The Incubator

Latest Episodes:

#440 - 🔵 [PAS 2026] - Could Donor Milk Cream Replace Dextrose Gel for Newborn Hypoglycemia? Apr 28, 2026

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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 — highlighting the well-known limitations of dextrose gel including inconsistent dosing, poor tolerance, and the way it interferes with breastfeeding immediately after administration. In 25 babies treated with cream, blood glucose rose from a median of 36 to 56 mg/dL, only one baby required NICU admission, and nurses and families loved it. She also shares her center's experience with probiotics in extremely low birth weight infants — where NEC rates dropped significantly with no cases of probiotic sepsis — and raises the urgent question of what is happening to NEC rates now that probiotics have been pulled from use in the US.

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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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#440 - 🔵 [PAS 2026] - Could a Quarterly Injection Replace a Liver Transplant for This Rare Kidney Disease? Apr 27, 2026

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Dr. David Sas, pediatric nephrologist at Mayo Clinic, joins Ben to discuss primary hyperoxaluria type 1 — 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 — showing that urinary oxalate drops rapidly within the first three months and stays down with quarterly injections, potentially changing the trajectory of this disease forever. He also issues a direct call to urologists and nephrologists everywhere: if your patient has recurrent calcium oxalate stones, check a 24-hour urine — because primary hyperoxaluria is almost certainly being missed.

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#440 - 🔵 [PAS 2026] - What Does It Take to Build a Pediatric Transport Team From Scratch? Apr 27, 2026

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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 — 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 transport program from the ground up, presents early pilot data using the NASA Task Load Index to measure the subjective cognitive burden on transport nurses and respiratory therapists, and makes an open call for collaboration with anyone else navigating the same uncharted territory — because the transport leg of a critically ill child's journey should never be an afterthought.

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#440 - 🔵 [PAS 2026] - Is Gaming Addiction in Kids With ADHD About the Games or the Parenting? Apr 27, 2026

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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 — more than hyperactivity, anxiety, depression, or autism symptoms — was the factor most strongly associated with meeting criteria for gaming addiction, mirroring patterns seen in adolescent research. Perhaps most striking was the parenting finding: each additional negative parenting behavior, such as yelling or losing one's temper, tripled the child's risk of gaming addiction — suggesting that evidence-based parent training programs already used in ADHD populations may be one of the most promising avenues for intervention.

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#440 - 🔵 [PAS 2026] - Are We Studying the Right Things the Right Way in Neonatology? Apr 27, 2026

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Dr. Lily Lou joins Daphna and Rupa to reflect on this year's Silverman Lecture at PAS — the annual honorary lecture of the AAP Section on Neonatal Perinatal Medicine — 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 appropriately, and publishing the right amount? Dr. Lou also makes a heartfelt call for trainees to prioritize these foundational lectures alongside the practical career-building sessions, arguing that understanding the history and philosophy of how neonatology does science is just as important as learning how to get published.

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#440 - 🔵 [PAS 2026] - Is the Real Fix to Neonatology Training Shorter Residency, Not Shorter Fellowship? Apr 27, 2026

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Dr. Satyan Lakshminrusimha, pediatric chair and neonatologist, joins Ben hot off the ONTPD meeting to share his perspective on the ABP fellowship reform debate — and it's more nuanced than a simple yes or no to a two-year fellowship. He argues that the real problem is a six-year training pipeline that is driving medical students away from pediatric subspecialties under crushing debt, and that the solution for procedure-heavy specialties like neonatology is not to shorten fellowship but to truncate the pediatric residency to two years — following the precedent already set by pediatric neurology. He also makes the case that the workforce crisis is ultimately an entry ticket problem: before debating fellowship length, we need to convince more medical students to choose pediatrics in the first place, and more pediatric residents to choose subspecialty training before it's too late.

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#440 - 🔵 [PAS 2026] - Are We Actually Delivering Good Bag Mask Ventilation in the Delivery Room? Apr 27, 2026

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Dr. Nathan Sundgren, neonatologist and NRP educator at Texas Children's Hospital, joins Ben to discuss one of the most deceptively difficult skills in neonatal resuscitation — effective bag mask ventilation. He shares findings from a fellowship training study showing that respiratory function monitor feedback improves ventilation technique equally well across all three device types, and tackles the harder question of why that same technology has yet to show clinical benefit in the delivery room — pointing to human factors, cognitive overload, and the need for a dedicated respiratory coach role rather than a better device alone. He also reflects on the evolution of team leadership in neonatal resuscitation, why doing a procedure and leading a team simultaneously is impossible, and where people can find his free educational content on YouTube at Texan Neo-Ed.

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#440 - 🔵 [PAS 2026] - What If a Conference Actually Told You Both Sides of Every Controversy? Apr 27, 2026

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Dr. Matthew Saxonhouse, neonatologist at Atrium Health, joins Ben to discuss two initiatives designed to fill the gaps that traditional conferences often leave behind. The first is Neonatal Insights, a biennial meeting returning January 29-31, 2027 in Houston — both in person and virtual — where controversial topics like the new hypoglycemia guidelines, cord blood transfusions, optimal caloric targets for growing infants, and wasteful NICU practices are presented from all sides with the explicit goal of reaching a working consensus. The second is Neonatal Insider, a monthly virtual series combining physiology and current evidence on hot topics, now opening its five-year archive to subscribers. He also reflects on why education that presents competing perspectives honestly is one of the most valuable things neonatology can offer its community.

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#440 - 🔵 [PAS 2026] - Is There a Journal That Actually Lets Everyone in Neonatology Publish? Apr 27, 2026

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Dr. Mitchell Goldstein, neonatologist at Loma Linda University and editor-in-chief of Neonatology Today, joins Ben to share the story behind one of neonatology's most accessible and wide-reaching publications — a peer-reviewed, open-access journal with 25,000 monthly readers worldwide, no publication fees, no page limits, and no color charges. He explains the philosophy behind the Academic True Open Model that guides the journal, why author development and rapid peer review turnaround of as little as 72 hours set it apart, and how the journal has used platforms like LinkedIn to find voices that traditional publishing would never have reached. He also highlights the 39th International Gravens Conference on the Physical and Developmental Environment of the High-Risk Infant, taking place June 16-18 in South Bend, Indiana — use code Special10 for 10% off registration.

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#440 - 🔵 [PAS 2026] - What Do We Actually Know About Epinephrine in Neonatal Resuscitation? Apr 27, 2026

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Dr. Jayasree Nair, neonatal resuscitation expert, joins Ben to reflect on one of the most humbling realities in neonatology — nearly everything we know about epinephrine use in extensive neonatal resuscitation comes from animal studies, adult data, or pediatric populations, not neonates. She explains why the pyramid of resuscitation research narrows dramatically as you move toward chest compressions and epinephrine, why randomized controlled trials in this space may never be fully achievable, and why collaborative registries like the DRIVE network offer one of the most promising paths forward. She also shares her experience piloting the new NRP NICU resuscitation module and reflects on how the two-year fellowship debate ultimately circles back to the same root problem: the financial sustainability of a career in academic pediatrics.

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