Mildred Thornton Stahlman, Pioneer in Neonatal Care, Dies at 101

Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research on fatal lung disease in newborns led to lifesaving treatments and to the creation, in 1961, of one of the first neonatal intensive care units, died on Saturday at her home in Brentwood, Tenn. She was 101.

Her death was confirmed by Eva Hill, the wife of Dr. Stahlman’s nephew George Hill.

On Oct. 31, 1961, Dr. Stahlman fitted a premature baby who was gasping for breath into a miniature iron lung machine, also known as a negative pressure ventilator, the kind used for children with polio. The machine worked by pulling the baby’s frail chest muscles open to help draw in air.The baby survived.

That initial success, along with findings from Dr. Stahlman’s studies on newborn lambs, helped launch a new era of treating respiratory lung disease, a leading killer of premature babies. Immature lungs lack surfactant, a soapy chemical that coats air sacs. Without surfactant, the tiny sacs collapse.

Shortly after her first success, Dr. Stahlman reported that she used the iron lung machine to save 11 of 26 babies. By the 1970s, negative pressure tanks were jettisoned for positive pressure machines that worked by inflating the lungs. In the 1990s, the use of surfactants extracted from animal lungs dramatically improved the survival of babies with severe disease who required mechanical ventilation.

“Milly was one of the first to push the limits of viability of premature infants in a careful and scientific way,” said Dr. Linda Mayes, a Yale professor of child psychiatry, pediatrics and psychology and chair of the Yale Child Study Center who trained under Dr. Stahlman. “She was a physician-scientist long before that phrase was popular.”

In the early days of neonatology, Dr. Stahlman was one of the few doctors in the world who knew how to thread tiny catheters into the umbilical vessels of newborns to monitor blood oxygen, wrote Sarah DiGregorio in her book, “Early: An Intimate History of Premature Birth and What It Teaches Us about Being Human.” The procedure was vital to ensuring enough oxygen to keep the babies alive but not so much that it might trigger blindness.