neonatal

Dr. Jennifer Harling, a pediatrician and medical missionary in Burundi, shares her experiences and challenges in providing healthcare in a low-resource setting. She discusses the decision to do medical mission work, the background of Burundi and the hospital where she works, the language and cultural challenges she faced, and the improvements she has made in neonatal care. Dr. Harling also talks about staying inspired and connected, her role in medical education, and the importance of finding a balance between work and personal life.

Links mentioned in the episode

https://mccropders.blogspot.com

Dr. Harling’s contact: jenniferb.harling@gmail.com

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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In this episode, Dr. David Kaufman discusses his interest in pediatrics and infectious disease, particularly in the prevention and treatment of neonatal infections. He highlights the challenges of antibiotic use in the NICU and the interplay between probiotics, prebiotics, antibiotics, and infections. Dr. Kaufman emphasizes the need for better quality control and standardization of probiotics, as well as the importance of consent and shared decision-making in their use. He also discusses the potential benefits of lactoferrin in reducing necrotizing enterocolitis (NEC) and the future directions in infection management. The episode concludes with a discussion of the Neonatal Antibiotic Stewardship web app.

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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In this episode, Dr. Jonathan Swanson discusses the evolution of neonatal nutrition and the major tenants of neonatal nutrition that have been learned over the years. He emphasizes the importance of breast milk and the role it plays in neurodevelopment and short-term outcomes. Dr. Swanson also explores the impact of necrotizing enterocolitis (NEC) on neonatal nutrition and the efforts to prevent NEC through good nutrition and optimizing homeostasis. The conversation then delves into the role of the maternal-fetal dyad in preparing the infant microbiome and the potential for probiotics to re-regulate the microbiome. The discussion concludes with a focus on the challenges and opportunities surrounding the use of probiotics in the NICU, including the role of families in decision-making and the impact of FDA regulations.

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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In this episode, Dr. Jonathan Blau discusses the FDA warning on probiotics and its implications for the future of probiotic use in the NICU. He expresses mixed feelings about the FDA's involvement and highlights the need for regulation while also expressing concerns about the way the warning was issued. The debate between single-strain and multi-strain probiotics is also discussed, with Dr. Blau emphasizing the importance of using the triple strain recommended by ESPAGAN and AAP. He shares his experiences with rolling out probiotics in his NICU, including the decision-making process and the involvement of different disciplines. The administration and preparation of probiotics, as well as the consent and assent process, are also explored. Dr. Blau concludes by discussing the outcomes of probiotic use in his NICU and the ethical considerations surrounding the use of probiotics.

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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In this episode, Dr. Jonathan Blau discusses the evidence for probiotics in the prevention of necrotizing enterocolitis (NEC) in the neonatal intensive care unit (NICU). He explains that the history of probiotics in neonatology spans almost 20 years, with meta-analyses showing a significant reduction in NEC rates. The pathophysiology of NEC is related to dysbiosis in premature infants, and probiotics aim to restore a healthy microbiome. The use of probiotics varies internationally, with Europe and Canada having higher rates of use compared to the United States. Dr. Blau also discusses the optimal study design for probiotics and the potential benefits beyond NEC prevention.

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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In this episode of the Incubator Podcast, Ben and Daphna discuss maternal mental health with Maureen Fiora, CEO of Mammha, a femtech startup aimed at revolutionizing maternal mental health care. Mammha focuses on addressing postpartum and perinatal depression by improving identification, diagnosis, referral, and treatment processes. Maureen shared her personal journey, highlighting the significant gaps in current healthcare systems regarding maternal mental health, emphasizing that less than 20% of physicians screen for these conditions. She detailed how Mammha streamlines screening with technology and ensures that women who screen positive receive comprehensive follow-up care, overcoming the usual fragmentation in care pathways.

The conversation also touched on the importance of screening in NICUs due to the heightened vulnerability of parents there, with Mammha capturing significant data on both mothers and fathers experiencing mental health issues. Maureen explained how Mammha operates, starting with provider-initiated screening using QR codes and validated tools, to engaging care coordinators for immediate follow-up. The company's success stories include partnerships and awards for their innovative approach to closing care gaps, especially among underserved populations.

