Meconium Aspiration Syndrome: What You Need to Know

Meconium aspiration syndrome refers to a set of breathing problems caused by inhalation of meconium, a baby’s first stool. It’s a thick, greenish substance that lines the lower intestines of the fetus and is made up of mucus, lanugo, epithelial cells, and amniotic fluid. Meconium is different from ordinary stool because it is sterile. (R)

In ordinary circumstances, your baby will pass the meconium within the first few days after birth. However, sometimes the baby passes the meconium while still in the uterus or during delivery — if he or she inhales it, this is called meconium aspiration syndrome. When that happens, it can have a serious impact on your baby’s health.

While meconium aspiration syndrome usually doesn’t have long-term side effects, very severe cases may have scary ones. Below, we’ll go over the causes, symptoms, and treatment for meconium aspiration syndrome, along with what questions you should ask your doctor, what sort of legal consequences surround this condition, and support resources to consult.

How does my baby swallow meconium?

Meconium aspiration syndrome occurs when the baby expels the meconium while still in the uterus and then makes a reflexive gasping movement, drawing meconium-contaminated amniotic fluid into the lungs. In addition, a baby that has expelled meconium will be born covered in the meconium-stained amniotic fluid and may aspirate that fluid with its first breaths. The sticky meconium can block the airways, irritate the lung tissue, and impair the lungs’ ability to exchange oxygen efficiently after birth.

In about 10% of births, meconium is passed into the amniotic fluid. It is most common in babies born at term, or those born post-term (42 weeks). (R)

Causes of Premature Release of Meconium

Babies don’t produce meconium until about 35 weeks of gestational age. As they approach 40 weeks of gestational age, their bodies are maturing and getting ready to handle life outside the womb. That means their digestive tracts kick into gear and produce the meconium. It also means they start to have reflexive reactions, such as gasping.

In general, babies expel the meconium prematurely due to stress in the womb. Most commonly, that stress is caused by a shortage of oxygen. An oxygen shortage also causes the gasping reaction that pulls the meconium-stained amniotic fluid into the lungs. An oxygen shortage can happen when the placenta ages and loses efficiency, when the umbilical cord is compressed, as a result of a difficult or prolonged delivery, as a result of maternal health issues, or as a result of fetal health issues.

Aging Placenta

Meconium aspiration syndrome is most common in babies who are delivered at or after term. The placenta wears out over the course of 40 weeks and loses some of its ability to deliver enough oxygenated blood to the fetus. That can cause fetal stress and cause the baby to expel and aspirate meconium in the womb.

In addition, babies who remain in the womb past term have more developed reflexes and internal systems and are more likely to release meconium. Post-term babies are also larger and surrounded by less amniotic fluid, meaning the concentration of any meconium released into the womb is higher and more likely to result in meconium aspiration syndrome.

After one post-term pregnancy, the risks for having another increase by two or three times. Other post-term pregnancy risks include it being a woman’s first pregnancy, being an older mom, having a baby boy, being a white mother, and having a family history of postmaturity. (R)

Umbilical Cord Compression

The umbilical cord is the baby’s lifeline. It carries vital nutrients and oxygen from the mother to the baby to nourish and support the baby in the womb. If the umbilical cord is compressed, the flow of nutrients and oxygen is diminished. That can cause the stress that leads to meconium release and aspiration. Hyperactivity in the womb is associated with risk of umbilical cord compression. (R)

Cord compression may occur simply as a result of the baby’s position in the womb. The cord may get trapped between the baby and the mother’s pelvis or the wall of the womb. Cord compression may also occur as the baby changes positions during delivery. Your doctor or midwife will try to make sure the cord stays as free as possible during delivery to avoid cord compression.

Difficult or Prolonged Labor

Labor is stressful even if it’s relatively uncomplicated. A difficult or prolonged labor is even more stressful for both mother and baby. The baby has been in a warm, stable womb for its entire life and is suddenly squeezed by contractions and forced through the birth canal. That alone causes stress and the pressure of labor can also compress the umbilical cord. The longer and more difficult the labor, the more likely it is that the baby will become stressed enough to release meconium.

