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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159 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.

  5. Fran Says:

    My baby was born healthy and swallowed some meconium during my scheduled C-section at thirty nine weeks 5pm. We noticed a slight difference in her breathing and told the two either residents or nurses that were standing there just looking at her. They called NICU and was told that my baby would have to wait because the doctor was busy with another baby ( only one doctor on staff ?). Approx ninety minutes later they strolled her to NICU- (no rush). Two hours later I was asked to sign a waiver because they were still trying to get a line – Not one employee reached out to the hospital full of doctors . Approx 2am they call a specialist to get a line – he is finished in 20 min – tells me they should be able to what they need to do and to go see her in 45 mins. I go to NICU(4:00am) only to find her in a junky dark room with two nurses blue bagging her- she is beat up from head to toe-her entire body is swollen even her private area – no sophisticated equipment to save her life – a doctor with a big ring on, running her fingers through her hair and holding a cell phone . The Doctor’s response – she had to call to see if she was doing it right. My daughter died soon after. Nov 2016

  6. Mummy Roberta Says:

    I gave birth on 28th April 2017 through C section after a whole night in labour to an active baby Girl. I heard her cry immediately after being born. We left the theatre together. I was taken to my ward and she was taken to the Nicu.One thing I remember is that she breathed so fast and had nasal flaring, I lost my sweet Angel on 29th April 2017 due to Meconium Aspiration Syndrome. I curse the day I was told my daughter had passed on. I didn’t get a chance of holding her .She only lived for one and a half days. I will always miss you Baby Roberta . The doctors thought she was distressed and put her on oxygen. Examinations and tests were done abit late on 29th April 2017 (the day she died) this not saving her life.

    My little princess Roberta rest in peace mummy.

    No one can ever understand the pain of a first time mother who has been in labour both natural and induced, had a C section, Lost the child , has a terrible back ache , has leaking breasts with no child to breast feed.

    This is so painful

  7. Ash Says:

    It’s so sad to read these mother’s stories who have lost a child. May God grant you patience. Those angels are in heaven. More nurses need to be trained to detect meconium when the water breaks. The nurse broke my water hours after giving me pitocin. She did not check the color. My babies heart rate changed many times and showed fetal distress, but the nurse was horrible and did not alert anyone or the doctor. The doctor arrived late as soon as baby was about to come out. She was pale and blue. Was limp and not crying. I only had her on my stomach for a min and was taken away to get suctioned. The nurses proceeded to weigh and measure. Hours passed by and they did not call a pediatrician. My husband yelled at the nurse who was shaking my babies arm and telling her to breathe. (um ok?) She finally called the doctor after some questioning. The doctor immediately did tests and there was an infection. She was taken to NICU the next day. You need to be on top of the nurses and advocate for your own child or they will be abused. If we hadn’t pushed the nurses to call the doctor, who knows what would have happened to my baby. She would not latch properly and I pumped for 3 weeks and also had to give her formula. I felt so guilty about not being able to breastfeed longer. I just pray to God, she doesn’t have any developmental delays like Cerebral Palsy. I was so angry at that nurse who delivered my baby. All the other nurses were nice except for that one. I’m thankful to have her alive.

  8. Mummy Roberta Says:

    Hi, Did your baby finally make it?

  9. Traci Says:

    My son Joseph was born on July 22nd via C-Section and had inhaled meconium on the way out. When I was in the hospital and my son in the NICU a huge help was reading other peoples stories so here is mine….

    On Friday 7/21 at 40 weeks and 5 days pregnant I had gone to the bathroom to find blood in the toilet, I called my OBGYN (office was closed so waited for a call back) and knew they were going to send me straight to the hospital so I jumped in the shower so I would be ready. When I got out I received a call back telling me to go to the hospital (as I suspected). As I was getting dressed a huge gush of brown tinted water came flowing out of me; my water had broken. Then followed a ton of green colored discharge. When I got to the hospital my doctor told me my water had broken and the baby had taken his first poop in utero.

    I was admitted, given an epidural and started pitocin as I was only 3.5 cm dilated. When given the pitocin the baby’s heart rate dropped from there my doctor and I decided its best to get the baby out ASAP and I was taken in for a C-Section.

    To keep the rest of my timeline short and to the point:

    Saturday 7/22 – born at 12:45 am, rushed up to NICU. first they put cpap on Joey then intubated him; relying on 100% oxygen & put on 7 day antibiotics (Ampicillin twice a day, Gentamicin once a day & TPN), he was also sedated and had his arms pinned down as he was very agitated.

    Sunday 7/23 – Intubated lowered oxygen down to 75% then 65%

    Monday 7/24 – Still Intubated lowered oxygen down to 50%

    Tuesday 7/25 – Took intubation tube out and started cpap at 30% – I was discharged from the hospital yet didn’t leave until 9:30 pm in order to spend time with Joey

    Wednesday 7/26 – cpap still at 30%, started feeding through feeding tube

    Thursday 7/27 – same as Wednesday

    Friday 7/28 – cpap came off, fed through feeding tube, last day of IV antibiotics; IV was taken out and Joey was circumcised

    Saturday 7/29 – Started bottle feeding

    Sunday 7/30 – was taken out of incubator and put into a crib

    Monday 7/31 – Joey ripped out his feeding tube and they kept it out, had an echocardiogram and hearing test, passed both and he was released

    My birth experience with my son was the most emotionally and physically draining experience of my life yet I am fortunate to have come out of this with a happy healthy baby boy.

    For those of you reading this while your baby is in the NICU have hope try and stay as strong as you can. When I was discharged from the hospital and had to leave my son I was a complete wreck, I was willing to pay $2,000+ out of pocket to stay an extra night in the hospital with my son.

    Each day my husband and I went to the hospital for 11:30 am for the first feeding, would stay until 3:30 pm and go back again at 7:30 pm after shift change and rounds and stay until 9:30 pm when they started rounds again. I would read Joey a book at night and pump next to his incubator every few hours.

    Do what makes you feel best with your child in the NICU, get to know the doctors and nurses, make yourself known (in a good way) and do your research.

    Traci xoxo

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