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Meconium refers to a tarry, sticky, and dark green substance, that line a baby's intestines before it is born. Generally, meconium does not get released into a baby's bowel movement until the baby is born. Sometimes meconium can pass while the baby is still in utero. This becomes worrisome, especially if the meconium is thick, because the baby is at risk for lung aspiration when this occurs. Typically, meconium that is scant poses little risk to the baby. When it is thick, however, it may harm lung function.
Typically, when meconium staining is evident, as occurs when normally clear amniotic fluid becomes either yellow or green, the mother is monitored carefully during labor. When this occurs, the health care provider stands by with an instrument referred to as a DeLee suction. This apparatus can suction the meconium out of the baby's lungs before he takes his first breath, possibly preventing aspiration. Generally, when evidence of meconium is present, the baby will be more intensely monitored for fetal distress.
As the labor process progresses, and abnormal heart rate or respiration rate tells the health care professionals that the baby is in fetal distress, a cesarean section birth may be warranted. If, however, surgery is not necessary, a hastened delivery using a vacuum extraction apparatus or forceps may be necessary. When meconium is aspirated or inhaled in the newborn's lungs, it is referred to as meconium aspiration. This condition can lead to infections such as pneumonia, and warrant a stay in the neonatal intensive care unit.
Ordinarily, treatment for meconium aspiration, or chemical pneumonia requires treatment with antibiotics. In addition, the baby may need oxygen therapy to assist with breathing until he can breathe unassisted. Because these babies can become gravely ill very quickly, their conditions need to be carefully monitored. This type of monitoring may include a cardiac monitor and frequent blood tests to gauge the function of the baby's heart, kidneys, and lungs.
The length of stay in the neonatal intensive care unit, or NICU, depends upon the severity and extent of the condition. The baby may stay in the unit from a few days to many weeks. Typically, the neonatal patient makes a complete recovery, with no lasting effects. Sometimes, however,they may encounter lasting respiratory effects that may need periodic monitoring and medical evaluation. Meconium staining is not uncommon, however, it needs to be carefully monitored and treated to reduce the risk of complication.