Dr. Mildred Thornton Stahlman, a Vanderbilt University pediatrician whose research into the deadly lung disease in newborns led to life-saving treatments and the creation in 1961 of one of the first neonatal intensive care units, died Saturday at her home in Brentwood , Tenn. It was 101.
Her death was confirmed by Eva Hill, wife of Dr Stahlman’s nephew George Hill.
On October 31, 1961, Dr. Stahlman placed a gasping premature baby in a miniature iron lung machine, also known as a negative pressure ventilator, used for children with polio. The machine worked by pulling on the baby’s fragile chest muscles to help pump air. The baby survived.
This initial success, along with findings from studies by Dr. Stahlman in newborn lambs, helped usher in a new era in the treatment of respiratory disease of the lungs, a leading killer of premature babies. Immature lungs lack surfactant, a soapy substance that coats the air sacs. Without surfactant, the tiny sacs collapse.
Shortly after her first success, Dr. Stahlman mentionted that, by 1965, he had used the iron lung machine to save 11 of the 26 babies at Vanderbilt. By the 1970s, negative pressure tanks were discarded 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 critically ill babies who required mechanical ventilation.
“Millie was one of the first to push the limits of the viability of premature babies in a careful and scientific way,” he said. Dr. Linda Mayes, professor of child psychiatry, pediatrics, and psychology at Yale and chair of the Yale Child Study Center who trained under Dr. Stahlman. “He was a doctor-scientist long before that phrase became popular.”
In the early days of neonatology, Dr. Stahlman was one of the few doctors in the world who knew how to insert tiny catheters into the umbilical vessels of newborns to monitor blood oxygen, Sarah DiGregorio wrote in her book. “Premature: An Intimate Story of Premature Birth and What It Teaches Us About Being Human.” The process was vital to ensure enough oxygen to keep the babies alive, but not enough to cause blindness.
Dr. Stahlman, a tiny, intimidating woman with piercing blue eyes and a tight bun, was known for her fierce devotion to her patients and her students. Many of her students remember the so-called Milly rounds, when she visited each newborn on the wards and was expected to know every detail of each baby, from accurate lab values ββto family life at home.
“Her rigor was shocking to the mostly male staff, especially coming from a woman who was only five feet tall and 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 the study of normal and abnormal lung physiology in newborn lambs. For a time, pregnant ewes grazed in a Vanderbilt yard.
“She was struck by the fact that some babies who were close to term, not premature, had hyaline membrane disease,” 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 health van that stabilized babies traveling from community hospitals to Vanderbilt. A former bread truck was retrofitted with a fan, screens and heating lights. Within a year, neonatal deaths fell by 24 percent, her team reported in the February 1979 issue of the Southern Medical Journal.
Dr. Stahlman also pioneered monitoring therapy for premature babies, monitoring them through childhood to monitor psychological and physical development.
“She led the way in research and innovation and was also very insightful, understanding the ethical issues and the limits of technology,” said Dr. Pradeep N. Mally, chief 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. editor of The Nashville Banner;.
Dr. Stahlman graduated from Vanderbilt University in 1943 and was one of three women out of 47 students to graduate from Vanderbilt University School of Medicine in 1946.
She served a year as an intern at Lakeside Hospital in Cleveland, followed by a year as a pediatric resident at Boston Children’s Hospital, completing her residency in pediatrics at Vanderbilt. He studied pediatric cardiology initially in La Rabida Children’s Hospital in Chicago, and then for 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 she held until 1989.
In addition to her laboratory and clinical work on premature babies, her concern expanded to the impact of poverty on disease, rampant health disparities, and the harm of profit-based models of medical care.
“Prematurity has become largely a social rather than a medical disease in the United States,” he wrote in 2005 in 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 it was profitable.”
Dr. Stahlman was a fellow of the Institute of Medicine and president of the American Pediatric Association 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 Pediatric Society.
He had no immediate survivors.
Today, Martha Lott, the first baby Dr. Stahlman who was placed on the iron lung machine, is a nurse at the very place where her life was saved. “I knew the story and I was tested for years,” Ms. Lott said. Dr. Stahlman was her godmother, she said.
βI think they assumed I would have problems,β about the bold treatment. He did not do it. “It’s amazing,” he added, “how much technology has changed in the last 60 years.”