Honoring Dr. Mary Ellen Avery – Surfactant Therapy Pioneer

Mary Ellen Avery

Photo credit: American Academy of Pediatrics

by Erika Goyer and Kelli Kelley, both mothers of preemies

December 4th, 2011 marked the end of the remarkable life of a remarkable woman. Doctor and medical researcher, Mary Ellen Avery, was responsible for what has been called the greatest “major advance in neonatal care in the last 50 years.” That advance was surfactant therapy.

As early as 1959 Dr. Avery realized that the lungs of premature infants lacked this foamy mix of proteins and fats that allowed full-term babies to breathe. But her observations were not immediately accepted. “The early response was ho-hum. Everybody had their own theory about hyaline membrane disease. Some thought the pulmonary circulation must be critical. It changed the scenery to think about surface tension. People couldn’t see why it mattered. I heard things like, ‘Mel’s playing with soap bubbles again’.”

A fortuitous meeting in the 1970’s at the University of California in San Francisco finally lead to the acceptance of  this promising therapy. Dr. Avery met Tetsuro Fujiwara, a pediatrician who would take Avery’s work and apply it in clinical practice in Japan. The results were unmistakable. Introducing artificial surfactant into the lungs of premature infants allowed them to breathe, and to survive. In 1991 the mixture used in surfactant replacement therapy was finally licensed for use in infants. That same year Dr. Avery was awarded the National Medal of Science.

Before surfactant therapy it is estimated that 15,000 babies died each year from what was then called “hyaline membrane disease,” or what we now call “respiratory distress syndrome.” Today we believe that each year fewer than 1,000 babies succumb to this terrible condition.

It is estimated that Dr. Avery’s discovery has led to the survival of more than 800,000 babies. In her honor, we share the following poem written by Kelli Kelley in 2005.

Breath of Life

Born too soon too small
we bathe them in our prayers and tears
willing them to live.

Breathe the breath of life we pray.

Arms ache to hold them;
yet they must fight alone.
Our hearts break as dreams of a future dissipate.

Breathe the breath of life we pray.

Stories of survivors provide comfort and hope;
we celebrate each milestone with joyous hearts.
Modern medicine and the power of prayer
deliver miracles to use beyond compare.

Breathe the breath of life we pray.

Their laughter now fills our homes and hearts
no memory of the war they fought.
Tiny scars are all that remain,
but we are forever changed.

For them and all those born too soon too small we pray,
breathe the breath of life.

Article Sources:

A Conversation with Mary Ellen Avery, MD.” Children’s News Online,  Children’s Hospital Boston, June 1, 2005.

Martin, D. “Mary Ellen Avery, Premature Babies’ Savior, Dies at 84.” New York Times, January 11, 2012.

Mary Ellen Avery, photo from American Academy of Pediatrics.



  1. […] The very tiniest preemies don’t wear diapers – they get a little scrap of muslin that won’t hurt their delicate skin. Maggie wore a newborn size diaper folded over that her bony legs stuck out from. Plastic wrap was stretched over her crib instead of a blanket because of all the wires attached to her. Tubes that seemed impossibly big but turned out to be the thinnest available ran down her throat to gently breathe air into her still developing lungs. I had had steroid shots a few weeks earlier to help her lungs develop faster and Maggie had been given artificial surfactant, a fairly recent treatment that has saved hundreds of thousands of preemies thanks to Dr Avery. […]

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