The Incubator

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#339 - The Giants of Neonatology: Dr. Edward Bell on Culture, Consistency, and Care at the Limits of Life Aug 10, 2025

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Picture this: You’re caring for a 22-week infant, uncertain whether survival is even possible—and yet you remember that someone like Dr. Ed Bell has been quietly tracking cases just like this for decades.

In this episode of The Incubator Podcast, we welcome Dr. Edward Bell, Professor of Pediatrics and Associate Vice Chair for Faculty Development in Neonatology at the University of Iowa. A leader in the care of extremely preterm infants, Dr. Bell shares the origins of the Tiniest Babies Registry, his views on how viability has shifted over the decades, and why institutional culture—not just technical capability—makes all the difference in outcomes for the smallest patients.

We talk through the evolution of care for infants born at the edge of viability, what defines success at 21–22 weeks, the growing segmentation of neonatology into subspecialties, and how consistency in care delivery plays a vital role. The episode closes with practical advice for young neonatologists entering the field today.

A grounded, no-nonsense conversation with someone who has shaped—and continues to influence—the trajectory of neonatal medicine.

Listen on Apple, Spotify, or wherever you get your podcasts.

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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.

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#338 - 🚀 The BiliHut: Rethinking Phototherapy with Portability and Precision Aug 08, 2025

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In this Tech Tuesday episode, Dr. Donna Brezinski, founder and CEO of Little Sparrows Technologies, joins the show to talk about the BiliHut — a portable, high-intensity phototherapy device designed to treat neonatal jaundice with both clinical effectiveness and practical usability in mind.

A neonatologist by training, Dr. Brezinski explains how her clinical experiences led to the development of the BiliHut, which delivers uniform phototherapy across the baby’s body while solving key issues like positioning errors, thermal regulation, and access for breastfeeding. Unlike traditional overhead lights or fiber-optic pads, the BiliHut is engineered for both hospital and home use, with versions adaptable to low-resource settings and unreliable power grids.

The conversation covers the physics behind its design, recent clinical data on treatment time, and deployment strategies from rural U.S. areas to clinics in Mongolia and Burundi. Dr. Brezinski also outlines how clinicians and families in the U.S. can access the device through durable medical equipment providers, visiting nurse agencies, or hospital DME programs.

More information about the BiliHut and its availability can be found at littlesparrowstech.com.

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#337 - Targeting NEC at the Cellular Level, A New Frontier in Research Aug 05, 2025

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In this episode, we sit down with Dr. Garabet Yeretssian, PhD, Senior Program Manager at the Chan Zuckerberg Initiative (CZI), to discuss how collaborative infrastructure and emerging technologies are reshaping research into necrotizing enterocolitis (NEC). Garabet shares how his background in GI inflammation and rare diseases led him to focus on cross-disciplinary research support, including CZI’s Rare As One Network and its emphasis on patient-led science.

We explore how tools like single-cell transcriptomics, organoid modeling, and AI-driven biomarker discovery are helping scientists better understand NEC pathophysiology — and potentially identify early risk markers. Garabet also talks about the growing effort to bridge the gap between adult GI research and neonatal care, and how aligning researchers, clinicians, and families can accelerate progress in diagnosis, prevention, and treatment.

The episode highlights CZI’s funding approach, which requires genuine collaboration with patient organizations, and outlines strategies for researchers and clinicians to engage with private funders. For those attending the NEXT Symposium, Garabet previews his role in sessions focused on inflammation, translational science, and scalable technologies.

Listeners can learn more and register for the 2025 NEXT Symposium at nextsociety.org using promo code incubator for 10% off.

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#336 - Building a World Without NEC – A Conversation with Dr. Mark Underwood Aug 03, 2025

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In this special collaboration with the NEC Society, Dr. Mark Underwood joins the podcast to discuss the evolving science and clinical approach to necrotizing enterocolitis (NEC). A long-time leader in neonatal nutrition and NEC prevention, Dr. Underwood shares his perspective on why prevention remains the most effective lever in tackling this devastating disease — from the irreplaceable role of maternal milk to the complex regulatory barriers around probiotics.

The conversation covers his recent articles unpacking the risks and benefits of formula, donor milk, and the current probiotic landscape in U.S. NICUs. Dr. Underwood also previews highlights from the upcoming NEC Symposium and shares his hopes for the future of NEC care, including earlier biomarker-driven interventions and smarter pasteurization of donor milk.

Whether you’re a clinician, researcher, or parent advocate, this episode offers pragmatic insights into the current NEC landscape and the road ahead.

Listeners can register for the 2025 NEC Symposium at NECSociety.org and use promo code incubator for 10% off.