Labor can be difficult or prolonged for a variety of reasons. Most commonly, labor is difficult simply because the baby is too large to pass through the mother’s pelvis easily. In some cases, the baby may have macrosomia (high birth weight of more than 8 pounds, 13 ounces) due to maternal diabetes, maternal obesity, or certain genetic conditions. In other cases, the mother simply has a narrow pelvis. (R)

Labor may also be difficult or prolonged if the baby is born in a breech position. Babies are typically born headfirst so that the arms are by the baby’s sides and can pass more easily through the birth canal. In a breech presentation, the baby is born feet-first. This makes delivery more difficult and can stress the baby.

See also: Water Births: Are They Safe?

Maternal Health Issues

A pregnant person’s health can have a serious impact on the baby. Sometimes, maternal health issues cause enough stress to cause the baby to expel meconium. If the mother has high blood pressure or diabetes, labor exacerbates these issues and stresses the mother’s body. That, in turn, stresses the baby.

Babies born to mothers who use tobacco or drugs (especially cocaine) during pregnancy can have a range of health issues, but they are particularly prone to meconium aspiration syndrome. They are more likely to experience distress in the womb and release meconium.

See also: Marijuana and Pregnancy: Just the Facts

Fetal Health Issues

In some cases, the baby may experience distress in the womb because of health issues. For example, a baby that has an underdeveloped circulatory system or abnormally high blood pressure is more likely to release meconium in the womb. Fetal health issues don’t typically directly cause the release of meconium, but add to the stress of labor and make the release of meconium more likely. (R)

Prevention of Meconium Aspiration Syndrome

The best way to prevent meconium aspiration syndrome is to avoid the release of meconium in the first place. That means minimizing the risk of fetal distress, which you can achieve by staying as healthy as possible during pregnancy. A healthy pregnancy involves eating the right foods, getting the proper amount of exercise, and avoiding tobacco, alcohol, and drug use.

Even in the healthiest pregnancies, however, fetal stress may be unavoidable. The causes of fetal stress during labor are varied, but attentive medical care can help identify fetal distress early and prevent meconium aspiration syndrome. When your water breaks, take a look at the fluid. If it’s greenish or brownish, it’s likely that the baby has released meconium.

Even if your amniotic fluid is clear of meconium when your water breaks, your doctor or midwife will pay close attention to your heart rate and to the baby’s heart rate. A sudden change in either can indicate fetal distress. If your pregnancy is high-risk, your doctor may perform certain tests to look for other indications of fetal stress.

Depending on the reasons for the fetal distress, the doctor or midwife may want to speed up the delivery to get the baby out before it releases meconium or suffers other adverse effects. In any event, the baby’s mouth and nose will be suctioned as soon as they’re accessible in order to remove any meconium and avoid aspiration.

See also: Safe Delivery: How Doctors Can Avoid Birth Injuries

What are the symptoms of meconium aspiration syndrome?

Babies have functioning digestive systems long before they’re born. Of course, they take in all their nutrients through the umbilical cord rather than through food. However, they do swallow amniotic fluid, mucus, epithelial cells, and other material in the womb. That material collects in the baby’s lower intestines to form meconium. Meconium is thick, gooey, and dark. It’s the first thing a baby passes after birth. (R)

In some cases, the baby expels meconium while still in the womb or during delivery. When that happens, the baby is at risk for breathing in amniotic fluid tainted with meconium. Meconium is sterile and won’t cause infection on its own, but it can affect the baby’s ability to breathe. The sticky substance can block the baby’s airways, affect the baby’s ability to exchange oxygen and carbon dioxide, and irritate the baby’s lung tissue. This is called meconium aspiration syndrome.

Diagnosing Meconium Aspiration Syndrome

Meconium aspiration syndrome may be identified by signs including meconium in the amniotic fluid, breathing distress, and low Apgar scores (anything lower than a 7). (R)

Meconium in the Amniotic Fluid

The first and most obvious symptom of meconium aspiration syndrome is the presence of meconium in the amniotic fluid. Amniotic fluid is mostly clear, while meconium is thick and greenish-black. If there are streaks of darker material in the amniotic fluid released during delivery or if the amniotic fluid has a green color, it’s likely that the baby has released meconium and may be at risk for meconium aspiration syndrome. The presence of meconium in the amniotic fluid does not necessarily mean the baby will suffer from meconium aspiration syndrome — only about 5% of babies who release meconium in the womb will develop other symptoms. (R)

Breathing Distress

Babies born at term should be able to breathe on their own — healthy babies typically cry as soon as they’re born. Babies with meconium aspiration syndrome may have a difficult time breathing. They may be straining to breathe, breathing too fast or too slow, or not breathing at all. Babies experiencing this type of respiratory distress may grunt while exhaling.

