Today, premature babies survive because of Dr. Fred Possmayer’s innovation.

That’s due to a treatment he co-invented in the 1980s called Bovine Lipid Extract Surfactant (BLES), which is used to treat respiratory distress syndrome (RDS) in preemies.  

“About one per cent of babies are born prematurely and about half of them develop RDS,” says Fred, professor emeritus of biochemistry at Western University’s Schulich School of Medicine & Dentistry. “When I began my research in 1971, over half of them died.”  

One of those babies was Patrick Kennedy, the youngest child of former U.S. President John F. Kennedy. He died in 1963 from RDS, just 39 hours after birth. His death brought worldwide attention to the condition.  

Some premature babies lack sufficient levels of a substance called pulmonary surfactant in the alveoli, tiny sacs in the lungs that enable us to breathe. The surfactant helps keep the alveoli flexible during inspiration and open during expiration. Without it, the lungs become stiff, making breathing hard. These babies have trouble breathing, resulting in RDS.  

American paediatrician Dr. Mary Ellen Avery was the first to discover the cause of RDS in 1957. Fred, who had been hired at Western to study the impact of insulin on the brain development of fetuses, became one of the many scientists around the world to investigate the surfactant challenge. A global problem had become a global research project.  

Fred eventually collaborated with Dr. Goran Enhorning of the University of Toronto to develop a process for extracting bovine surfactant to generate a preparation that could be given to premature babies. That became known as BLES.  

Soon after, Dr. Tetsuro Fujiwara, a neonatologist in Japan, partnered with a pharmaceutical company to create a surfactant similar to BLES. In 1980, Tetsuro published the results of a pilot trial, demonstrating the surfactant improved breathing in RDS infants.  

“That publication helped to open the door for us to get permission from Health Canada to conduct a clinical trial,” Fred says.

BLES proved effective, and the team published their findings in 1983. It was quickly adopted in Canadian hospitals.

It has proven to be a global lifesaver, dramatically reducing deaths from RDS. In fact, BLES has been recognized as one of Ontario’s top five medical breakthroughs by the Council of Ontario Universities and is now used in hospitals around the world. Fred’s research into RDS earned him the Order of Ontario in 2024 and many other honours.  

A humble man, Fred, now 87, shies away from taking credit for his work, preferring to praise others who were part of the journey to use surfactant extracts in infants. While he acknowledges scientific methodology is more complex today from the time he was a busy scientist, he says there are still enduring truths to scientific research.  

“You have to really diagnose the problem as well as you can. And I mean the whole problem. But then you investigate each part of the problem, as well as you can at the time, and just keep examining the details.”

And what if you get frustrated as you trudge through the research?

“You have to have a strong desire to understand, to obtain data to show your ideas are correct. Or better yet, that they are wrong, because that generates new directions and real progress.”