Pediatric Meconium Aspiration Syndrome

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)

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. Make sure your child sees his or her healthcare provider for a diagnosis.

Your child's healthcare provider will check the amniotic fluid for meconium at the time of birth. Your healthcare provider may also recommend 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 face mask or mechanical ventilator

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.