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#334 - Neonatal Neurology - A Year in a Review (ft the Newborn Brain Society) Jul 27, 2025

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In this episode of The Incubator Podcast, Daphna is joined by Dr. Pia Wintermark and Dr. Eleanor Molloy for a deep dive into the most impactful neonatal neurology studies of the past year. The discussion begins with a critical look at therapeutic hypothermia for mild hypoxic-ischemic encephalopathy (HIE) and preterm infants, highlighting recent pilot trials that challenge the practice of expanding cooling beyond established guidelines. They dissect key findings from multicenter studies, examining safety, feasibility, and the unintended consequences of “therapeutic creep.”

The conversation then shifts to the importance of precise terminology and standardized data collection in neonatal encephalopathy research. Pia and Eleanor explain why clearer definitions, genetic testing, placental pathology, and harmonized registries are essential for improving outcomes and guiding future clinical trials.

Finally, the team explores new and emerging interventions, including the feasibility of intranasal human milk as a stem cell therapy and the potential neuroprotective role of caffeine in neonatal hypoxia-ischemia models.

This episode offers a concise but comprehensive look at what’s shaping neonatal neurocritical care—from refining existing therapies to exploring innovative approaches that could change practice in the years ahead.

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#331 - 📑 Journal Club - The Complete Episode from July 20th 2025 Jul 20, 2025

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In this week’s Journal Club, Ben and Daphna dive into several impactful neonatal studies shaping today’s clinical decisions. The discussion opens with the MOCA Trial, exploring whether extending caffeine therapy in moderately preterm infants reduces hospital stays and improves outcomes. Despite reducing apnea episodes, the study highlights that extending caffeine treatment does not reduce time to discharge.

Next, the team reviews a randomized trial on late permissive hypercapnia in mechanically ventilated preterm infants, showing that targeting slightly higher CO₂ levels can shorten invasive ventilation time without worsening long-term outcomes.

Midway through the episode, we feature an EBNEO commentary with Dr. Kira McNellis on early full enteral nutrition with fortified milk in very preterm infants. She explains why fat-free mass is an important nutritional marker linked to neurodevelopment and why “negative” nutrition studies still matter for clinical practice.

Other key papers include cumulative neonatal morbidities predicting long-term neurodevelopment, the long-term academic

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#331 - [Journal Club Shorts] - 📌 Higher Carbon Dioxide Thresholds for Late Permissive Hypercapnia in Preterm Infants Jul 20, 2025

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Late Permissive Hypercapnia for Mechanically Ventilated Preterm Infants: A Randomized Trial.

Travers CP, Gentle SJ, Shukla VV, Aban I, Yee AJ, Armstead KM, Benz RL, Laney D, Ambalavanan N, Carlo WA.Pediatr Pulmonol. 2025 Jun;60(6):e71165. doi: 10.1002/ppul.71165.PMID: 40525736 Free PMC article. Clinical Trial.

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#331 - [Journal Club Shorts] - 📌 Clinical Recommendations for Imaging and Follow Up of Perinatal Urinary Tract Dilation Jul 20, 2025

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Perinatal Urinary Tract Dilation: Recommendations on Pre-/Postnatal Imaging, Prophylactic Antibiotics, and Follow-up: Clinical Report.

Anthony Herndon CD, Otero HJ, Hains D, Sweeney RM, Lockwood GM; Section on Urology; Section on Nephrology; Section on Radiology; Section on Hospital Medicine.Pediatrics. 2025 Jul 1;156(1):e2025071814. doi: 10.1542/peds.2025-071814.PMID: 40518141 Review.

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#331 - [Journal Club Shorts] - 📌 Extended Caffeine Treatment in Moderately Preterm Infants Does Not Shorten Hospital Stay Jul 20, 2025

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Extended Caffeine for Apnea in Moderately Preterm Infants: The MoCHA Randomized Clinical Trial.

Carlo WA, Eichenwald EC, Carper BA, Bell EF, Keszler M, Patel RM, Sánchez PJ, Goldberg RN, D'Angio CT, Van Meurs KP, Hibbs AM, Ambalavanan N, Cosby SS, Newman NS, Vohr BR, Walsh MC, Das A, Ohls RK, Fuller J, Rysavy MA, Ghavam S, Brion LP, Puopolo KM, Moore R, Baack ML, Colaizy TT, Baserga M, Osman AF, Merhar SL, Poindexter BB, DeMauro SB, Kumar V, Cotten CM; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.JAMA. 2025 Jun 24;333(24):2154-2163. doi: 10.1001/jama.2025.5791.PMID: 40294395 Clinical Trial.

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#331 - [Journal Club Shorts] - 📌 Three Neonatal Complications Strongly Associated with Adverse Long Term Outcomes Jul 20, 2025

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Association of a Count of Inpatient Morbidities with 2-Year Outcomes among Infants Born Extremely Preterm.

Dorner RA, Li L, DeMauro SB, Schmidt B, Zangeneh SZ, Vaucher Y, Wyckoff MH, Hintz S, Carlo WA, Gustafson KE, Das A, Katheria A; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.J Pediatr. 2025 Mar;278:114428. doi: 10.1016/j.jpeds.2024.114428. Epub 2024 Dec 4.PMID: 39643110

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