Mammha's model has significantly increased engagement and follow-up care for screened parents, showcasing a promising pathway to better maternal mental health outcomes. Maureen's background in policy and advocacy, combined with personal experience, positions her uniquely to lead this initiative, aiming to make a tangible difference in the lives of parents navigating the challenges of mental health during the perinatal period.

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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In this week’s episode of The Incubator Podcast, hosts Ben Courchia, MD, and Daphna Yasova Barbeau, MD, dive into the complex world of neonatal care for infants with congenital heart disease. 

Our guest, Dr. Nim Goldshtrom, shares insights from his extensive experience in neonatology and pediatric cardiac intensive care, focusing on the multidisciplinary approach to caring for the sickest infants at Columbia University Irving Medical Center and Morgan Stanley Children’s Hospital. Dr. Goldshtrom discusses the evolution of his career, the importance of specialized training for dealing with congenital heart disease in neonates, and how modern technology like near-infrared spectroscopy (NIRS) is being used to improve patient outcomes. The conversation also touches on the challenges and opportunities presented by genetic screening and the future directions of neonatal and congenital heart disease care. Join us for an enlightening discussion that sheds light on the nuanced care required for these vulnerable patients and the ongoing advancements in the field.

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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Hello Friends,

We have a new episode of journal club for you this week. On this episode Ben & Daphna review the latest research in neonatology, and welcome the EBNEO team for a new commentary. The articles reviewed this week include:

Esophageal versus Rectal Temperature Monitoring during Whole-body Therapeutic Hypothermia for Hypoxic-ischemic Encephalopathy: Association with Short and Long-term Outcomes. Wu TW, Schmicker R, Wood TR, Mietzsch U, Comstock B, Heagerty PJ, Rao R, Gonzalez F, Juul S, Wu YW.J Pediatr. 2024 Feb 1:113933. doi: 10.1016/j.jpeds.2024.113933. Online ahead of print.PMID: 38309524 Free article.

Neonatal Outcomes After COVID-19 Vaccination in Pregnancy. Norman M, Magnus MC, Söderling J, Juliusson PB, Navér L, Örtqvist AK, Håberg S, Stephansson O.JAMA. 2024 Feb 6;331(5):396-407. doi: 10.1001/jama.2023.26945.PMID: 38319332

Maternal syphilis rates tripled in the US between 2016 and 2022, data show. Tanne JH.BMJ. 2024 Feb 15;384:q416. doi: 10.1136/bmj.q416.PMID: 38359912 No abstract available.

 Therapeutic hypothermia for preterm infants 34-35 weeks gestational age with neonatal encephalopathy. Kim SH, El-Shibiny H, Inder T, El-Dib M.J Perinatol. 2024 Jan 16. doi: 10.1038/s41372-024-01874-x. Online ahead of print.PMID: 38228763

Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins. Tracy MB, Hinder M, Morakeas S, Lowe K, Priyadarshi A, Crott M, Boustred M, Culcer M.Arch Dis Child Fetal Neonatal Ed. 2024 Feb 9:fetalneonatal-2023-326256. doi: 10.1136/archdischild-2023-326256. Online ahead of print.PMID: 38336472

Dextrose gel prophylaxis for neonatal hypoglycaemia and neurocognitive function at early school age: a randomised dosage trial. Wei X, Franke N, Alsweiler JM, Brown GTL, Gamble GD, McNeill A, Rogers J, Thompson B, Turuwhenua J, Wouldes TA, Harding JE, McKinlay CJD; pre-hPOD Early School-age Outcomes Study Group.Arch Dis Child Fetal Neonatal Ed. 2024 Feb 12:fetalneonatal-2023-326452. doi: 10.1136/archdischild-2023-326452. Online ahead of print.PMID: 38307710

Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomised controlled trial. Jensen, G. B., Domellöf, M., Ahlsson, F., Elfvin, A., Navér, L., & Abrahamsson, T. eClinicalMedicine (2023).

