Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research into a deadly newborn lung disease led to life-saving treatments and helped create one of the world's first neonatal intensive care units in 1961, died Saturday at her home in Brentwood, Tennessee. She was 101 years old.
Her death was confirmed by Eva Hill, wife of Dr. Stahlman's nephew, George Hill.
On October 31, 1961, Dr. Stalman fitted a premature baby who was having difficulty breathing with a small iron lung prosthesis, also known as a negative pressure ventilator, used on children with polio. The prosthesis works by stretching open the baby's weak chest muscles to allow air to be sucked in. The baby survived.
This initial success, combined with Dr. Stahlman's findings in newborn lambs, helped usher in a new era in the treatment of respiratory lung disease, the leading cause of death in premature babies. Immature lungs lack surfactant, a soap-like chemical that coats the air sacs in the lungs. Without it, these tiny air sacs would collapse.
Shortly after his initial success, by 1965, Dr. Stahlman reported that he had saved 11 of 26 babies using iron lung prostheses at Vanderbilt University. By the 1970s, negative pressure tanks were phased out in favor of positive pressure devices that worked by inflating the lungs. In the 1990s, the use of surfactants extracted from animal lungs dramatically improved the survival rates of seriously ill babies who required artificial ventilators.
“Millie was one of the first to push the boundaries of survival for premature babies in a careful, scientific way,” said Dr. Linda Mays, professor of child psychiatry, pediatrics and psychology at Yale University and director of the Yale Child Research Center, who trained under Dr. Stahlman. “She was a physician-scientist long before the term physician-scientist was fashionable.”
In the early days of neonatology, Dr. Stahlman was one of the few doctors in the world who knew how to insert a tiny catheter into a newborn's umbilical blood vessels to monitor their blood oxygen levels, writes Sara DiGregorio in her book “Preterm Birth: An Intimate History of Premature Birth and What It Teaches Us About Being Human.” The procedure was essential to ensure that babies had enough oxygen to stay alive, but not so much that it caused them to go blind.
A small, commanding woman with piercing blue eyes and a tight hair bun, Dr. Stahlman was known for her fierce devotion to her patients and students. Many of her students remember her “millie rounds,” when she was required to visit each newborn on the ward, learning every detail about each baby, from their exact lab results to their families' home lives.
“Her severity was shocking to the mostly male staff, especially coming from a 5-foot-tall, 90-pound woman,” said Dr. Elizabeth Parquet, a former professor of pediatric pulmonology at Vanderbilt University and the University of New Mexico.
Dr. Stahlman's research included studying normal and abnormal lung physiology in newborn lambs. For a time, pregnant ewes grazed in the Vanderbilt courtyard.
“She was struck by the fact that some of the babies who were not born prematurely, but close to their due date, were suffering from hyaline membrane disease, the former name for respiratory distress syndrome,” said Dr. Hakan Sandel, professor emeritus of pediatrics and director of the animal laboratory at Vanderbilt University.
In 1973, Dr. Stahlman launched an outreach program, training rural nurses and overseeing the construction of a mobile medical van to stabilize infants traveling from area hospitals to Vanderbilt. Formerly a bread truck, it was retrofitted with ventilators, monitors and warming lights. Within a year, neonatal mortality rates fell by 24 percent, her team reported in the February 1979 Southern Medical Journal.
Dr. Stahlman also pioneered follow-up care for premature babies, testing them into toddlerhood to monitor their psychological and physical development.
“She was at the forefront of research and innovation, and she understood the ethical issues and the limitations of technology and was very visionary,” said Dr. Pradeep N. Murray, chief of the neonatology division at NYU Langone Health and a neonatologist at NYU Langone Hassenfeld Children's Hospital.
Mildred Thornton Stahlman was born July 31, 1922, in Nashville, the son of Mildred Porter (Thornton) Stahlman and James Geddes Stahlman. Publisher of the Nashville Banner.
Dr. Stahlman graduated from Vanderbilt University in 1943 and was one of three women among 47 students who graduated from Vanderbilt University School of Medicine in 1946.
She did a one-year residency at Lakeside Hospital in Cleveland, followed by a one-year pediatric residency at Boston Children's Hospital and completed her pediatric residency at Vanderbilt University. She first studied pediatric cardiology at La Rabida Children's Hospital in Chicago, followed by a year at the Karolinska Institute in Sweden.
Dr. Stahlman returned to Vanderbilt in 1951 and became director of the neonatology department in 1961, a position he held until 1989.
In addition to her laboratory and clinical research on premature babies, her interests have expanded to include the impact of poverty on disease, pervasive health disparities, and the harms of the profit-driven medical model.
“In the United States, premature birth has become a social rather than a medical disorder,” she wrote in the Journal of Perinatology in 2005.. “For-profit hospitals, where shareholder interests supersede patient interests, have proliferated rapidly, followed by the emergence and profit-making of for-profit neonatal care.”
Dr. Stahlman is a member of the Institute of Medicine and served as president of the American Academy of Pediatrics from 1984 to 1985. She has received numerous awards, including the Virginia Apgar Award from the American Academy of Pediatrics and the John Howland Medal from the American Academy of Pediatrics.
She had no direct survivors.
Now, Martha Lott, the first baby Stahlman put in an iron lung, works as a nurse in the very place where her life was saved. “I knew the story, and I've been tested for years,” said Lott, who said Dr. Stahlman was her godmother.
“I think they assumed I would have problems,” she said of the bold treatment. But there were no problems. “It's amazing how far technology has come in the last 60 years,” she added.