Meconium aspiration

Meconium is the stuff that first poops are made of. It’s greenish-black, sticky and tar-like, but may be treated as gold because it shows that the baby’s intestines are working.

Sometimes the passing of the first stool happens while the baby is still in Mom’s uterus or during delivery.  Meconium aspiration happens when a newborn inhales (or aspirates) a mixture of meconium and amniotic fluid.  The inhaled meconium can partially or completely block the baby’s airways, making it difficult to breathe and causing meconium aspiration syndrome, or MAS.

If that happens, the doctor will order a number of tests to see how affected a baby might be.  The primary focus is to clear the airway as much as possible to decrease the amount of meconium that is aspirated. This is done by inserting a plastic tube into the baby’s windpipe through the mouth or nose and applying suction as the tube is slowly removed. This allows for suction of both the upper and lower airways. The doctor will continue trying to clear the airway until there’s no meconium in the suctioned fluids.

MAS can affect the baby’s breathing in a number of ways including irritation to the lung tissue, airway obstruction by a meconium plug, infection, and the destruction of surfactant by the meconium (read our previous post on surfactant.)  The severity of MAS depends on the amount of meconium the baby inhales and, generally, the more meconium a baby inhales, the more serious the condition.

Babies with MAS may be sent to a special care nursery or a NICU to be carefully monitored for the next few days. Most babies with MAS improve within a few days or weeks and usually there is not severe permanent lung damage.  These babies, however, may be at a higher risk of having reactive airway disease (lungs that are more sensitive and can possibly lead to an asthmatic condition).  Severe cases may necessitate the baby be given mechanical ventilation, which can increase the risk for bronchopulmonary dysplasia, a lung condition that can be treated with medication or oxygen.  Rarely, MAS can lead to a collapsed lung or pneumonia.

If not at the hospital when her water breaks, it’s important for a pregnant woman to tell her doctor immediately if meconium is present in the amniotic fluid, or if the fluid has dark green stains or streaks. Doctors may use a fetal monitor during labor to monitor the baby’s heart rate for any signs of fetal distress. In some cases they may recommend amnioinfusion, adding saline to the amniotic fluid to wash meconium out of the amniotic sac before the baby has a chance to inhale it at birth.

Although MAS is a frightening complication for parents to face during the birth of their child, the majority of cases are not severe.  Did any of you face this problem?

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154 Responses to “Meconium aspiration”

  1. Lisa Says:

    My son was born with MAS and a collapsed lung and spent the first week in the NICU. He is 7 now and his lungs are excellent and no remaining lung problems.

    What are the associated brain injuries or developmental problems with MAS? My son struggles in school and has a very hard time paying attention or completing a task in a timely manner. He is very bright but even getting dressed in the morning is a challenge with his attention. He will easily mistake the task at hand, for example when he is asked to turn off his bedroom light he will close the door instead. Could these be related?

  2. Monica Says:

    Definitely set up an appointment with an OT and a Psychologist. There is SO much info and help available. What you are describing sounds similar to many therapies I have done to help my son. I hope this helps. A loving Mom. 🙂

  3. Kenia Says:

    Hello, I had a similar experience as you! I was having a perfect pregnancy as I was tuning 41 weeks and still not going into labor they decided to induce me my baby had MAS and had to be flown to a bigger hospital with NICU 4. Thankfully he did not need ECMO ECMO was the next step if he did not get better. But he did we spent 41 days in the NICU before he came home. May I ask how did your baby die at 9 months? Was she still in the hospital or in your home? And you are right there needs to be more awarenes as for it can happen to anyone!

  4. Kerry Says:

    My son died from MAS 22 yrs ago i had staining right from the start 52 hrs later he was born a floppy baby it was a nightmare, I begged my dr throughout the Labour for a c section but she said no you will have this baby naturally, after the birth my dr asked me to sign a form to say he was still born & later that morning after leaving the hospital she visited me at my home & told me i was right if we had done a c section he would be alive! My case went to an inquest but the judged ruled in her favor because my son didn’t show any change in heart rate. There is not a fay that goes by that I wish I could turn back time & change things there was no justice just heartache for myself. The coroner had ststed in all his yrs he has never seen a baby so full of Meconium.

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