Treatment:

The delivering obstetrician or midwife should suction the newborn's mouth as soon as the head emerges during delivery.

Further treatment is necessary if the baby is not active and crying immediately after delivery. A tube is placed in the infant's trachea and suction is applied as the endotracheal tube is withdrawn. This procedure may be repeated until meconium is no longer seen in the suction contents.

The infant may be placed in the special care nursery or newborn intensive care unit for close observation. Other treatments may include:

• Antibiotics to treat infection
• Breathing machine (ventilator) to keep the lungs inflated
• Oxygen to keep blood levels normal
• Radiant warmer to maintain body temperature

If there have been no signs of fetal distress during pregnancy and the baby is an active full-term newborn, experts do not recommend deep suctioning of the windpipe, because it carries a risk of causing a certain type of pneumonia.

Expectations (prognosis):

Meconium aspiration syndrome is a leading cause of severe illness and death in newborns.

In most cases, the outlook is excellent and there are no long-term health effects.

In more severe cases, breathing problems may occur. They generally go away in 2 - 4 days. However, rapid breathing may continue for days.

An infant with severe aspiration who needs a breathing machine may have a more guarded outcome. Lack of oxygen before birth, or from complications of meconium aspiration, may lead to brain damage. The outcome depends on the degree of brain damage.

Meconium aspiration rarely leads to permanent lung damage.

Complications:

• Aspiration pneumonia
• Brain damage due to lack of oxygen
• Breathing difficulty that lasts for several days
• Collapsed lung (pneumothorax)
• Persistent pulmonary hypertension of the newborn (inability to get enough blood into the lungs to take oxygen to the rest of the body)