Send us Fan Mail

The transfusion threshold consensus is here — but practice hasn't fully caught up. In the second episode of On with VON, Ben and Daphna sit down with Dr. Roger Soll and Dr. Ravi Patel to extend the conversation from the Vermont Oxford Network Grand Rounds on evidence to practice for transfusion thresholds.

The core finding across trials is consistent: lower thresholds for both packed red blood cells and platelets appear safe. The guidelines are freely available in JAMA Network Open and actionable — 11, 10, 9 grams per deciliter across the first three weeks for infants on respiratory support. So why hasn't practice shifted uniformly?

The group works through the populations the trials didn't fully capture — hypoxic-ischemic encephalopathy, the most premature infants, and babies in the first week of life when intraventricular hemorrhage risk peaks. On NEC and feeding during transfusion: the data may surprise you. On transfusion volume and infusion duration: an underappreciated variable, particularly for platelets.

The episode closes with practical guidance on implementing transfusion guidelines at the unit level — who needs to be in the room, how informatics tools can support decision-making, and why understanding protocol deviations matters as much as the guidelines themselves.

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

The AAP has weighed in on therapeutic hypothermia for HIE, and Daphna walks through the clinical report in full. The core eligibility criteria haven't moved — but the edges have gotten more nuanced. Late initiation, the 35-week zone, mild HIE, sentinel events, MRI timing, and feeding during cooling are all addressed.

Also this week: a prospective pilot from Australia tests whether adding bedside ultrasound to plain radiography improves surgical risk stratification in NEC. The X-ray-only model couldn't separate the clusters. The combined model produced a more than six-fold difference in odds of surgery — complex ascites, absent peristalsis, and abnormal bowel perfusion did the heavy lifting.

Daphna then covers F-NeoBright, a small but compelling feasibility study testing intranasal fresh breast milk in infants with moderate to severe HIE. Ten babies, high adherence, no safety signals, and parents administering doses at home.

Ben rounds out Journal Club with the two-year follow-up of the CALI trial examining outcomes after early caffeine plus LISA versus CPAP alone. Mortality trended toward LISA. The statistics didn't get there — but the direction held.

The week closes with Ben and Eli on the Guttmacher Institute study linking restrictive abortion laws to higher maternal mortality across two decades of US data.

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

In this episode of Neo News, Ben and Eli discuss a sobering Guttmacher Institute study recently featured in Bloomberg. Analyzing data from 2005 to 2023, the research reveals a troubling association between restrictive abortion laws and increased maternal mortality, specifically driven by cardiovascular complications and violent deaths. The hosts explore the clinical and social pathophysiology behind these findings, emphasizing how a lack of prenatal care and compounded social stressors disproportionately affect birthing people. Tune in for an important conversation on the "package" of restrictions driving these outcomes and practical ways neonatal professionals can advocate for maternal health equity!

----

https://www.bloomberg.com/news/articles/2026-02-12/pregnant-women-die-at-higher-rates-when-states-restrict-abortion?srnd=phx-industries-health

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

In this Journal Club episode, Ben reviews a secondary analysis of the CALI trial, published in JAMA Network Open, examining two-year neurodevelopmental and pulmonary outcomes in preterm infants who received early caffeine combined with LISA versus caffeine and CPAP alone. Building on the original CALI trial's finding that early caffeine prior to LISA reduced intubation rates and BPD, this follow-up asks the next logical question: does that early advantage translate into better long-term outcomes? Ben walks through the Bayley scores, gross motor function, ASQ-3, M-CHAT, and pulmonary outcomes — and delivers a reassuring if not statistically significant picture. Tune in for a deep dive into the evidence behind one of neonatology's most debated respiratory strategies!