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula: A Randomized Clinical Trial. Colaizy TT, Poindexter BB, McDonald SA, et al. JAMA. 2024;331(7):582–591. doi:10.1001/jama.2023.27693

EBNEO Commentary: De-MIST-ifying the 2-year outcomes of non-invasive surfactant therapy. Loft L, Ferguson KN, Tingay DG. Acta Paediatr. 2024 Jan 25. doi: 10.1111/apa.17116. O

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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Esophageal versus Rectal Temperature Monitoring during Whole-body Therapeutic Hypothermia for Hypoxic-ischemic Encephalopathy: Association with Short and Long-term Outcomes. Wu TW, Schmicker R, Wood TR, Mietzsch U, Comstock B, Heagerty PJ, Rao R, Gonzalez F, Juul S, Wu YW.J Pediatr. 2024 Feb 1:113933. doi: 10.1016/j.jpeds.2024.113933. Online ahead of print.PMID: 38309524 Free article.

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!

EBNEO Commentary: De-MIST-ifying the 2-year outcomes of non-invasive surfactant therapy. Loft L, Ferguson KN, Tingay DG.Acta Paediatr. 2024 Jan 25. doi: 10.1111/apa.17116. Online ahead of print.

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!

Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomised controlled trial. Jensen, G. B., Domellöf, M., Ahlsson, F., Elfvin, A., Navér, L., & Abrahamsson, T. eClinicalMedicine (2023).

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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Summary
Dr. Eliza Myers, an academic neonatologist, shares her journey in neonatology and her passion for combining art and medicine. She discusses the importance of pursuing personal passions and making time for hobbies. Dr. Myers also highlights the role of visual arts in medicine and the impact it has on creativity and problem-solving. She then delves into her dedication to breastfeeding and lactation, including the development of the Track My Milk app. She explains the process of building the app and its integration into the electronic medical record system. Dr. Myers emphasizes the importance of parent compliance and engagement in using the app and the positive impact it has on the bedside experience. She also discusses the collaboration between physicians and lactation specialists and the support needed for trainees with unique ideas. Finally, Dr. Myers shares her thoughts on expanding the app to other electronic medical record systems and the challenges and rewards of the development process. In this conversation, Eliza Myers discusses her work on Track My Milk, a mobile app for tracking breast milk production. The conversation covers challenges of collaboration, the impact of technology on research in medicine, the importance of parent engagement and data collection, the potential of artificial intelligence in healthcare, and the exploration of brain microstructure in neonatology. The conversation concludes with a discussion on the future of Track My Milk and its potential dissemination.

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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In this episode of “At the Bench”, we have the privilege of interviewing one of our hosts, Dr. Misty Good. Dr. Good discusses her amazing career journey from learning to pipette water at the beginning of her neonatology fellowship to becoming a multiple R01-funded investigator. She shares how she is inspired every day to improve the care of preterm infants with necrotizing enterocolitis through her research and how she decided to pursue a career as a physician-scientist due to the desire to improve the lives of all babies. Dr. Good’s story serves as an inspiration to early career faculty and those navigating the challenging but incredibly rewarding career path of a neonatologist-scientist. 

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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In this week's episode of The Incubator Podcast's Journal Club, Ben and Daphna delve into recent pivotal studies impacting neonatal intensive care. Their expert discussion navigates through the latest research findings, offering deep insights for professionals in the field. Highlights include:

• Hydrocortisone in Preterm Neonates for BPD Prevention: A detailed analysis of hydrocortisone's role in preventing bronchopulmonary dysplasia, based on a systematic review and meta-analysis.
• Factors Influencing CRP Status in Neonates: An exploration of the determinants affecting C-reactive protein levels, with a focus on gestational age, birth weight, and specific maternal and neonatal conditions.
• Transition to Adulthood for Extremely Preterm Survivors: Insights from a longitudinal study on the long-term outcomes of extremely preterm/low birth weight survivors in education, employment, and health.
• Sustained Inflation and Chest Compression in Neonatal CPR: A comparison of CPR methods for asphyxiated newborns, evaluating sustained inflation versus traditional compression to ventilation ratios.
• Early vs. Late Tracheostomy in Infants with Severe BPD: An examination of the neurodevelopmental outcomes associated with the timing of tracheostomy in infants with severe BPD and the impact of postnatal steroid exposure.

