Mildred Thornton Stahlman, pioneer in neonatal care, dies at 101

Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research into fatal 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 panting premature baby into a miniature iron lung machine, also known as a negative-pressure ventilator, of the type used for children with polio. The machine worked by opening the baby's fragile chest muscles to help suck in air. The child survived.

That initial success, along with the results of Dr. Stahlman's studies on newborn lambs, helped launch a new era in the treatment of respiratory and lung diseases, a leading cause of death in premature babies. Immature lungs lack surfactant, a soapy chemical that lines the air sacs. Without surfactant, the tiny sacs collapse.

Dr. Stahlman later reported that in 1965, she had used the iron lung machine, augmented with positive pressure, to save 11 of the 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 dramatically improved survival for children with serious illnesses who required mechanical ventilation.

“Millie was one of the first to push the limits of the viability of premature babies in a thoughtful and scientific way,” said Dr. Dr. Linda Mayes, 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 expression became 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 vital to ensure there was enough oxygen to keep the babies alive, but not so much that it could cause 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 babies who were near-term, not premature, 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 lab.

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

Dr. Stahlman also pioneered follow-up therapy for premature babies, monitoring them from infancy to monitor their psychological and physical development.

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

Mildred Thornton Stahlman was born on 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.

He served one year as an intern at Lakeside Hospital in Cleveland, followed by a year as a pediatric intern at Boston Children's Hospital and completed his 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, with shareholder interests trumping the interests of our patients, was followed by for-profit neonatology, and profit was.”

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 survive.

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

“I think they assumed I would have problems” with the bold treatment, she 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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