One page summary: Meconium aspiration syndrome

In two sentences

meconium is a baby's first stool. Sometimes a baby passes it before birth, which stains the fluid green or brown. That is common and most of those babies are completely well. ¹

Meconium aspiration syndrome is different. It means the baby breathed meconium into the lungs, where it blocks airways, irritates the tissue and interferes with surfactant. That causes breathing difficulty that can be severe. ²

The numbers, with their sources

• Stained fluid is common. Meconium-stained amniotic fluid is a frequent finding, particularly at and after the due date, and most babies born through it do not develop the syndrome ³
• What changed in practice. Routine suctioning of the airway of a vigorous baby born through meconium is no longer recommended, and neither is routine intubation to suction a non-vigorous baby ¹
• What replaced it. The focus is on effective ventilation. A baby who is not breathing well is given breaths rather than delayed for airway suctioning ¹
• The main complication. Persistent pulmonary hypertension of the newborn, in which the lung blood vessels stay tight and oxygen levels stay low ⁴
• When it is more likely. At or beyond the due date, and where there are signs of fetal distress before or during labor ³
• Treatments used. Oxygen and ventilation, surfactant, inhaled nitric oxide, and ECMO in the most severe cases ⁴

What to do this week

1. Ask whether there was a period of low oxygen, and what the cord gases showed.
2. Ask whether persistent pulmonary hypertension of the newborn is present and what is being done for it.
3. Ask whether cooling was considered, if there is any concern about brain injury.
4. Ask whether an infection screen was done.
5. Ask for a hearing assessment to be arranged before discharge.
6. Ask for developmental follow-up to be arranged.
7. Request the labor records, including the fetal monitoring strips, using the records request builder.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the neonatologist

• How severe is the lung disease, and what support is my baby on?
• Is there pulmonary hypertension?
• What were the cord blood gases?
• Was there a period of low oxygen, and was cooling considered?
• Is infection being treated or ruled out?
• What is the plan if this gets worse?

For the obstetric team

• When was meconium first noted?
• What did the fetal heart rate tracing show, and for how long?
• How many weeks pregnant was I, and what was the plan for the pregnancy?
• What was the indication for the mode of delivery?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Meconium aspiration syndrome

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.