Neonatologist, blogger at neonatalresearch.org, father of extreme preterm infanthttps://bsky.app/profile/neonatalresearch.bsky.socialhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3msgqcnqew32uNot neonatology. Trip to Costa Rica Our family vacation this year was to Costa Rica. One week just Annie and me, then another 2 weeks with Annie's mother and 2 of our children. Costa Rica has a well-deserved reputation as a destination for holidays with abundant easy access to wildlife. 30% of… http://neonatalresearch.org/2026/08/06/not-neonatology-trip-to-costa-rica/06 Aug 2026 19:05 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3msgqcnqew32uhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3msgqaftttx2dRoutine vitamin K prophylaxis. Why are there so many refusals? This is still a fairly rare phenomenon in my hospital, but it does seem to increasing slightly here, as it is just about everywhere else. The science is settled, transplacental transfer of vitamin K is extremely limited, hepatic stores… http://neonatalresearch.org/2026/08/06/routine-vitamin-k-prophylaxis-why-are-there-so-many-refusals/06 Aug 2026 19:03 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3msgqaftttx2dhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mprbbpmjym2eFinally, a SMART approach for the PDA? One of the thorniest topics in neonatology currently. Some experts seem certain that we can define PDAs that benefit from early treatment. In contrast, the recent trials don't show any clinical benefit in early treated groups compared to controls, and indeed… http://neonatalresearch.org/2026/07/03/finally-a-smart-approach-for-the-pda/03 Jul 2026 19:19 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mprbbpmjym2ehttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mkldbbc5xb2zA new standard for NOWS Neonatal Opioid Withdrawal is a major public health problem in the world. Large numbers of infants born after fetal exposure to opioids experience unpleasant symptoms, requiring non-pharmacologic and pharmacologic intervention. Studies of different approaches for symptom… http://neonatalresearch.org/2026/04/28/a-new-standard-for-nows/28 Apr 2026 19:33 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mkldbbc5xb2zhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mi2xrmfdvv26Neonatal Research Shorts : March 2026 Pineda R, et al. Language and sound exposure across neonatal intensive care hospitalization and relationships with early outcome. J Perinatol 2026. In this short term outcome study, 64 very preterm infants http://neonatalresearch.org/2026/03/27/neonatal-research-shorts-march-2026/27 Mar 2026 20:34 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mi2xrmfdvv26https://bsky.app/profile/neonatalresearch.bsky.social/post/3mhxyfutqla2eSteroids and BPD, what do we really know? My first foray into systematic review and meta-analysis was about 25 years ago with this article Barrington KJ. The adverse neuro-developmental effects of postnatal steroids in the preterm infant: a systematic review of RCTs. BMC Pediatr. 2001;1:1. As you… http://neonatalresearch.org/2026/03/26/steroids-and-bpd-what-do-we-really-know/26 Mar 2026 16:08 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mhxyfutqla2ehttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mhja6c2oj322Registration of clinical trials. Since 2005 the International Committee of Medical Journal Editors has required that a condition of publication of a prospective controlled trial is that it should be registered in an accessible database prior to starting the trial. It is understandable that for a… http://neonatalresearch.org/2026/03/20/registration-of-clinical-trials/20 Mar 2026 19:17 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mhja6c2oj322https://bsky.app/profile/neonatalresearch.bsky.social/post/3mhixc6egyi22Neonatal Acute Respiratory Distress Syndrome, what is it and how should we treat it? ARDS is a fairly common problem in the adult and the paediatric ICU; following trauma, or systemic sepsis, or other extrapulmonary insults, usually inflammatory in nature, or as a complication of direct pulmonary… http://neonatalresearch.org/2026/03/20/neonatal-acute-respiratory-distress-syndrome-what-is-it-and-how-should-we-treat-it/20 Mar 2026 16:38 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mhixc6egyi22https://bsky.app/profile/neonatalresearch.bsky.social/post/3mhbcg2tvvd23Neonatal Research Shorts : February 2026 Dereymaeker A, et al. Neonatal sleep physiology and early executive functioning in preterm children. Pediatr Res. 2026. In this observational study, the authors recorded sleep architecture overnight shortly prior to discharge of 76 preterm infants,… http://neonatalresearch.org/2026/03/17/neonatal-research-shorts-february-2026/17 Mar 2026 15:36 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mhbcg2tvvd23https://bsky.app/profile/neonatalresearch.bsky.social/post/3mgx2gichtb23Optimizing ventilation in established BPD Babies with established BPD (I won't worry about the exact diagnostic criteria here, but very preterm infants who are still ventilated as they approach term are the group I am talking about) have somewhat reduced compliance, increased airways resistance,… http://neonatalresearch.org/2026/03/13/optimizing-ventilation-in-established-bpd/13 