Meconium Aspiration Syndrome

Meconium is a thick, dark green, sticky substance that is found in the intestines of a fetus. Meconium is passed in a baby's first bowel movement. Usually this occurs after birth, but sometimes it occurs before birth or during labor. Meconium that is passed before birth or during labor goes into the liquid that surrounds the fetus (amniotic fluid), where it may be breathed into the baby's lungs. Meconium aspiration syndrome is a lung problem that can occur if meconium is breathed in before it can be removed from the mouth and throat.

RISK FACTORS

Passing of meconium in the amniotic fluid happens more often:

  • In term or overdue babies.  

  • When the fetus is not getting enough oxygen, especially during labor (fetal distress).  

  • If the mother has diabetes or hypertension.

  • After a long or difficult labor.

SIGNS AND SYMPTOMS

  • Difficulty breathing. This usually lasts only a few days.  

  • Rapid breathing. This may last for several days, even after the baby is better.  

  • Grunting noise when breathing out.  

  • Sucking in of the spaces between the ribs when breathing in.  

  • Nostrils flare open when the baby breathes in.  

  • Blue skin color.  

  • Skin is stained with meconium.  

  • Limpness.

DIAGNOSIS

A diagnosis is made based on the labor and delivery, a physical exam, and tests. These may include:

  • A chest X-ray.  

  • Blood tests.  

TREATMENT

Your infant may be kept in the neonatal intensive care unit (NICU). Care may include:

  • A warmer to maintain body temperature.  

  • Oxygen and monitoring for oxygen levels.  

  • Breathing assistance through a nasal cannula, mask, or breathing machine (ventilator).

  • In very severe cases, a treatment that uses a machine to give the blood oxygen outside of the body. This is called extracorporeal membrane oxygenation (ECMO). ECMO is used when a ventilator has not worked.  

  • IV fluids because your baby will not be able to eat until the breathing problems improve.  

  • Antibiotic medicines. Early in the care of your baby, it may be hard to know if your baby has an infection, meconium aspiration syndrome, or both. Antibiotics may be given until your health care provider feels it is safe to stop giving them.  

  • A medicine that helps keep the tiny air sacs in the lungs from collapsing (surfactant).  

HOME CARE INSTRUCTIONS

  • Only give over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your child's health care provider.  

  • Give your child antibiotics as directed. Make sure your child finishes them even if he or she starts to feel better.  

  • Follow the health care provider's recommendations regarding an immunization schedule for your child.

  • Ask the health care provider if your child should have his or her hearing monitored, because severe meconium aspiration has been associated with hearing loss.

  • Babies who have had meconium aspiration syndrome may have lung trouble for the first year or two of life. Follow the health care provider's recommendations if your baby is sent home with oxygen or breathing treatments.

  • Even a mild illness can be more difficult for babies who have had meconium aspiration syndrome, so monitor your baby closely for signs that he or she should see a health care provider.

SEEK MEDICAL CARE IF:

  • Your baby has a cough.  

  • Your baby is not feeding well.  

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child who is younger than 3 months has a fever.  

  • Your child who is older than 3 months has a fever and persistent symptoms.  

  • Your child who is older than 3 months has a fever and symptoms suddenly get worse.  

  • Your baby has trouble breathing. Signs that there is trouble breathing include:  

  • Rapid or noisy breathing.  

  • Grunting noise when breathing out.  

  • Sucking in of the spaces between the ribs when breathing in.  

  • Nostrils flare open when breathing in.  

  • Your baby is not easy to wake up.

  • Your baby's lips or fingers and toes appear blue.