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

Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research on deadly lung diseases in newborns led to life-saving treatments and the creation of one of the first neonatal intensive care units in 1961, died Saturday at her home in Brentwood , Tennessee. She was 101 years old.

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

On October 31, 1961, Dr. Stahlman placed a premature infant he was gasping for air into a miniature steel lung machine, also known as a negative-pressure ventilator, the kind used for children with polio. The machine worked by pulling on the newborn's fragile chest muscles to help him take in air. The newborn survived.

That initial success, together with the discoveries of Dr.'s studies. Stahlman on newborn lambs, helped launch a new era in the treatment of respiratory lung disease, a leading cause of death in premature babies. Immature lungs lack surfactant, a soapy chemical that lines the alveoli. Without surfactant, the small alveoli collapse.

Dr. Stahlman later reported that, in 1965, she had used the iron lung machine, augmented with positive pressure, to save 11 of 26 children at Vanderbilt. In the 1970s, negative pressure tanks were replaced by positive pressure machines that worked by inflating the lungs. In the 1990s, the use of surfactants extracted from animal lungs significantly improved the survival of children with serious illnesses who required mechanical ventilation.

“Millie was one of the first to push the boundaries of preterm infant viability in a thoughtful, scientific way,” said Dr. Linda Mayes, a professor of child psychiatry, pediatrics, and psychology at Yale and president of the Yale Child Study Center, who trained with 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 oxygen in the blood, Sarah DiGregorio wrote in her book “Early: An Intimate History of Premature Birth and What It Teaches Us About Being Human” (2020). The procedure was critical to ensuring there was enough oxygen to keep the children alive, but not so much that it could trigger blindness.

Dr. Stahlman, a petite, intimidating woman with piercing blue eyes who wore her hair in a tight bun, was known for her fierce dedication to her patients and students. Many of her students recall the so-called Millie rounds, when they would visit every newborn on the wards and were expected to know every detail about each child, from the precise lab values ​​to the family's home life.

“Her rigor was shocking to the predominantly male staff, especially for a woman who stood just five feet tall and weighed 90 pounds,” said Dr. Elizabeth Perkett, a retired professor of pediatric pulmonology at Vanderbilt University and the University of New Mexico.

Dr. Stahlman's research also included studying normal and abnormal lung physiology in newborn lambs. For a time, pregnant sheep grazed in a Vanderbilt yard.

“She was struck by the fact that some near-term, non-premature babies had hyaline membrane disease,” the old name for respiratory distress syndrome, said Dr. Hakan Sundell, professor emeritus of pediatrics at Vanderbilt University and director of the animal laboratory.

In 1973, Dr. Stahlman began an outreach program, training nurses in rural areas and overseeing the creation of a mobile medical van that stabilized babies traveling from community hospitals to Vanderbilt. A former bread truck was retrofitted with a fan, monitors, and warming lights. Within a year, his team reported in the February 1979 issue of the Southern Medical Journal, neonatal deaths dropped 24 percent.

Dr. Stahlman also pioneered follow-up therapy for premature infants, monitoring their psychological and physical development throughout infancy.

“She pioneered research and innovation, and she was also very forward-thinking, understanding the ethical issues and limitations of the technology,” said Dr. Pradeep N. Mally, chief of the division of neonatology at NYU Langone Health and a neonatologist at Hassenfeld Children's Hospital at New York University Langone.

Mildred Thornton Stahlman was born July 31, 1922, in Nashville, to Mildred Porter (Thornton) Stahlman and James Geddes Stahlman, the publisher of The Nashville Banner.

Dr. Stahlman graduated from Vanderbilt in 1943 and was one of three women out of 47 students to graduate from the university with a medical degree in 1946.

She worked for a year as an intern at Lakeside Hospital in Cleveland, followed by a year as a pediatric intern at Boston Children's Hospital and completed her residency in pediatrics at Vanderbilt. She studied pediatric cardiopulmonary physiology for a year at the Karolinska Institute in Sweden and completed a residency in cardiology at La Rabida Children's Hospital in Chicago.

Dr. Stahlman returned to Vanderbilt in 1951 and became director of the Division of Neonatology in 1961, a position she held until 1989.

In addition to her clinical and laboratory work with premature infants, her concerns have extended to the impact of poverty on disease, widespread health inequalities, and the harms of profit-driven models of medical care.

“Prematurity has become largely a social rather than a medical disease in the United States,” he wrote in 2005 in the Journal of Perinatology. “The rapid rise of for-profit hospitals, where the interests of shareholders trumped the interests of our patients, was followed by for-profit neonatology, and that was a real profitable business.”

The Dr. Dr. Stahlman was a member of the Institute of Medicine and president of the American Pediatric Society from 1984 to 1985. Among her many awards, she received the Virginia Apgar Award from the American Academy of Pediatrics and the John Howland Medal from the American Pediatrics Society.

No immediate family members survived.

Today, Martha Lott, the first baby Dr. Stahlman put in the iron lung machine, is a nurse in the very place where her life was saved. “I knew the story and I was tested for years,” Ms. Lott said, adding that Dr. Stahlman was her godmother.

“I think they thought I would have problems” related to the bold treatment, he said, but that's not the case. “It's amazing,” she added, “how much technology has changed in the last 60 years.”

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