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?