The Incubator

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This week on The Incubator Podcast, Ben and Daphna dig into four studies testing what the evidence supports at the bedside. They open with the 24-month BeNeDuctus follow-up, where expectant management and early ibuprofen for PDA yield identical survival without neurodevelopmental impairment. Daphna then presents the Nourish trial, finding individually targeted milk fortification did not improve growth, body composition, or brain MRI outcomes. Next, a Dutch study links probiotics to halved NEC rates, but rising non-NEC mortality and a fatal probiotic sepsis case leave Ben ambivalent. Daphna closes Journal Club with an Australian cohort suggesting nearly a third of NICU deaths met organ donor criteria. The week wraps with Ben and Eli on Neo News, unpacking a sibling-matched study finding no link between prenatal Tylenol and autism or ADHD.
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Long-Term Outcomes of Expectant Management versus Early Ibuprofen for Patent Ductus Arteriosus: 24-Month Follow-Up of the BeNeDuctus Trial. Apers WMJ, Hundscheid T, Kooi EMW, Onland W, Vijlbrief D, Steiner K, Donders R, Mulder AL, de Boode WP; BeNeDuctus Trial Investigators.J Pediatr. 2026 Sep 17;299:115292. doi: 10.1016/j.jpeds.2026.115292. Online ahead of print.PMID: 42637114
Individually Targeted Human Milk Fortification: A Randomized Clinical Trial. Belfort MB, Ahtam B, Bell KA, Berger P, Cherkerzian S, Ellard D, Foster L, Fusch C, Gagoski B, Grant PE, Kuncham M, Pepin H, Solti M, Steele T, Woodward L, Inder T.JAMA Pediatr. 2026 Sep 14:e264220. doi: 10.1001/jamapediatrics.2026.4220. Online ahead of print.PMID: 42734908
Probiotic Implementation and Necrotizing Enterocolitis Risk in Preterm Infants. Imren C, Jongejans V, Onland W, Keyzer-Dekker CMG, Been JV, Derikx JPM, van Kaam AH, Simons SHP, Twisk JWR, van den Akker CHP, Vermeulen MJ.JAMA Netw Open. 2026 Aug 3;9(8):e2631601. doi: 10.1001/jamanetworkopen.2026.31601.PMID: 42671836 Free PMC article.
Potential Neonatal Donors in Australia: A National Cohort Study. Barzegar R, Cavazzoni E, Popat H, Wong G.Pediatrics. 2026 Sep 3:e2025075110. doi: 10.1542/peds.2025-075110. Online ahead of print.PMID: 42686207
The Untapped Potential of Organ Donation from the NICU. Nguyen BV, Coloma M, Crouch EE.Pediatrics. 2026 Sep 3:e2026076954. doi: 10.1542/peds.2026-076954. Online ahead of print.PMID: 42686210 No abstract available.
Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts. Luo S, Gong Q, Ai Y, Zhang J, Chan L, Wong WCW, Ip P, Chan EWY, Tanuseputro P, Wong ICK, Wan EYF.JAMA Intern Med. 2026 Sep 1;186(9):1102-1111. doi: 10.1001/jamainternmed.2026.2215.PMID: 42371637
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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Does Tylenol in pregnancy cause autism or ADHD? In this edition of Neo News, Ben and Eli break down a major JAMA Internal Medicine study from Hong Kong that followed hundreds of thousands of mother-child pairs and used a sibling-matched design to answer the question. The verdict: no association between prenatal acetaminophen exposure and autism spectrum disorder or ADHD, regardless of timing, pattern, or dose. But data alone doesn't win hearts. The conversation turns to the bedside: how do we explain study methodology to families without dismissing their concerns? Eli shares his approach to vaccine hesitancy in the NICU, built on continuity, persistence, and transparency, and draws lessons from journalism about corrections, trust, and why showing up matters. Tune in.
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Prenatal Acetaminophen (Paracetamol) Use and the Risk of Autism and/or Attention-Deficit/Hyperactivity Disorder Among Sibling-Matched Cohorts. Luo S, Gong Q, Ai Y, Zhang J, Chan L, Wong WCW, Ip P, Chan EWY, Tanuseputro P, Wong ICK, Wan EYF.JAMA Intern Med. 2026 Sep 1;186(9):1102-1111. doi: 10.1001/jamainternmed.2026.2215.PMID: 42371637
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 reviews the first national estimate of potential neonatal organ donors, a Pediatrics cohort study from 23 Australian NICUs, along with its companion commentary. Of 1,760 infants who died in the NICU between 2012 and 2022 at 35 weeks corrected age or later, about one in three met conservative eligibility criteria. Most would have donated after circulatory death, and a smaller group with severe HIE could potentially have donated after neurological determination of death. They discuss referral timing, outcomes of en bloc kidney transplants from neonatal donors, and how NICUs can offer families this option as part of end-of-life care.
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Potential Neonatal Donors in Australia: A National Cohort Study. Barzegar R, Cavazzoni E, Popat H, Wong G.Pediatrics. 2026 Sep 3:e2025075110. doi: 10.1542/peds.2025-075110. Online ahead of print.PMID: 42686207
The Untapped Potential of Organ Donation from the NICU. Nguyen BV, Coloma M, Crouch EE.Pediatrics. 2026 Sep 3:e2026076954. doi: 10.1542/peds.2026-076954. Online ahead of print.PMID: 42686210 No abstract available.
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 JAMA Network Open study from two Dutch Level IV NICUs. It examined NEC before and after routine implementation of a three-strain probiotic in 1,413 infants born before 30 weeks or under 1,000 grams. NEC fell from 11.9% to 5.3%, and late-onset sepsis also declined. But non-NEC mortality rose after implementation. NEC also dropped in an unexposed reference cohort, and one infant died of B. infantis sepsis. Ben and Daphna discuss how baseline NEC rates, seasonal patterns, and number needed to harm should shape how units weigh probiotic use.
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Probiotic Implementation and Necrotizing Enterocolitis Risk in Preterm Infants. Imren C, Jongejans V, Onland W, Keyzer-Dekker CMG, Been JV, Derikx JPM, van Kaam AH, Simons SHP, Twisk JWR, van den Akker CHP, Vermeulen MJ.JAMA Netw Open. 2026 Aug 3;9(8):e2631601. doi: 10.1001/jamanetworkopen.2026.31601.PMID: 42671836 Free PMC article.
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 a JAMA Pediatrics randomized trial led by Mandy Belfort and Terrie Inder. It tested whether point-of-care human milk analysis, used to individually target protein and fat fortification, improves outcomes in infants born at 24 to 30 weeks. Milk was analyzed every weekday with the Miris analyzer. Fortification in the intervention group was adjusted to meet protein and energy targets. Growth, body composition by air displacement plethysmography, and term-equivalent brain MRI were no different from standard fortification, and all infants met recommended intakes. Two-year outcomes will be reported separately.
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Individually Targeted Human Milk Fortification: A Randomized Clinical Trial. Belfort MB, Ahtam B, Bell KA, Berger P, Cherkerzian S, Ellard D, Foster L, Fusch C, Gagoski B, Grant PE, Kuncham M, Pepin H, Solti M, Steele T, Woodward L, Inder T.JAMA Pediatr. 2026 Sep 14:e264220. doi: 10.1001/jamapediatrics.2026.4220. Online ahead of print.PMID: 42734908
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!