Babies who are struggling to get enough oxygen may appear “cyanotic,” which means the baby will look blue because of the lack of oxygen in the blood. (R)

If the baby appears to be in respiratory distress, your doctor will use a stethoscope to listen to the sound of the air as it passes through your baby’s lungs. The lungs of babies with meconium aspiration syndrome often make crackling or rattling noises. Your doctor may also use a chest x-ray to look for patches or streaks of meconium on the lungs.

Low Apgar Scores

The Apgar test is performed 1 minute after delivery and again 5 minutes later. It’s a measure of how well the baby tolerated delivery and how well it’s doing outside the womb. Generally, low Apgar scores are caused by fluid in the airway, a C-section, or a difficult birth. (R)

The test measures the baby’s breathing, heart rate, muscle tone, skin color, and reflexes. Healthy babies will cry, react to stimuli such as pinching, and actively move their limbs. They will have regular heart rates and pink skin tone. It’s rare that a baby will score a perfect 10 on the Apgar test, as blue hands and feet after birth is considered normal and they’ll lose a point for that. Any scores between a 7-9 are considered healthy.

Babies with meconium aspiration syndrome are typically struggling to breathe. That makes the heart rate change and can leave the skin blue. Babies in serious respiratory distress may be floppy and may not react to stimuli.

See also: Moro Reflex and Apgar Score: Baby’s First Tests

When Babies Swallow Meconium: Effects

Meconium aspiration syndrome can cause obstruction of the baby’s airways, pneumonitis, and dysfunction of the baby’s lungs. Let’s take a look at each.

Airway Obstruction

Meconium is sticky and thick and can clog the baby’s airways. This can cause the “ball-valve effect,” or “hyperdistension of the alveoli.” The baby’s airways expand as the baby inhales, allowing air into the lungs. The airways then contract as the baby exhales, allowing the meconium to block the passage and trapping air in the lungs. That can lead to hyperinflation of the lung. In serious cases, the hyperinflated portion of the lung may rupture and leak air out into the baby’s chest cavity. (R)

When a rupture allows air into the cavity surrounding the lungs, that air then pushes back on the lung itself. This may cause the lung to collapse. A lung collapse may be called a pnemomediastinum, a pneumopericardium, or a pneumothorax, depending on which part of the lung collapses. (R) (R) (R)

Pneumonitis

“Pneumonitis” is a general term referring to inflammation of the lungs. You’ve probably heard of pneumonia, which is a type of pneumonitis. Lung inflammation may be caused by a bacterial or viral infection. It may also be caused by molds or radiation exposure. Babies with meconium aspiration syndrome are at risk for chemical pneumonitis, which is caused by the introduction of foreign material into the lungs. Symptoms include breathing that sounds wet or gurgling, cough, and difficulty breathing. (R) (R)

Meconium contains proteins and enzymes that irritate the lung tissue and cause it to swell. In serious cases, chemical pneumonitis may cause parts of the baby’s lung to die and collapse.

Surfactant Dysfunction

The process by which your lungs exchange carbon dioxide and oxygen is a complicated one, dependent on a number of physical and chemical processes. Pulmonary surfactants are a crucial part of a healthy lung. Pulmonary surfactants are a fluid made of proteins and fats that form a film on the surface of the alveoli — the tiny chambers where oxygen is pulled into the blood and carbon dioxide is pulled out. The pulmonary surfactants make it easier for these gases to pass through the alveoli. (R)

Meconium can interact with pulmonary surfactants and strip them away from the alveoli. That makes it harder for the baby to get enough oxygen into the blood and get rid of carbon dioxide. Lung lavage using diluted surfactant to wash out meconium from the lungs can be beneficial. (R)