Mar 2026 13:46 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mgx2gichtb23https://bsky.app/profile/neonatalresearch.bsky.social/post/3mg3ppkdi3v2jManaging Post-Haemorrhagic Hydrocephalus PHH, as I will call it, is an extremely important determinant of outcomes in a small subgroup of preterm infants. Infants with severe IVH who don't develop PHH have outcomes that are little affected. As our group reviewed, even grade 4 IVH, if unilateral,… http://neonatalresearch.org/2026/03/02/managing-post-haemorrhagic-hydrocephalus/02 Mar 2026 16:52 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mg3ppkdi3v2jhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mftu3hnw2j23Give your opinion: what should we call the most immature babies? There is an upcoming workshop, sponsored by the AAP, and other groups, that is investigating what shared language should be used for the babies of less than 25 weeks gestation. At present there are not as many responses as they would… http://neonatalresearch.org/2026/02/27/give-your-opinion-what-should-we-call-the-most-immature-babies/27 Feb 2026 13:49 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mftu3hnw2j23https://bsky.app/profile/neonatalresearch.bsky.social/post/3mf5tebig7y2hAutomated oxygen control; is it worth it? The history of automated controls of inspired oxygen goes back many decades, to before the invention of pulse oximetry. The first studies I remember used transcutaneous PO2 as the target variable, which had major limitations, as well as the advantage of… http://neonatalresearch.org/2026/02/18/automated-oxygen-control-is-it-worth-it/18 Feb 2026 19:38 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mf5tebig7y2hhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mf3ijvn2ne2gProphylactic acetaminophen in the preterm In a newly published trial (Roze JC, et al. Prophylactic Treatment of Patent Ductus Arteriosus With Acetaminophen: A Randomized Clinical Trial. JAMA Pediatr. 2026) nearly 800 infants of 23 to http://neonatalresearch.org/2026/02/17/prophylactic-acetaminophen-in-the-preterm/17 Feb 2026 21:19 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mf3ijvn2ne2ghttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mf347otcz32lNot just neonatology, trip to Rwanda I was very fortunate to be able to take a trip to Rwanda to participate in their neonatal training scheme, in what was termed a "respiratory bootcamp". Rwanda is a small country of 23000 km2, with a young population of over 14 million, and 400,000 births… http://neonatalresearch.org/2026/02/17/not-just-neonatology-trip-to-rwanda/17 Feb 2026 17:38 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mf347otcz32lhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3mb5uavo77g2pHow much oxygen for the resuscitation of the preterm? I like a good acronym, so my initial response to the new TORPIDO trial was very positive! TORPIDO 30/60 was a large multicentre RCT comparing initial FiO2 concentrations for resuscitation of the preterm infant (Oei JL, et al. Targeted Oxygen… http://neonatalresearch.org/2025/12/29/how-much-oxygen-for-the-resuscitation-of-the-preterm/29 Dec 2025 22:13 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3mb5uavo77g2phttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m7vfkx6oit2pUniversal Neonatal Genome sequencing? It is over 2 years since I posted about this issue, in the meantime there have been a number of new initiatives, and several review articles and opinion pieces. Including a JAMA, "research of the year" article". I was triggered to return to this issue by a… http://neonatalresearch.org/2025/12/13/universal-neonatal-genome-sequencing/13 Dec 2025 20:04 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m7vfkx6oit2phttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m7svtdpnip22Why doesn’t closing the PDA help preterm infants? I have been continuing to think about this issue, so will subject you all to some of my thoughts. The large RCTs of medication for closure of the PDA show no benefit, and some evidence of harms, but we all know that the PDA usually closes shortly… http://neonatalresearch.org/2025/12/12/why-doesnt-closing-the-pda-help-preterm-infants/12 Dec 2025 20:17 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m7svtdpnip22https://bsky.app/profile/neonatalresearch.bsky.social/post/3m7nvnbij6q2qShould we ever close the PDA? The latest large multicentre RCT has just been published. Laughon MM, et al. Expectant Management vs Medication for Patent Ductus Arteriosus in Preterm Infants. JAMA. 2025. In this trial, infants of 22 to 28 weeks GA were randomized at between 48 hours and 21 days of… http://neonatalresearch.org/2025/12/10/should-we-ever-close-the-pda/10 Dec 2025 20:30 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m7nvnbij6q2qhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m65rmibho32zIs this article trustworthy? There are many ways that an article in the medical literature may not be worthy of trust, and whose results may be unreliable. I remember one of my own trials, LACUNA, which was a pilot RCT of lactoferrin supplementation to prevent late-onset sepsis (LOS). As a pilot.