The Incubator

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Disclosure: Dr. Wanda Barfield appeared on this episode in her personal capacity. The views she expresses are her own and do not represent the official positions of the Centers for Disease Control and Prevention, the Department of Health and Human Services, or the United States government.
The American Academy of Pediatrics has never had a neonatologist as president. This September, that could change. In this special episode, Ben sits down with Dr. Wanda Barfield, neonatologist, retired Rear Admiral and Assistant Surgeon General in the US Public Health Service, and longtime director of the CDC's Division of Reproductive Health, to hear what she would bring to the role. She lays out her three priorities, supporting pediatricians, protecting access, and leading with science and equity, and addresses the questions our field is wrestling with right now: training, staffing, the erosion of trust in science, and whether neonatology should go it alone. Her answer is that we are stronger together, and that having a neonatologist at the helm of the AAP would give our specialty a voice it has never had. Voting is open to AAP members through September 16. Meet the candidate, then go vote.

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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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This week's Journal Club. Monday, nasal CPAP versus NIPPV as the bridge to minimally invasive surfactant in infants born before 30 weeks, first author Dr. Hui Zhang. Tuesday, the PAEAN trial on high-dose erythropoietin for neonatal HIE, led by Dr. Helen Liley. Wednesday, extended infusion versus bolus feeding for weight gain in extremely-low-birth-weight infants, from Dr. Haribalakrishna Balasubramanian's team in India. Thursday, the DROP-ROP trial, testing dexamethasone eye drops against treatment-requiring ROP, led by Dr. Ann Hellström. Friday, Neo News: Eli and Ben on The Pitt's viral boundary-setting scene and what it says about burnout in medicine.
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Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation in Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial. Zhang H, Zhang Y, Zeng L, Tong X, Piao M, He H, Zhao C, Xie H, Zheng Z, Cui Q, Lai Y, Wang H, Wang L, Liu H, Tian X, Wu H, Kang L, Han T.JAMA Netw Open. 2026 Jun 1;9(6):e2619785. doi: 10.1001/jamanetworkopen.2026.19785.
Erythropoietin for Neonatal Hypoxic-Ischemic Encephalopathy: A Randomized Clinical Trial. Liley HG, Hunt RW, O'Connell RL, Battin MR, Novak I, Wu YW, Ballard R, Askie L, Badawi N, Ghadge A, Jacobs SE, Juul SE, Sebastian L, Wagh D, Simes RJ; PAEAN Study Investigators.JAMA Pediatr. 2026 Jul 27:e263082. doi: 10.1001/jamapediatrics.2026.3082. Online ahead of print.
Effect of Extended Infusion Versus Intermittent Bolus Feedings on Hospital Weight Gain in Extremely Low Birth Weight Infants Born at <29 Weeks of Gestation: A Randomized Noninferiority Clinical Trial. Balasubramanian H, Sahoo M, Chhadva D, Choubey R, Sakharkar S, Pillai A, Kabra NS.J Pediatr. 2026 Jul 13;298:115235. doi: 10.1016/j.jpeds.2026.115235. Online ahead of print.
Dexamethasone Eye Drops to Prevent Treatment-Requiring Retinopathy of Prematurity: The DROPROP Randomized Clinical Trial. Hellström A, Petrishka-Lozenska M, Sjöbom U, Wallander J, Nilsson AK, Löfqvist C, Ley D, Gränse L, Öhnell HM, Hård AL, Jakobsson G, Sävman K, Domellöf M, Löfgren S, Larsson E, Smith LEH, Pivodic A, Lundgren P; DROPROP Collaboration Group.JAMA Pediatr. 2026 Aug 3:e263247. doi: 10.1001/jamapediatrics.2026.3247. Online ahead of print.
Haridasani Gupta A. On "The Pitt," She Clocked Out on Time. In Real Life, It Started a Debate. The New York Times. May 11, 2026. https://www.nytimes.com/2026/05/11/style/the-pitt-joy-kwon-irene-choi-work-life-balance.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!

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A medical student on The Pitt finishes her shift, is asked to stay, and tells her supervisor to learn some boundaries. The internet did not let it go. Ben and Eli use that moment to work through what boundary setting actually looks like in a NICU, why a tired clinician makes different decisions at three in the morning than at three in the afternoon, and where duty hours collide with the fact that patients do not arrive on a curriculum. Also, why handing a resident your pager at two PM may be the cheapest patient safety intervention available.
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Haridasani Gupta A. On "The Pitt," She Clocked Out on Time. In Real Life, It Started a Debate. The New York Times. May 11, 2026. https://www.nytimes.com/2026/05/11/style/the-pitt-joy-kwon-irene-choi-work-life-balance.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 us Fan Mail
Steroids again? This time in the eye. Daphna brings the DROP-ROP trial from JAMA Pediatrics, a double-masked randomized study across fourteen Swedish centers asking whether topical dexamethasone can stop pre-threshold ROP from progressing to type one disease. One hundred infants, born under 30 weeks, dosed for up to twelve weeks, some still getting drops at home. Twenty percent needed laser or anti-VEGF in the dexamethasone arm versus thirty-eight percent on placebo, a relative risk reduction that did not reach significance. Ben and Daphna talk through the safety signals, the intraocular pressure question, and how fast our field adopts promising ROP data.
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Dexamethasone Eye Drops to Prevent Treatment-Requiring Retinopathy of Prematurity: The DROPROP Randomized Clinical Trial. Hellström A, Petrishka-Lozenska M, Sjöbom U, Wallander J, Nilsson AK, Löfqvist C, Ley D, Gränse L, Öhnell HM, Hård AL, Jakobsson G, Sävman K, Domellöf M, Löfgren S, Larsson E, Smith LEH, Pivodic A, Lundgren P; DROPROP Collaboration Group.JAMA Pediatr. 2026 Aug 3:e263247. doi: 10.1001/jamapediatrics.2026.3247. Online ahead of print.
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
Every unit has a bolus camp and a continuous camp, and both are usually dug in. Ben brings a single center non-inferiority trial from India, published in the Journal of Pediatrics, randomizing 132 infants born before 29 weeks and under a thousand grams to extended infusion feeding or two hourly bolus feeds. Weight gain at discharge was essentially identical at 15.3 versus 15.7 grams per kilo per day, but the infusion group lost two fewer days to interrupted feeds. Ben and Daphna talk through the five on one off infusion cycle, two hourly bolus feeding, and why fewer interruptions may be the real outcome.
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Effect of Extended Infusion Versus Intermittent Bolus Feedings on Hospital Weight Gain in Extremely Low Birth Weight Infants Born at <29 Weeks of Gestation: A Randomized Noninferiority Clinical Trial. Balasubramanian H, Sahoo M, Chhadva D, Choubey R, Sakharkar S, Pillai A, Kabra NS.J Pediatr. 2026 Jul 13;298:115235. doi: 10.1016/j.jpeds.2026.115235. Online ahead of print.
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!