----

Two-Year Outcomes of Less Invasive Surfactant Administration Among Preterm Neonates: A Secondary Analysis of a Randomized Clinical Trial. Dorner RA, Morales A, Banerji A, Uy C, Ines F, Finer N, Vaucher Y, Katheria AC.JAMA Netw Open. 2026 Mar 2;9(3):e263852. doi: 10.1001/jamanetworkopen.2026.3852.PMID: 41915392

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

In this Journal Club episode, Daphna presents the F-NeoBright trial — a pilot feasibility and safety study out of Hungary exploring intranasal fresh breast milk administration in neonates with moderate to severe HIE undergoing therapeutic hypothermia. With so few adjunct therapies available beyond cooling, the idea of harnessing breast milk's rich bioactive components — including neurotrophic growth factors, cytokines, and multipotent stem cells — to support the developing brain is both compelling and refreshingly low-risk. Daphna walks us through the protocol, the feasibility outcomes, and why 100% of approached families consented, including those who had never planned to breastfeed. Sometimes the simplest intervention really is the right one!

----

F-NEO-BRIGHT: feasibility and safety of intranasal fresh breast milk in neonatal encephalopathy. Tarjanyi E, Jermendy A, Szabo M, Brandt FA, Szasz B, Nyilas N, Meder U.Pediatr Res. 2026 Mar 3. doi: 10.1038/s41390-026-04847-2. Online ahead of print.PMID: 41776367

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

In this Journal Club episode, Ben takes the lead and reviews a prospective cohort pilot study from the Archives of Disease in Childhood examining whether combining abdominal ultrasound with plain radiography can improve surgical risk stratification in neonates with suspected NEC. With mortality remaining as high as 20–40% and diagnosis still heavily reliant on clinical judgment, the stakes couldn't be higher. Ben walks through the study's unsupervised clustering approach, explaining how adding ultrasound data to X-ray findings produced a more than six-fold difference in the odds of surgery between risk groups — something X-ray alone simply couldn't achieve. Tune in to hear why dynamic ultrasound features like peristalsis, ascites, and bowel perfusion may be the missing piece in your NEC diagnostic toolkit!

----

Combining abdominal ultrasound and radiography for surgical risk stratification in necrotising enterocolitis: a prospective cohort pilot study. Priyadarshi A, Angiti R, Chabra S, McAdams R, Webb A, Badawi N, Hinder MK, Tracy MB.Arch Dis Child Fetal Neonatal Ed. 2026 Mar 5:fetalneonatal-2025-329960. doi: 10.1136/archdischild-2025-329960. 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

In this Journal Club episode, Ben and Daphna dive into the American Academy of Pediatrics' February Clinical Report on Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy. Daphna, who presented this paper at the Florida Neonatal Neurologic Network, walks us through the key action statements — from the established 33.5°C target temperature to the more nuanced discussions around late cooling (6–24 hours), gestational age eligibility at 35 weeks, and the controversial question of cooling mild HIE. They also cover optimal MRI timing post-rewarming, continuous EEG monitoring, early enteral feeds during cooling, and the growing evidence supporting the "cool cuddle." A must-listen for anyone navigating the evolving landscape of HIE management!

----

Therapeutic Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy: Clinical Report. Zanelli SA, Wusthoff CJ, Lucke AM, Kaufman DA; Committee on Fetus and Newborn; Section on Neurology.Pediatrics. 2026 Feb 1;157(2):e2025073627. doi: 10.1542/peds.2025-073627.PMID: 41581784 Review.

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

In this Tech Tuesday episode, Ben sits down with Dr. Itamar Nitzan and Alon Meritrikin-Gold, the co-founders of SkinCubator, a revolutionary wearable incubator designed to transform neonatal skin-to-skin care. They discuss how reframing kangaroo care from a rare procedure to a continuous necessity inspired this paradigm-shifting device. The hosts dive into the clinical logistics, from safely transferring intubated extremely preterm infants to alleviating parental anxiety and nursing resistance. Tune in to hear how this innovative "pocket incubator" maintains thermoregulation, secures critical lines, and promises to safely extend skin-to-skin duration for our most vulnerable NICU patients!

Learn more about the skincubator: https://www.skincubator-neocare.com/

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!