… http://neonatalresearch.org/2025/11/21/is-this-article-trustworthy/21 Nov 2025 17:10 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m65rmibho32zhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m63foz6mhm2sHope for HIE I was struck this morning by a new article in Pediatric Research a "Family Perspectives" written by the founder of the organisation that has the same name as the title of this post, "Hope for HIE", Betsy Pilon (Pilon B. Family reflections: what’s next for hypoxic-ischemic… http://neonatalresearch.org/2025/11/20/hope-for-hie/20 Nov 2025 18:32 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m63foz6mhm2shttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m5jxeohlbg2oLonger term outcomes after cooling One of the numerous major advances in neonatology during my career has been the introduction of therapeutic hypothermia for infants with Hypoxic Ischemic Encephalopathy (HIE). Mortality is decreased, by about 25%, and long term morbidity among survivors is also… http://neonatalresearch.org/2025/11/13/longer-term-outcomes-after-cooling/13 Nov 2025 20:00 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m5jxeohlbg2ohttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m5gzosr24e2lFace masks for resuscitation? Blank DA, et al. Face mask versus nasal mask device use for initial resuscitation in extremely and very preterm infants (FONDUE): an open-label, single-centre, randomised, controlled trial. Lancet Child Adolesc Health. 2025;9(10):715–23. An excellent acronym for this… http://neonatalresearch.org/2025/11/12/face-masks-for-resuscitation/12 Nov 2025 16:03 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m5gzosr24e2lhttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m5ehcsteli2cBeware articles written by AI I subscribe to Google alerts, which sends me an email whenever the phrase "neonatal research" appears on a new website or a new post. I was interested, therefore to receive an alert about an article which, according the blog "Bioengineer.org", showed a major genetic… http://neonatalresearch.org/2025/11/11/beware-articles-written-by-ai/11 Nov 2025 15:29 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m5ehcsteli2chttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m5bziehnzo2sNeonatal Research Shorts : November 2025 Ybarra M, et al. Low-Grade Germinal Matrix Hemorrhage-Intraventricular Hemorrhage and Concomitant Preterm Brain Injuries: Neurodevelopmental Outcomes at 3 Years of Age. J Pediatr. 2025:114713. Previous studies of the long term outcome of infants with… http://neonatalresearch.org/2025/11/10/neonatal-research-shorts-november-2025/10 Nov 2025 16:17 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m5bziehnzo2shttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m5336fgtc72oClinical examination and treatment of septic shock. Not neonatology. Andromeda-Shock-2 Investigators for the Andromeda Research Network SSoAR, et al. Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial. JAMA.… http://neonatalresearch.org/2025/11/07/clinical-examination-and-treatment-of-septic-shock-not-neonatology/07 Nov 2025 21:58 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m5336fgtc72ohttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m4y4x67lct2sLactoferrin supplementation does not prevent late-onset sepsis in the preterm… or is it more complicated that that? Many of my readers will remember the impressive results of the high-quality study by Paolo Manzoni, Manzoni P, et al. Bovine lactoferrin supplementation for prevention of late-onset… http://neonatalresearch.org/2025/11/06/lactoferrin-supplementation-does-not-prevent-late-onset-sepsis-in-the-preterm-or-is-it-more-complicated-that-that/06 Nov 2025 17:52 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m4y4x67lct2shttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m4vwi7jxvl2cReturn to the Regression to the Mean After my post on regression to the mean, and its importance in studies of apnoea therapy, I was thinking of other examples. Some which have been most evident to me are those which impact on areas of medicine that I have researched myself. One example, from many… http://neonatalresearch.org/2025/11/05/return-to-the-regression-to-the-mean/05 Nov 2025 20:51 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m4vwi7jxvl2chttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m4sy5iw5xc2gBeware of meta-analysis factories I mentioned in my previous post, an issue with meta-analyses; there have been several I have read recently which are very problematic. They seem to be produced by groups that have little concern for the quality of their product. This recent meta-analysis, for… http://neonatalresearch.org/2025/11/04/beware-of-meta-analysis-factories/04 Nov 2025 16:43 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m4sy5iw5xc2ghttps://bsky.app/profile/neonatalresearch.bsky.social/post/3m4qx4q3jl72zDo blood transfusions treat apnoea of prematurity? There has for a long time been a thought that anemic babies with many apnoeas could benefit from a blood transfusion which would decrease their apnoeic spells. This idea has never been directly tested by an RCT. That is, a trial in which infants… http://neonatalresearch.org/2025/11/03/do-blood-transfusions-treat-apnoea-of-prematurity/03 Nov 2025 21:19 +0000at://did:plc:nycdkuvnqte22bibadq3e2pd/app.bsky.feed.post/3m4qx4q3jl72z