Stefan Johansson

today, on November 17, is World Prematurity Day. We, being neonatal health care professionals, are much aware of the many unmet needs for preterm newborns. But, for the larger context, there is still much to do, creating awareness of the large public health challenge to reduce the burden of preterm birth. If you have some time today, join the WHO webinar about the launch of a new global clinical practice guide for Kangaroo Mother Care (KMC). Register here!

@Mohan I looked into the original publication and it seems to be the Sarnat classification. PubMedMild hypoxic-ischemic encephalopathy (HIE): timing and pa...Almost two-thirds of infants with mild HIE have evidence of brain injury on MRI obtained in the early neonatal period. Subacute brain injury was seen in 37% of infants with mild HIE. Neuroprotective t

I admit we don't do this in any systematic way. But I found this systematic review, in case it has not come on your radar https://pubmed.ncbi.nlm.nih.gov/38213009/

There’s much to say about Mastodon, and how it is part of a large group of online plattforms / technologies that are connected together, i.e. federated. Here are two short videos about the principals, and see you in the NICUVERSE. Click here to join!

I spent a few wonderful days at jENS 2025. While I had great days at this large neonatology conference, I also checked in into the various social media channels, to find out about missed out things. And realised… the neonatal social media is pretty dead ☹️ In the beginning, we had a pretty basic Internet. It offered the opportunity to search for information unilaterally and connecting people over electronic mail. Later came the embryo of the social web, taking the communication beyond emails. The first multi-lateral gatherings happened on so-called Bulletin Boards, often geeky/niched online spaces where like-minded people found freedom and space to “share and care”, as the saying went back then. The 99nicu Discussion Forum was started in 2006 with such an intention, to build a dedicated online community for NICU staff. The social web, as we know it today, was/is built on scale. I believe the initiatives that developed into the large global platforms had sound intentions, but the magnitude of fast growth required business models and venture capital to sustain. As we all know, there is no such thing as a free lunch. Through massive user bases and algorithms, the typical social media feed selectively promotes content aligning with your own posts. In the early days of Twitter, this worked wonderfully well. I was an early Twitter user and truly enjoyed an engaging and active feed. Back then, Twitter was my primary space for finding and discussing new research publications. However, when the open athmosphere got lost, I decided to log out for good. Large social media platforms will, sooner or later, need to capitalise on you, using your data/content for promotion of advertising content. Furthermore, the social web offers anonymity and automation, enabling less nice accounts to ruin your good feeling about your freedom of speech. “Enshittification”… Coming back to jENS and social media... There are a larger set of social webs now. In addition to “the old” X, Facebook, and LinkedIn, we now have Threads, BlueSky, and Instagram. I checked in myself on all mentioned platforms, browsing the conference hash tags #jENScongress and #jENS2025. The results were indeed disappointing. With the exception of companies advertising their presence, very few posts popped up with professional reflections, questions, and comments about sessions and workshops. Back in the days, it was possible to follow news and views shared as conference "live-feeds" on Twitter, as if almost being there in person. The social media coverage of jENS was nothing but a disappointment. Why this? This variety of social webs has led to fragmentation. Today, there is no natural single space for online instant sharing/discussion. People are spread out, there is no critical mass of niched content / people. What now? As a believer of independent initiatives driven by Greater Good Goals beyond business models, I think there is indeed room for our older and slower 99nicu Discussion Forums. But I would love to have an instant feed like Twitter with focused neonatology content, like my old Twitter feed. A large number of NICU staff has joined BlueSky, but despite my attempt to curate a focused feed, it gets cluttered by pets, politics, and all problems in today’s complicated world. I have nothing against pets, politics, or world problems (the other way around!), but I prefer to get such content through other channels (like regular news media). Some time ago, 99nicu opened “the NICUVERSE”, i.e an own Mastodon server. Mastodon is a self-hosted social media platform that gives full control to you as a user (and to us hosting it). There is a slightly higher threshold to get into how it all works. And, the technical platform is also a work in progress (being open source). But we are all smart people and learn by doing! There are several principal advantages with Mastodon: there are no adverts, no one sells your data, you control your integrity and privacy. I do believe Mastodon to be the platform for a community feed with uncluttered neonatal care content. If you are curious to try this out, register for the NICUVERSE here! I will do my best to contribute with content 😀

Breastfeeding mothers having propofol sedation at surgery, may have green discoloration of the breast milk, I just read a short clinical pharma column in the Swedish Medical Journal. I found this longer case report from Canada about this, it seems propofol metabolites can discolour biological fluids other than urine. The authors advice no breast feeding until the color has normalised. Rare thing but still interesting to know and be aware of! https://pmc.ncbi.nlm.nih.gov/articles/PMC6306180/

Here is the winner 😀, the VentFirst study, I paste the graphic abstract below. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2818953

@Vicky Payne so well deserved 🎉🎉🎉!

