driven by institutional alignment, standardized protocols, and a dedicated multidisciplinary team. She also presents Golden ...

Apr 29, 2026β€’12 minβ€’Season 5Ep. 101

#440 - πŸ”΅ [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 β€” 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 populat...

Apr 29, 2026β€’10 minβ€’Season 5Ep. 100

#440 - πŸ”΅ [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 β€” Less Invasive Surfactant Administration β€” 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 re...

Apr 29, 2026β€’12 minβ€’Season 5Ep. 99

#440 - πŸ”΅ [PAS 2026] - Could Donor Milk Cream Replace Dextrose Gel for Newborn Hypoglycemia?

Send us Fan Mail Dr. 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 β€” highlighting the well-known limitations of dextrose gel including inconsistent dosing, poor tolerance, and the way it interferes with breastfeeding immediately after admin...

Apr 29, 2026β€’14 minβ€’Season 5Ep. 98

#440 - πŸ”΅ [PAS 2026] - Could a Quarterly Injection Replace a Liver Transplant for This Rare Kidney Disease?

Send us Fan Mail Dr. David Sas, pediatric nephrologist at Mayo Clinic, joins Ben to discuss primary hyperoxaluria type 1 β€” 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 β€” show...

Apr 27, 2026β€’11 minβ€’Season 5Ep. 97

#440 - πŸ”΅ [PAS 2026] - What Does It Take to Build a Pediatric Transport Team From Scratch?

Send us Fan Mail Dr. 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 β€” 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 tra...

Apr 27, 2026β€’11 minβ€’Season 5Ep. 96

#440 - πŸ”΅ [PAS 2026] - Is Gaming Addiction in Kids With ADHD About the Games or the Parenting?

Send us Fan Mail Dr. 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 β€” more than hyperactivity, anxiety, depression, or autism symptoms β€” was the factor most strongly associated with meeting criteria for gaming addict...

Apr 27, 2026β€’13 minβ€’Season 5Ep. 95

#440 - πŸ”΅ [PAS 2026] - Are We Studying the Right Things the Right Way in Neonatology?

Send us Fan Mail Dr. Lily Lou joins Daphna and Rupa to reflect on this year's Silverman Lecture at PAS β€” the annual honorary lecture of the AAP Section on Neonatal Perinatal Medicine β€” 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...

Apr 27, 2026β€’8 minβ€’Season 5Ep. 94
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