On this episode of The Swallow Your Pride Podcast, Karli Negrin, MA, CCC-SLP, joins the show to talk about what happens when the clinical guidelines say one thing and the babies in front of you need another.
Karli has spent nearly two decades in the cardiac intensive care unit at Nemours Children’s Health working with infants with critical congenital heart disease. When she wanted to start using FEES with her breastfed post-op patients, her cardiac team asked for a literature review. She went looking and found almost nothing. So she and a multi-site team of cardiac SLPs, an aerodigestive chair, and a cardiac intensivist ran a survey of practice instead. What they found: 58% of responding centers are performing FEES in the CICU, 71% of those still prefer VFSS as their primary instrumental exam, and most are doing it without lesion-specific inclusion criteria or physiologic stopping parameters.
In this conversation, Karli breaks down why NICU feeding research doesn’t transfer cleanly to term infants with cCHD, why aspiration risk shows up regardless of surgical STAT category or vocal fold mobility, how coupling FEES with the postoperative NPL could work (and where it gets complicated), and the research article on parental role alteration that changed the way she approaches every bedside. She also makes the case that you do not need a PhD to start collecting data on a clinical question you can’t find the answer to.
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Research source: Negrin K, Willette S, Godsil J, LaManna S, Garcia R, Morris K, Jones C, Morrow M, Wiscount J, Meyer-Macaulay C, Aaronson N, Reynolds J. Perioperative Management of Dysphagia Within the Cardiac Intensive Care Unit Utilizing Flexible Endoscopic Evaluation of Swallowing: A Survey of Practice. Am J Speech Lang Pathol. 2026 Mar 10;35(2):763-771. doi: 10.1044/2025_AJSLP-25-00100. Epub 2026 Feb 24. PMID: 41734216.
Karli Negrin, MA, CCC-SLP is a Speech-Language Pathologist at Nemours Children’s Health with more than 20 years of experience addressing feeding and swallowing challenges in infants with critical congenital heart disease (cCHD). She serves as Co-Chair of the Cardiac Newborn Neuroprotective Network (CN3), a special interest group of the Cardiac Neurodevelopmental Outcome Collaborative (CNOC). Karli’s clinical and research interests focus on feeding difficulties in infants with congenital heart disease, neuroprotection strategies, and preserving the infant-parent feeding relationship throughout hospitalization and recovery. She leads national quality improvement initiatives aimed at improving feeding outcomes and supporting infants and families affected by congenital heart disease. An experienced national and international presenter, Karli has authored numerous manuscripts, abstracts, and professional presentations on feeding and swallowing disorders in infants with congenital heart defects. Through her clinical leadership, research, and collaborative work, she is dedicated to advancing evidence-based practices that improve neurodevelopmental and feeding outcomes for this vulnerable population.