We should invite people like Johan Gyllensvärd and Eric Giannoni to a webinar discsussion around this!

Thanks @Mariana Oliveira for kind words, and yes, I shall find my way. I think, a more street-smart one 🙂

Yes, we do have a low use of antibiotics in Sweden. We did some informal looks into the Kaiser Permanent Sepsis Calculator with hypothetical cases, whether our clinical strategy would differ from the recommendation from the Calculator. It seemed that our current approach was still more restrictive compared to the Calculator, so, we have some secret sauce when it comes to anitbiotics use. There are two recent publications about antibiotics use in Sweden, giving some raw numbers on the proportion of infants given antibiotics (roughly 2% of all NICU admissions): https://fn.bmj.com/content/early/2025/07/18/archdischild-2025-328944 https://pubmed.ncbi.nlm.nih.gov/38517437/ But even with this small rate, there are substantial variations between hospitals, without different sepsis risks, so it seems possible to improve the use even further.

I’ve done it, the last night shift. What in many ways defines us, devoted to neonatal care, is no longer part of my working life. One of my gifts in life has been endurance and grit, allowing a good amount of workload. It has enabled my long journey from the countryside where I grew up to an intellectually affluent position with many hats: one clinical, one academic, one for greater-good projects (like 99nicu!), and one as a startup entrepreneur. But with time and age usually come limitations, even for me. Approaching my 60s, and accepting that our family’s cardiovascular phenotype is also my trajectory, I decided to follow the advice to stop working shifts. There’s no drama or anything like that (no need to send flowers!), but I want to stay in good shape until the finishing line. Still, quitting night shifts is a big step for me, one I’ve been hesitant about. While there are many upsides, including a sense of relief, I also feel a certain fear of missing out. I think many of you reading this can relate to how shift work becomes part of your DNA when you dedicate your professional life to neonatal care. Babies are born seven days a week, and they don’t care if delivery happens at 2 a.m. on Midsummer’s Eve.* As NICU staff, we know this. Our setup is planned accordingly, and most of us would admit that we actually like this lifestyle, being able and willing to open our large toolbox of small things, at any time. During my many shifts over the years, I’ve been privileged to meet countless families and their newborns under challenging circumstances. In most (though unfortunately not all) cases, these situations have brought relief and reward, especially when later meeting families and NICU graduates at our follow-up clinics. So, what now? Honestly, I’m not entirely sure. My daytime clinical role won’t change much, but the bigger shift is in my overall “business model” for work. In Sweden, on-duty hours can be compensated with time off instead of pay. For example, if you work a weekend, you can get a full week off with salary instead of “grabbing the money.” For me, time has its own precious value, and our model of compensating shift work with time have allowed me to engage in many fulfilling but unfunded projects still connected to neonatal care. Such as research, 99nicu and EBNEO, and starting Neobiomics from scratch. Now, without the opportunity to “earn time” from night shifts, I’ll need to rethink how to fit my life into a tighter schedule. That’s not entirely a bad thing, but it will require new, creative ways to keep working for the bigger picture. ⸻ *Maybe this isn’t the best example — at 2 a.m. on Midsummer’s Eve in Sweden, many Swedes are still awake, enjoying the early morning sun. But you get my point.

Help Select the 2024 EBNEO Impact Article of the Year!The EBNEO Impact Article of the Year (IAOTY) celebrates research that shapes neonatal practice and sparks global discussion. From the Impact Article of the Month (IAOTM), EBNEO editors have selected the eight most impactful articles of 2024, and now it’s the community’s turn to decide which study stands out. The public vote is open for five days, and the two articles with the highest votes will advance to the final round, where the neonatal community will select the ultimate IAOTY winner. Only one vote per participant is allowed; multiple votes will be monitored and removed. This award reflects not only scientific excellence but also the voices and priorities of clinicians worldwide, true to EBNEO’s mission of making evidence-based neonatology both accessible and impactful. Which 2024 publication will have the most impact on neonatal care? Click here to vote or visit https://ebneo.org/impact

we wanted to promote two neonatology media projects. First of all, the Preemie voices videos, meeting some of the preemie participants who wrote the inspiring letters in “Preemie Voices” book by Dr Saroj Saigal. Both videos, from 2014 and 2024, are added to the Links Directory but also embedded directly below. Our second recommendation is to follow Neonatology Now, a podcast hosted by European School of Neonatology. The most recent episode is a very interesting interview with Prof Barbara Schmidt.