Long-Term Effects of Swallowing Meconium

In the short term, your baby may need treatment for pneumonitis or the effects of a rupture. About 15% to 30% of babies with meconium aspiration syndrome develop pulmonary air leaks. Babies who aspirate meconium may also require suction of the mouth and upper airways to clear out any meconium there. (R)

In severe cases, your baby may need to be placed on a ventilator. That ensures that the baby is getting enough oxygen. It also takes the strain off of the baby’s lungs to give them a chance to rest and heal. Babies with meconium aspiration syndrome may be more vulnerable to lung infections and pneumonia for the first year or so after birth. They may also suffer from reactive airway problems early in life. (R)

Oxygen deprivation as a result of meconium aspiration syndrome can have serious side effects, including brain damage. Prompt diagnosis and treatment are crucial to ensure that your child is getting enough oxygen. Fortunately, most babies who suffer from meconium aspiration syndrome do not suffer any long-term effects, and have a complete recovery of their pulmonary function.

How is meconium aspiration syndrome treated?

Treatment for meconium aspiration syndrome varies depending on the severity of the case and may involve suction, oxygen, a ventilator, or extracorporeal membrane oxygenation. Your baby may also need treatment for secondary effects of meconium aspiration, such as infection or lung collapse.

When meconium is released, it stains the amniotic fluid and turns it green. Once your water breaks, your doctor will know that the baby has released meconium and may be at risk for meconium aspiration syndrome. She will want a team of nurses and doctors on hand during the delivery to handle any potential consequences of meconium aspiration.

Only a small fraction of babies who release meconium prematurely will actually aspirate it. Most babies who release meconium are completely healthy and have no meconium in their lungs or airways. It’s important to note that squeezing the chest of the baby or inserting a finger into the mouth of the baby is very dangerous and should not be performed when trying to prevent aspiration. (R)

Your doctor will use a small bulb to suction out the baby’s nose and mouth as in any delivery and perform an Apgar test to ensure that the baby’s breathing, heart rate, reflexes, and muscle tone are normal. If they are, there is no need for any further treatment.

Suction Treatment

If there is meconium in the amniotic fluid and the baby is not crying normally or is struggling to breathe, your doctor will need to administer some treatment. In most cases, the baby only aspirates a small amount of meconium. Your doctor will suction out the baby’s mouth and nose and use a tube to suction out the trachea as well. That removes the meconium from the baby’s airways so the baby can breathe easily and to avoid the risk of hyperinflation and collapse of the lung.

Both thin meconium and thick meconium can be suctioned prior to the delivery of the baby’s shoulders, although thick meconium may require other treatment methods. (R)

Oxygen Treatment

If suctioning out the baby’s airways is not enough and the baby doesn’t start to breathe and cry normally, your baby may need a little more help. The next step is to give the baby more oxygen. Your doctor may use a face mask or a special hood to deliver oxygen to the baby. If the baby’s oxygen levels are still too low, the baby may need oxygen delivered under pressure, either by squeezing a pump attached to a face mask or by use of a CPAP (continuous positive airway pressure) machine. (R)

If the baby still isn’t getting enough oxygen, your doctor may decide to “intubate,” or put the baby on a ventilator. Intubation involves placing a tube through the baby’s mouth into the airways. That tube is connected to the ventilator, which pushes air into the baby’s lungs so they can fully inflate and get enough oxygen into the bloodstream. The ventilator does the work of breathing, allowing the baby’s lungs to rest and heal.

Before intubation and while on the ventilator, your baby may be sedated to prevent distress. Ventilators have their own risks and will only be used in very serious cases.

Extracorporeal Membrane Oxygenation

In the most extreme cases of meconium aspiration syndrome, even a ventilator may not be enough. The next step in treatment is extracorporeal membrane oxygenation (ECMO). ECMO means the baby is placed on a heart-lung bypass machine. The machine acts like an artificial lung. The baby’s blood is pumped through the machine, oxygenated, and then pumped back into the baby’s body. This allows the heart and lungs to rest and heal while keeping healthy levels of oxygen in the baby’s blood. (R)

Meconium aspiration syndrome alone is rarely severe enough to require ECMO. This treatment is typically needed where the baby also has persistent pulmonary hypertension of the newborn (PPHN). PPHN refers to a hardening and constriction of the arteries that take blood to the lungs. PPHN makes it hard for the baby to get enough oxygen and is typically caused by stress in the womb. Babies with PPHN almost always also release meconium prematurely, so the two conditions often occur together. (R)

ECMO is even more serious than use of a ventilator and, like a ventilator, has its own risks. So, ECMO is reserved for very serious cases of respiratory distress.

