On 7 September 1888, a tiny baby named Edith Eleanor McLean became the first infant recorded to receive incubator care in the United States. Weighing little more than a kilogram, her survival marked an early milestone in a medical journey that would transform the prospects of babies born too soon.
On this day in 1888, at the State Emigrant Hospital on Ward’s Island in New York, a premature baby was placed inside a device that must have looked as extraordinary as it did unsettling to those who saw it.
Her name was Edith Eleanor McLean. Born on 7 September, she weighed just 1,106 grams – around 2lb 7oz. The apparatus into which she was placed was a far cry from the sophisticated incubators now found in neonatal intensive care units. Heated by some 57 litres of water, the early device was essentially designed to do one crucial thing: keep a fragile newborn consistently warm.
It became known as a “hatching cradle”, a name that hints at the unlikely origins of the technology.
From chicken incubators to newborn medicine
The idea did not begin in New York. Various devices for warming vulnerable newborns had appeared in Europe earlier in the 19th century, but French obstetrician Stéphane Tarnier is widely credited with developing the design that became the foundation of the modern infant incubator.
The often-told story is that Tarnier saw incubators being used to hatch poultry at the Paris Zoo and wondered whether the same principle could protect premature babies from the cold. Working with an instrument maker, he developed a hot-water-heated apparatus that was installed at the Paris Maternity Hospital in around 1880.
The concept was deceptively simple, but potentially revolutionary. Premature babies have little body fat and struggle to regulate their temperature. Long before modern respiratory support, antibiotics or electronic monitoring existed, merely keeping them warm and feeding them effectively could make an enormous difference.
Research by French obstetricians in the 1880s found that the combination of incubators and tube feeding could almost halve mortality among premature infants.
Edith McLean’s case is widely cited as the first use of such an incubator for a baby in the United States. She survived, becoming an early example of something many doctors of the era still considered unlikely: that a very small premature infant might be saved rather than simply expected to die.
When premature babies became a public attraction
Yet the incubator did not immediately sweep through American hospitals.
The machines were expensive, the science of premature infant care was still in its infancy, and attitudes towards babies born very early were often fatalistic. Some physicians doubted whether attempting to save extremely small infants was worthwhile at all.
What happened next is one of the strangest chapters in medical history.
At the end of the 19th century and into the early decades of the 20th, premature babies in incubators became public attractions at world’s fairs and amusement parks. Visitors paid admission to see rows of tiny infants being cared for behind glass.
The man most closely associated with these exhibitions was Martin Couney, who operated his famous infant incubator attraction at New York’s Coney Island for decades. Parents were not charged for their babies’ treatment; the entrance fees paid by spectators financed round-the-clock nurses, wet nurses, equipment and care.
The spectacle was controversial, but its medical consequences were significant. Couney claimed that around 8,000 babies passed through his facilities and that approximately 6,500 survived, although those figures cannot now be independently verified. More importantly, his operation demonstrated publicly that premature babies who might previously have been dismissed as too small to survive could, with intensive care, grow into healthy children.
There is an additional twist: later research found no evidence that Couney ever actually qualified as a doctor, despite presenting himself as one. Nevertheless, respected paediatricians collaborated with him, and historians of medicine credit the skilled doctors and nurses employed at his facilities with helping to push premature infant care towards mainstream acceptance.
From an incubator to the NICU
By the early 20th century, doctors had begun designing increasingly sophisticated equipment specifically for premature infants. Chicago paediatrician Julius Hess, for example, developed an electrically heated, water-jacketed incubator that allowed greater control over temperature and humidity.
But the real transformation came when medicine moved beyond treating the incubator as a single lifesaving machine and began creating entire units dedicated to newborn care.
In 1960, Louis Gluck established what Yale describes as the first neonatal intensive care unit in the United States at Grace-New Haven Hospital, now Yale New Haven Hospital. Bringing premature and critically ill babies, specialised staff and equipment together created the model from which the modern NICU developed.
Then advances arrived rapidly.
In 1971, researchers reported remarkable results using continuous positive airway pressure, or CPAP, to help babies with severe respiratory distress keep their lungs open while breathing. Sixteen of the 20 infants in the landmark study survived.
A year later, Graham Liggins and Ross Howie published their landmark research showing that giving corticosteroids to mothers at risk of premature delivery could accelerate fetal lung development, sharply reducing respiratory distress and neonatal deaths. The treatment eventually became a cornerstone of modern obstetric care.
Another huge breakthrough came with surfactant therapy. Premature lungs may lack enough of the substance that prevents the tiny air sacs from collapsing. Once replacement surfactant entered routine clinical practice around the beginning of the 1990s, hospital mortality among very-low-birth-weight infants fell substantially; one large US study found the odds of death fell by around 30 per cent following its introduction.
Alongside these developments came safer ventilation, sophisticated monitoring, intravenous nutrition, infection control, neonatal surgery and an increasingly detailed understanding of the premature brain, lungs and immune system.
From 1.1kg to babies born at 22 weeks
The contrast with 1888 is extraordinary.
Today, in wealthy countries, almost all babies born at or beyond 32 weeks survive, while specialist neonatal centres now care for some infants born at around 22 weeks’ gestation, near the present limits of viability.
But that progress is far from equally shared. The World Health Organization estimates that around 15 million babies are born prematurely every year, more than one in ten births worldwide. Prematurity remains a leading cause of death among children under five. In high-income countries most extremely premature babies survive, while in low-income countries the majority of those born before 28 weeks may still die within the first days of life.
And, surprisingly, one of the most important advances in neonatal medicine has brought care partly outside the incubator.
WHO now recommends kangaroo mother care, prolonged skin-to-skin contact between a premature or low-birth-weight baby and a parent or caregiver, beginning as soon as possible after birth. Combined with breast-milk feeding and appropriate medical care, it reduces hypothermia, infection and mortality. WHO reported in 2025 that the approach is associated with a reduction of more than 30 per cent in newborn deaths among small and preterm babies.
It represents a striking evolution in thinking. Where early neonatal medicine sought principally to protect a premature child by placing it inside a heated box, modern care combines advanced technology with something fundamentally human: warmth, feeding, touch and closeness to family.
A small beginning with an enormous legacy
When Edith Eleanor McLean was placed in that primitive heated cradle on 7 September 1888, nobody could have imagined the monitors, ventilators, medicines and specialised neonatal teams that would follow.
The significance of the moment was not simply the invention of another machine. It represented a profound change in medicine’s attitude towards premature babies: the growing conviction that their lives could, and should, be fought for.
More than a century later, incubators remain among the most recognisable symbols of neonatal care. But the glass boxes of today’s NICUs belong to an entire system of medicine built around giving the smallest patients time to do what Edith McLean managed to do in 1888: survive, grow and eventually go home.
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