Meconium Aspiration

Meconium aspiration is when a
newborn breathes in a mixture of meconium and amniotic fluid. Amniotic fluid is the
liquid that surrounds the baby in the womb. Meconium is the baby’s first stool, or
poop,
which is sticky, thick, and dark green. It is typically passed in the womb during
early
pregnancy and again in the first few days after birth.

Healthcare providers don’t fully
understand why babies release stool before they are born. It may be a natural event,
or
it may be caused by stress. Meconium aspiration only happens in a small number of
births.

Meconium aspiration is most common in babies who are born:

• Full-term (between 37 to 41 weeks) who
  are small for gestational age
• Post-term (after 42 weeks)
• To mothers with high blood pressure, diabetes, or a history of
  smoking
• Via a difficult delivery, such as having problems with the
  umbilical cord

Meconium gives the amniotic fluid a greenish color. This is called meconium staining.
If meconium has been in the amniotic fluid for a long time, your baby may have yellowed
skin and nails.

Your baby may also have symptoms such as:

• Rapid breathing
• Muscles of the ribs pulling in toward the chest when the child breathes
• Grunting sounds with breathing
• Bluish skin color
• An enlarged or bloated chest because of trapped air

The symptoms of meconium aspiration
may look like other health conditions.

Your child’s healthcare provider
will check the amniotic fluid for meconium at the time of birth. Your baby’s healthcare
provider will do a physical exam, looking specifically at the Apgar score, vital signs,
and the heart and lungs. They may also recommend a blood gas test to look at the amount
of oxygen in your baby’s blood. They may also do a chest X-ray to check for problems
in
your baby’s lungs.

Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is. Your baby’s healthcare provider will likely
recommend treatment for meconium aspiration based on:

• The amount and thickness of the meconium
• How long your baby was exposed to the meconium
• How well your baby can breathe

At birth, treatment may include:

• Suctioning of the upper airways,
  including the nose, mouth, and throat
• Suctioning of the lower airways
  through an endotracheal tube placed in the windpipe. This is not recommended
  routinely unless it is needed.
• Oxygen given by facemask or mechanical
  ventilator
• Antibiotics, if the provider is concerned about pneumonia
• Surfactant medicine to help expand your baby’s lung volume

When babies take their first
breaths at birth, bits of meconium can enter the airway. They can then be inhaled
deep
into the lungs. The meconium may stick to the air sacs (alveoli). This makes it hard
for
your baby to take in oxygen. It may also trap air in the baby’s lungs.

It can also cause an infection such as pneumonia. Most babies generally get better
within a few days. But severe cases of meconium aspiration may lead to death in a
small number of babies.

It’s important to know if your baby has been exposed to meconium to prevent severe
breathing problems. A procedure called amnioinfusion may be used during labor if you
have meconium-stained amniotic fluid. During this procedure, your healthcare provider
puts a small tube into your uterus through the vagina. Sterile fluid is put into the
womb through the tube to help thin out the thick meconium.

• Meconium aspiration happens when a newborn breathes in a mixture of meconium and amniotic
  fluid.
• Healthcare providers don’t fully
  understand why babies release stool before they are born.
• It is most common in babies born
  full-term (between 37 to 41 weeks) who are small for their gestational age. It is
  also most common in babies who are born post-term (after 42 weeks).
• Your healthcare provider will check the amniotic fluid for meconium at the time of
  birth.
• Most babies generally get better within a few days.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child.
  Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose
  for that visit.
• Know how you can contact your child’s provider after office hours. This is important
  if your child becomes ill and you have questions or need advice.