Secondary Side Effects of Meconium Aspiration Syndrome

Meconium aspiration syndrome may cause secondary side effects such as lung hyperinflation and collapse and chemical pneumonitis. Your baby may require treatment for one of these secondary effects.

Lung Hyperinflation and Collapse

Meconium can act as a ball valve in the baby’s airways, letting air in but not out. That causes the baby’s lungs to hyperinflate. In some cases, part of a lung may actually rupture and leak air out into the cavity surrounding the lungs. If enough air leaks outside of the lungs, the pressure of that air can cause part of the lung to collapse. Depending on the location of the collapse, it may be called a pneumopericardium, a pneumothorax, or a pneumomediastinum.

If the collapse is relatively small, it may go away on its own. Larger collapses may require treatment to remove the air around the lung. That air is usually sucked out by a small tube or needle inserted into the air pocket. This relieves the pressure on the lung and allows it to reinflate.

If removing the air pocket isn’t enough, your baby may require surgery to find and seal the leak.

Chemical Pneumonia

Pneumonitis refers to inflammation of the lung tissue. Meconium contains a number of proteins and enzymes that can irritate the lung tissue and cause it to swell. Your baby may need corticosteroids to reduce the inflammation.

Secondary Infections

Tissue that is already inflamed is vulnerable to infection. That means babies with meconium aspiration syndrome are at higher risk for infection for the first part of their lives. Bacterial respiratory infections may be treated with antibiotics. Viral respiratory infections are much harder to treat; doctors are typically limited to managing the symptoms while the infection runs its course. A viral infection at such a young age also will shape an infant’s immune system and future response to infection. (R)

Long-Term Treatment

Most babies with meconium aspiration syndrome recover completely and require no special long-term care. Some babies may be at higher risk for infection for the first few years of life.

Very severe cases of meconium aspiration syndrome may cause permanent damage to the baby’s lungs. In addition, side effects of drastic treatments like ventilators and ECMO may result in permanent damage requiring long-term care. Finally, remember that meconium aspiration syndrome deprives the baby of oxygen. Oxygen deprivation can cause permanent brain damage.

What are the legal issues surrounding meconium aspiration syndrome?

While most cases of meconium aspiration syndrome do not cause long-lasting effects, some cases can result in brain damage and other serious side effects of oxygen deprivation.

In some cases, the effects of meconium aspiration are unavoidable. Even if your doctor and medical team was carefully monitoring the fetus’s vital signs and did everything they could to ensure no meconium made it into the baby’s lungs and airways, meconium aspiration can still occur. However, this condition is often preventable. If the negligence of a medical care provider resulted in your child suffering from meconium aspiration syndrome, you may have a claim for compensation.

What is medical malpractice?

A claim against a medical care provider for meconium aspiration syndrome is a type of medical malpractice claim. In general, medical malpractice claims have three parts. First, you must show the existence of a “doctor-patient relationship.” That’s a legal term that means the doctor or care provider agreed to care for you and your child. Second, you must show that the care provider was negligent in caring for you and your child. This usually involves having an expert witness (typically another doctor in the same field) testify about the care provider’s behavior. The expert witness will describe the accepted standard of care in the medical field and show that your care provider’s actions did not meet that standard.

Finally, you must show that the care provider’s negligence actually caused the injury your child suffered. For example, a doctor is liable if your baby suffers a broken bone because the doctor yanked on the baby’s arm in a dangerous way. If your doctor yanks on the baby’s arm in a dangerous way but the baby isn’t injured, the doctor isn’t liable. If the doctor yanks on the baby’s arm in a dangerous way and the baby is injured due to an unrelated cause, the doctor isn’t liable. There has to be a clear link between the doctor’s negligence and the injury.

