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Meconium refers to the first stool of a newborn. The stool of a newborn, just out of the mother's womb, who is yet to be breastfed, will not contain breast milk or formula. Instead, it would be packed with materials that the baby ingested while in the uterus. For instance, the skin cells that have been shed, the amniotic fluid, mucus, bile, water and lanugo, the fine soft hair that covers the baby's body.
Meconium is greenish-black in colour and is sticky, thick and super-dark. Due to its high viscosity, it can cling to your baby's back. But, did you know, the very first stool of your newborn is free of bacteria? However, infants pass meconium only on the first day or so. Thereafter the colour of the stool changes to greenish brown and then yellow.
1. What Is Foetal Meconium Aspiration?
2. How Does Meconium Aspiration Impact The Baby?
3. How Is Meconium Aspiration Treated?
4. Complications Of Meconium Aspiration
5. Long-term Effects Of Meconium Aspiration
What Is Foetal Meconium Aspiration?
Sometimes (in 25 per cent of the cases), the baby may pass meconium in the womb or on their way out. This pre-birth meconium also taints the colour of the amniotic fluid, and your doctor gets an indication that meconium has been passed.
Then the doctor will have to monitor the baby carefully to ensure that the baby doesn't develop any complications. This is because, when the stool is passed in the womb, there are chances that the unborn baby may inhale it. This complication is referred to as Meconium Aspiration Syndrome (MAS). This mostly happens when the baby is overdue. It can also occur while the baby is in the womb, during labour or after delivery, as the baby inhales a mixture of meconium and amniotic fluid, which could partially or completely block the airways.
The severity of Meconium Aspiration Syndrome is dependent on how much meconium the baby has inhaled and, other underlying conditions such as infections within the uterus, or when the baby is overdue for delivery.
The real cause of meconium aspiration is still not known, while some doctors feel it may be due to stress. In case the doctor feels that the baby has trouble breathing, the doctor may insert a laryngoscope into the trachea to remove any meconium. The doctor will also monitor the baby's lungs to check for sounds similar to Meconium Aspiration Syndrome. Some blood tests may be ordered to determine if the baby is getting sufficient oxygen and a chest X-ray that can show patches on the lungs found in babies with this syndrome.
How Does Meconium Aspiration Impact The Baby?
A newborn with Meconium Aspiration Syndrome will be impacted as below:
• Dark green stains may be noticed in the amniotic fluid.
• Discolouration may be seen on baby's skin (blue or green).
• Breathing troubles may develop, such as rapid breathing, difficult breathing or suspension of breathing. Sometimes grunting sound may be heard when breathing.
• Low heart rate may be seen in the baby before birth.
• The baby may have a low 'Apgar' score, such as the evaluation of heartbeat, colour, muscle tone, reflexes or breathing.
• There may be limpness in the baby.
• The baby may show signs of post-maturity.
• A bloated chest due to trapped air.
• Babies with severe aspiration may need ventilation
How Is Meconium Aspiration Treated?
Treatment of meconium aspiration would depend on your child's symptoms and general health. It also depends on the severity of the condition. The treatment for meconium aspiration would depend on factors such as the amount of meconium inhaled, the duration of baby's exposure to meconium, and how your baby breathes.
Treatment at birth may include:
• Use of suction on upper airways including mouth, nose and throat
• Using suction on lower airways by the way of an endotracheal tube placed in the windpipe. But, this is done only if absolutely necessary.
• Giving oxygen by use of a face mask or mechanical ventilator.
Most babies generally get better within a few days. But, in severe cases, it may prove to be fatal.
Complications Of Meconium Aspiration
When the baby inhales first breath, bits of meconium can enter the airway and be inhaled deep into the lungs. Meconium may then adhere to the air sacs, making it hard for your baby to breathe. It may also trap air in baby's lungs. One possible complication of Meconium Aspiration is contracting an infection, which leads to pneumonia.
Long-term Effects Of Meconium Aspiration
Unfortunately, severe cases of meconium aspiration syndrome may deprive oxygen supply to the baby's brain, long enough to cause brain damage. A brain damage due to oxygen deprivation may lead to developmental disabilities, cerebral palsy, mental retardation or physical disabilities.
However, long-term outcomes are largely dependent on the degree of aspiration and the actual condition during delivery, and whether the treatment was given in a timely manner. Most babies recover well from meconium aspiration if they are given proper care at the right time.