Join us for a deep dive into these topics, designed to inform and challenge the current understanding and practices in neonatal care.

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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Hydrocortisone in very preterm neonates for BPD prevention: meta-analysis and effect size modifiers.

De Luca D, Ferraioli S, Watterberg KL, Baud O, Gualano MR.Arch Dis Child Fetal Neonatal Ed. 2024 Jan 17:fetalneonatal-2023-326254. doi: 10.1136/archdischild-2023-326254. Online ahead of print.PMID: 38237961

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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In this episode, Shelly-Ann, Ben, and Gabriel discuss the Newborn Toolkit with Dr. Joy Lawn, Dr. Mbozu Sipalo, and Lauren Allison from the Newborn Toolkit Team. They highlight the importance of newborn care, the challenges faced in providing adequate care globally, and the development of the Newborn Toolkit to address these challenges. 

Newborn Toolkit link - https://newborntoolkit.org/toolkit

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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In this episode of The Incubator, hosts Ben and Daphna discuss Bronchopulmonary Dysplasia (BPD) with Dr. Steve Abman, Dr. Milenka Cuevas Guaman, and Dr. Laurie C. Eldredge from the BPD Collaborative. They cover the progression of BPD understanding, emphasizing the collaborative efforts in neonatology, the critical role of interdisciplinary care, and current approaches to improve patient outcomes.

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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In this episode of The Incubator Podcast, hosts Ben and Daphna sit down with Tracy Warren, co-founder and CEO of Astarte Medical, to discuss the NICUtrition tool. They delve into how NICUtrition is tailored to improve nutritional outcomes in premature infants, its development journey, and real-world application insights.

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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In the latest episode of the Incubator Podcast's Journal Club, the hosts, Ben and Daphna, delve into a detailed discussion of recent neonatology research.

• The Oscar Trial: Examined the efficacy of early ibuprofen treatment for large patent ductus arteriosus (PDA) in extremely preterm infants to improve outcomes like survival and severe bronchopulmonary dysplasia (BPD). The study, a randomized double-blind placebo-controlled trial across 32 UK units, found no significant benefit of early ibuprofen treatment.
• Breastfeeding as a Protective Factor Against BPD: A retrospective study from the British Journal of Nutrition by José Uberos, focusing on the intake of mother's own milk, donor human milk, or preterm formula within the first two weeks of life in very low birth weight infants. It highlighted the benefits of mother's milk in reducing the odds of BPD and noted the importance of enteral nutrition in the development of BPD.
• Clinical Chorioamnionitis and Neurodevelopment: Drawn from the Epipage to cohort, the study found no significant association between clinical chorioamnionitis and neurodevelopmental disorders at five years of age for infants born between 24 and 34 weeks of gestation.
• Polyethylene Bags Before Cord Clamping: This randomized control trial published in the Archives of Disease in Childhood investigated whether placing very preterm infants in a polyethylene bag before cord clamping could ensure normothermia upon NICU admission. The trial concluded that there was no significant difference in the normothermia rates between those bagged before and after cord clamping.
• Marijuana Use and Breastfeeding: Survey results from a Pediatrics journal article showing variability in hospital practices regarding breastfeeding for mothers who use marijuana. It calls for more standardized, evidence-based practices to ensure healthcare equity.
• Platelet Transfusion and Neurodevelopmental Impairment: A JAMA Network Open study using data from the PEANUT trial, examining the association between platelet transfusion exposure and death or severe neurodevelopmental impairment at two years of age in extremely preterm children.
• Azithromycin During Routine Well Infant Visits: A study from Burkina Faso published in the New England Journal of Medicine tested the effectiveness of Azithromycin given during routine health care visits in preventing infant mortality. The results did not support the prophylactic use of Azithromycin for this purpose.
• Challenges in Managing Refractory Pain and Sedation in Infants: A review article from Frontiers in Pharmacology compiling guidelines and providing insights into the management of pain, sedation, and withdrawal in infants, including the issue of delirium in the NICU setting.
• EBNEO Commentary with Dr. Eugene How and Dr. Cami Martin on the study by Ariel Salas et al published in Pediatrics: Early human milk fortification in infants born extremely preterm: A randomised trial. 

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!

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!