Meconium Aspiration Birth Injury Claims

A malpractice claim related to meconium aspiration syndrome must meet the same three basic requirements of any medical malpractice claim. The existence of a doctor-patient relationship is easy to prove; the fact that a doctor worked on your delivery is typically enough to show that aspect. The second two parts are more complicated. Medical negligence leading to meconium aspiration syndrome can occur either during the delivery or after birth.

Negligence During Delivery

Fetuses typically expel meconium as a result of stress, most commonly due to oxygen deprivation. The fetus may be oxygen-deprived as a result of an aging placenta, compression of the umbilical cord, prolonged and difficult labor, or various health issues in both mother and child. During delivery, your medical care team will place fetal heart rate monitors on your belly. If the baby’s heart rate drops, that’s a sign that the baby isn’t getting enough oxygen and is experiencing distress. In addition, your medical care team should check your amniotic fluid when your water breaks. If it has streaks of darker material in it or if it is green, that’s a sign that your baby has already expelled meconium.

The appropriate course of action will depend on the unique circumstances of your labor and delivery, but doctors will typically attempt to speed up labor to minimize the amount of time the baby is deprived of oxygen. In some cases, a Cesarian section may be required to remove the baby immediately. If your medical care team ignores signs of fetal distress or fails to appropriately monitor the baby’s heart rate, the baby may expel meconium and suffer meconium aspiration syndrome or other permanent damage due to oxygen deprivation.

Negligence After Birth

Meconium aspiration can occur even after delivery. If the fetus is in distress (as shown by the heart rate monitors) or if there is meconium in the amniotic fluid, your medical care team should suction out the baby’s mouth, nose, and airways immediately after birth to clear out any meconium and prevent the baby from inhaling meconium deeper into the lungs. Failure to clear out this meconium can lead to meconium aspiration syndrome. One study shows that this could be a big difference between life and death — about 1 in 3 hospitalized babies in Pakistan died after being diagnosed with meconium aspiration syndrome; however, the overall mortality rate in the United States for children diagnosed with meconium aspiration syndrome is much lower at 1.2%. (R) (R)

If your baby has already aspirated meconium, your medical care team will need to administer the appropriate treatment to ensure that the baby is receiving enough oxygen. Your doctor will examine the baby immediately after birth to make sure the baby is breathing normally, has a healthy heart beat, has pink skin (indicating sufficient blood oxygen levels), and has healthy muscle tone. If your baby is crying and breathing normally, no treatment is required. If your baby is struggling to breathe, meconium aspiration syndrome may be at fault and your medical care team will need to give the proper treatment. In addition to suctioning out the airways, treatment may include administering oxygen or using a ventilator or ECMO. Failure to treat meconium aspiration syndrome promptly can cause serious and permanent brain damage — depriving the brain of oxygen for even a few minutes can have lifelong consequences.

In addition to the direct effects of meconium aspiration, your baby may suffer injuries as a result of medical negligence during treatment for secondary effects. Meconium aspiration can cause lung collapse and chemical pneumonitis. If your baby’s doctors act negligently in treating these issues, your baby may suffer permanent lung damage or brain damage due to oxygen deprivation.

When to Speak to an Attorney

If you believe that negligence by your medical care team may have caused your child’s meconium aspiration syndrome or failed to prevent its secondary effects, contact an experienced local attorney for a case evaluation and consultation. No amount of money can undo the pain of an injured child, but it can ease the burden of big medical bills and any ongoing care requirements.

What questions should I ask my doctor?

Meconium is the sticky black substance that usually makes up your little one’s first bowel movement. Sometimes, the baby will release meconium before birth and subsequently inhale it. That can cause meconium aspiration syndrome, a serious respiratory problem.

If your child is diagnosed with meconium aspiration syndrome, you need some information from your doctor.

1. What care does my child need now?

Your little one may need immediate medical attention to clear the meconium from the airways. Severe cases may need even more invasive treatment, such as being placed on a ventilator or receiving surgery for a collapsed lung. Make sure your doctors keep you informed of the care your child is receiving.

2. Is there long-term damage?

Mild cases of meconium aspiration may leave your child with little more than an increased risk for respiratory infections for a few months. Severe cases can cause permanent lung damage. Ask your doctor how severe your child’s case is and whether there will be lasting damage to the lungs or airways.

