A health condition in which a newborn breathes in a sticky substance known as meconium just before or during birth is called meconium aspiration syndrome. It may cause breathing problems and respiratory distress. In general, it is rare for this condition to cause chronic complications or serious health problems. Usually, early diagnosis and proper treatment help improve the outcomes.
Sometimes, this condition is called meconium aspiration, and it occurs when a sticky substance enters the lungs before or during birth. Moreover, meconium is a substance that becomes the baby’s first poop. Inhaling this substance may lead to blocked or irritated airways, damage to the lungs, and blocked surfactant.
Why is Meconium Aspiration Dangerous?
This is a specific substance that has a thick and sticky texture. Usually, it is so sticky that it is difficult to remove from the baby’s bottom with a wipe. Now, imagine what could happen if this substance enters the baby’s lungs. It can get stuck inside the airways, which prevents the lungs from inflating and deprives them of air.
How Common is Meconium Aspiration Syndrome?
This substance passes into the amniotic fluid in about 12% to 20% of all births. The medical term that describes it is meconium-stained amniotic fluid. More commonly, the meconium enters the amniotic fluid in full-term (40 weeks of gestation) or post-term (after 42 weeks of gestation) babies. Thus, only 2% to 10% of babies born through meconium-stained amniotic fluid develop this syndrome.
Symptoms
In general, inhaling meconium is dangerous. Check the most common symptoms of meconium aspiration syndrome below:
- Slow heart rate
- Cyanosis (blue skin color)
- Grunting
- Fast breathing
- Chest retractions
- Limpness
- Difficulty breathing
Immediately contact your healthcare professional if you notice your child has any of the previous symptoms. Otherwise, it may lead to serious health problems.
What Are The Signs of Meconium-stained Amniotic Fluid?
When the amniotic fluid contains meconium, its color turns greenish-brown. Moreover, babies who are exposed to meconium-stained amniotic fluid may have yellow skin and nails at birth. Usually, doctors are trained to detect meconium aspiration during or after birth.
Causes and Risk Factors
In general, there are several reasons that can cause this condition. One of the most common is stress, but it may also happen due to other causes (including infections or low oxygen levels). However, stress can cause your baby to make strong and deep gasps. Hence, a forceful gasp allows the meconium to enter the lungs. As a result, the aspirated meconium blocks the baby’s airways, causing breathing problems.
Furthermore, there are some factors that increase the risk of meconium-stained amniotic fluid. These include:
- Post-term pregnancy – The risk of meconium aspiration syndrome increases in babies who are born after 40-42 weeks due to placental aging and reduced amniotic fluid.
- Fetal distress – Health conditions that cause reduced oxygen to the fetus (hypoxia) during labor also increase the risk of meconium aspiration syndrome.
- Maternal health conditions – For example, preeclampsia, hypertension (high blood pressure), gestational diabetes, and others.
- Prolonged labor
- Oligohydramnios (reduced level of amniotic fluid)
- Thick meconium
- Intrauterine growth restriction (IUGR)
- Misuse of recreational drugs or alcohol
- Smoking during pregnancy
- Infections (such as chorioamnionitis)
What Happens if Meconium Aspiration Syndrome is Left Untreated?
Babies who do not get treatment may experience the following complications. These include:
- Neurological damage – For example, hypoxic-ischemic encephalopathy (HIE) that occurs due to oxygen deprivation. Without immediate treatment, it may lead to permanent damage to the brain or cerebral palsy.
- Cardiovascular problems – One example is persistent pulmonary hypertension of the newborn (PPHN).
- Respiratory issues – These include pneumothorax (collapsed lung), pneumonia, pulmonary air leaks, asthma, chronic lung disease, and others.
- Developmental delays – Babies with meconium aspiration syndrome may develop long-term (chronic) impairment in speech, motor skills, or learning.
- Death (in severe cases)
This document does not contain a complete list of meconium aspiration syndrome complications, but you can consult with your doctor about measures to reduce the risk of the complications listed above. In addition, not everyone who gets meconium in the lungs will develop this syndrome.
How to Prevent Meconium Aspiration Syndrome?
Unfortunately, there is no way to prevent your baby from aspirating meconium. The best ways to reduce the risk of this syndrome are to monitor the amniotic fluid for meconium and watch for fetal distress. Early detection and proper treatment often help prevent life-threatening complications. Doctors may also recommend managing risk factors for this condition (such as gestational diabetes).
Diagnosis
When doctors suspect meconium in the amniotic fluid, they will watch for signs of aspiration during or after delivery. Moreover, if the babies release meconium, it does not necessarily mean they will breathe it in. Healthcare professionals may also perform an imaging test (an X-ray) of the baby’s chest to get more information about the disease. This imaging test is the most common test used to confirm or rule out meconium aspiration syndrome. During this test, doctors may also check oxygen and carbon dioxide levels.
Treatment
Physicians often prescribe different treatments for meconium aspiration syndrome. It often depends on the volume and consistency of meconium and the amount of respiratory distress your baby is experiencing. When your baby’s born crying and active, treatment may not be needed.
In general, the first treatment for this syndrome is suction. During this procedure, physicians will remove meconium from the baby’s mouth, nose, and throat using a bulb syringe. Therefore, they may insert a tube down the baby’s throat to remove this substance from the airways. Rarely, babies with meconium aspiration syndrome need to stay in the neonatal intensive care unit (NICU) for regular monitoring and more advanced treatment. For example:
- A ventilator
- Surfactant or antibiotics to open their lungs and clear infections
- ECMO (extracorporeal membrane oxygenation)
- CPAP (continuous positive airway pressure)
- A radiant warmer (it helps control the baby’s temperature)
Frequently Asked Questions
What is meconium?
This is a sticky substance that is the first baby’s poop. It is made up of cells, mucus, hair, bile, and other substances. Usually, babies pass meconium within 48 hours of birth.
What happens when a baby swallows meconium?
In general, swallowing meconium does not cause serious health problems. However, if this substance enters the lungs, it may cause serious health problems, including pneumonia, pneumothorax, and asthma.
How long does it take to recover from meconium aspiration syndrome?
Most of the time, babies recover within a few hours, but in more severe cases, it may take several days in the NICU or require supplemental oxygen for weeks. If you have additional questions, ask your healthcare provider.