3. Will my child need treatment at home?

Children with breathing problems typically won’t be released from the hospital until they can reliably breathe on their own, but your doctor may recommend use of a humidifier or certain medications to help keep your baby’s airways clear.

4. What signs of side effects should I watch for?

Some of the symptoms of meconium aspiration may not appear right away. Ask your doctor what signs to watch out for and when to seek medical attention.

5. How did my child get meconium aspiration syndrome?

Ask your doctor about the likely causes of your child’s condition. You may need that information for future pregnancies. Your doctor may also have made a medical mistake, in which case you may be entitled to compensation for the costs associated with the injury.

What should I expect if my baby has meconium aspiration syndrome?

Advances in management of meconium aspiration syndrome has seen a decrease in the amount of cases over the years. This can be attributed to fewer post-term deliveries, increased fetal heart rate monitoring, and fewer infants with low Apgar scores. (R)

If your baby has aspirated meconium, your doctor will administer the appropriate treatment immediately after birth. As soon as your baby is born, a doctor or nurse will suction out the baby’s mouth and airways to remove any meconium there. Then the doctor will perform an Apgar test to check the baby’s breathing, heart rate, and muscle tone.

For mild cases, the suction alone is sufficient and your baby will start to breathe and cry normally. If suction is insufficient and your baby is still showing signs of oxygen deprivation, your doctor may administer oxygen to the baby.

For severe cases, the baby may need to be taken away to the Newborn Intensive Care Unit (NICU) for more serious treatment. The baby may be placed on a ventilator or on ECMO to relieve the strain on the baby’s lungs and ensure healthy oxygen levels. The baby will be placed in an incubator to stay warm and may be connected to one or more machines. It can be overwhelming to see your new little one surrounding by tubes and machines, but these machines are making sure your baby’s brain gets enough oxygen. (R)

In most cases, treatment for meconium aspiration syndrome will take just a few days. After that, you’ll be able to take your new arrival home. You’ll need to keep a careful eye out for symptoms of breathing trouble: grunting or straining to breathe, limpness, blue skin tone, failure to cry, or failure to nurse. If you see any of these signs, seek medical attention immediately to ensure that your baby does not suffer long-term problems from oxygen deprivation.

Can meconium cause brain damage?

Unfortunately, severe cases of meconium aspiration syndrome can deprive the baby’s brain of oxygen for long enough to cause brain damage. In that case, your child may suffer a variety of long-term symptoms due to that damage. Brain damage from oxygen deprivation may cause cerebral palsy, developmental disabilities, physical disabilities, or mental retardation. If your child suffers any of these effects, you’ll need to work with your child’s doctors to create an appropriate treatment plan.

As mentioned above, most cases of meconium aspiration syndrome have no long-term effects. For the first year or so of life, babies who suffered meconium aspiration syndrome may be more likely to contract respiratory infections. You’ll need to watch out for signs of infection such as fever, coughing, and limpness. (R)

Meconium Aspiration Syndrome Resources for Parents

Fortunately, most cases of meconium aspiration syndrome are mild and resolve with few or no long-term effects. The more severe cases, however, may require extensive medical care. That can take its toll on your family’s emotions and finances. These resources can help ease the burden.

• Medicare and Medicaid: If your child has health problems and you don’t have insurance, Medicare or Medicaid can provide the coverage your little one needs. Children with meconium aspiration syndrome may need emergency care, which is extremely expensive, so insurance coverage is crucial.
• Social Security Disability Benefits: Your child may be entitled to Social Security Disability benefits if there is long-term damage due to meconium aspiration.
• Prescription medication help: Your child may need prescription drugs, which can be costly. Two different organizations may be able to help. The Partnership For Prescription Assistance and NeedyMeds can connect you with low-cost or no-cost medications and clinics.
• United Healthcare Children’s Foundation: Whether or not you use United insurance products, the UHCCF can provide your family with needed financial assistance.
• Online communities: Raising kids is hard enough. When your child has health problems, it can be even harder. Search online for local communities of parents and children who also are dealing with the effects of this condition. They may be able to offer tips and tricks, advice, emotional support, and local events for you and your little one.