Meconium Aspiration Syndrome

Hearing your baby cry for the first time should be a magical moment. Although there will be countless nights in the future when the baby’s crying feels decidedly less wonderful, that first cry out means your baby has taken its first breath and its little lungs are full of fresh air.

If your baby is delivered and the crying doesn’t start, it can be a moment of absolute terror. Why is it taking so long? What could be wrong? Will my baby be okay? 

There are many reasons why a newborn may not be breathing on its own or labouring for breath, but all require prompt action on the part of the doctor, midwife, and/or delivery team. Newborns need oxygen within a few minutes of birth or the risk of brain damage increases quickly.

One of the most common reasons for an infant’s breathing difficulties immediately after birth is meconium aspiration syndrome (MAS). If the newborn breathes in meconium (a mixture of the baby’s first stool and amniotic fluid) around the time of delivery, it can result in respiratory distress.

Meconium aspiration syndrome is fairly common and occurs in between five to 10 percent of births. With prompt treatment, most cases will resolve without any long-term effects on the child. However, if a medical provider does not diagnose or properly treat MAS, it can be a leading cause of severe disease or death for infants. If your child has been injured by meconium aspiration syndrome and you believe it was due to medical malpractice, you may be able to make a claim for compensation and damages for your losses.

How does Meconium Aspiration Syndrome occur?

A birth injury risk.

Late in a pregnancy carried to term, the fetus will begin producing its first stool/feces.  Known as meconium, it consists of intestinal secretions like bile, chemical substances (fats, proteins, carbohydrates, nitrogen and electrolytes), cells and swallowed amniotic fluid containing lanugo hair. This stool is thick, sticky and usually a dark green colour.

The meconium is normally excreted in the hours or first few days after birth. Sometimes, meconium is released when the fetus is still in the womb. This may occur if the pregnancy has passed the due date, but most often occurs if the fetus is stressed before or during delivery. A disruption of oxygen to the fetus, for example, may cause the sphincter muscles to relax.

When meconium is passed during pregnancy or delivery, it may mix with amniotic fluid. Sometimes the fetus will gasp for breath while still in the womb or during delivery. If meconium gets into its lungs it can block airways, cause injury to lung tissue, and block surfactant (a substance that opens the lungs).

What are the risk factors for Meconium Aspiration Syndrome?

Risk factors for meconium aspiration syndrome include:

• A late pregnancy. 
• The fetus is in the breech position prior to delivery.
• A long and challenging delivery.
• Low amniotic fluid.
• Complications causing low oxygen levels in the fetus.
• Maternal health issues (infections, high blood pressure, diabetes, smoking during pregnancy).
• Poor growth of the fetus during pregnancy, placental dysfunction.

What are the signs of Meconium Aspiration Syndrome?

Infants with meconium aspiration syndrome may have:

• A blue tone in their skin colour or nail beds.
• Breathing difficulties or abnormal breathing sounds.
• A slow heart rate.
• Low blood pressure.
• Limpness.
• Yellow nails and skin.
• A distended chest.
• Green urine.

How is Meconium Aspiration Syndrome diagnosed?

Medical providers have a number of ways to diagnose meconium aspiration, including observing:

• Abnormal heart rates on the fetal monitor prior to birth.
• The presence of meconium in the amniotic fluid.
• Meconium stains on the baby’s vocal chords.
• Crackling sounds heard through a stethoscope.
• Abnormal readings on a blood gas analysis test (low oxygen, high carbon dioxide, low blood acidity).
• Patches or streaks on the lungs seen on an X-ray.
• Blood tests reveal polycythemia (infant blood has an abnormally high red blood cell count indicating a previous period of oxygen deprivation in the womb).

How is Meconium Aspiration treated?

As soon as the baby’s head is visible, external bulb suctioning should occur to remove fluids from the mouth and nose. Tapping on the chest once the baby is delivered may also help loosen secretions in the lungs. Sometimes internal suctioning through a tracheal suction tube is needed. Additional treatment is required if the meconium present is especially thick or the baby is showing signs of distress.

Babies requiring higher levels of care will be transferred to special nurseries or the neonatal intensive care unit where warmers may be used to maintain a healthy body temperature. If the baby is receiving oxygen but not responding or continuing to struggle, (s)he will be put on a ventilator and given additional interventions such as:

• Surfactant to open and support the lungs.
• Nitric oxide added to oxygen to help open blood vessels.
• Extracorporeal membrane oxygenation (ECMO). This medical device acts like a pump to move blood from the body into an artificial lung. Excess carbon dioxide is removed from the blood and oxygen is added to the bloodstream.
• Antibiotics to treat potential infections from any remaining meconium in the lungs.

What happens if Meconium Aspiration is untreated or the baby does not respond to treatment? 

Even minor cases of meconium aspiration syndrome can cause severe, long-term effects or permanent disability if it remains untreated.

Persistent chemical irritation of airways by meconium creates inflammation in the lungs that may cause long-term respiratory problems. For example, a baby may: 

• Develop severe asthma-like symptoms.
• Suffer from hindered growth.
• Be prone to viral or bacterial pneumonia.
• Oxygen deprivation from meconium aspiration can also lead to brain injury which can cause: 
• Seizures.
• Hypoxic-ischemic encephalopathy.
• Cerebral Palsy.
• Strokes. 

Has there been medical negligence?

Meconium Aspiration is often preventable. If the condition occurs, it is worth considering whether medical negligence on the part of a doctor, midwife, or medical team has occurred.

Since newborn meconium aspiration primarily occurs from fetal distress, the medical provider should be aware of risk factors and causes of meconium aspiration syndrome in advance of delivery and act decisively if fetal monitoring reveals complications during delivery that could prompt a release of meconium.

Medical providers should:

• Be aware of maternal risk factors.
• Consider inducing labour if the pregnancy goes past the due date.
• Ask whether the mother saw a greenish colour when her water broke.
• Perform an emergency caesarean section if fetal distress is observed and unmanageable.
• Take steps to reduce agitation in the newborn.
• Delay first feeding until the condition is treated.

It is important to note that meconium aspiration syndrome itself may not be the cause of serious birth injury. Rather, it may be a symptom of a previous birth injury that occured in the womb, such as chronic oxygen deprivation or placental insufficiency.

Medical providers have strict standards of care to follow while monitoring a pregnancy, delivering a baby and offering post-natal care. If these standards are breached due to negligent actions or inaction and you or your baby are injured as a result, the medical provider may be liable for damages and losses.

What should I do if my baby has suffered an injury from Meconium Aspiration Syndrome?

Discovering your baby has aspired or ingested meconium can be disturbing. If you believe your baby has sustained a serious injury due to meconium aspiration (or believe it may be a symptom of a previous birth injury), it is always worthwhile to investigate why this may have occurred.

When you contact one of Gluckstein’s medical malpractice lawyers, we will listen with interest and empathy as you explain what has happened. During this free, no obligation consultation, we will explain your various options and outline the steps we will take as your legal representatives if you pursue a medical malpractice claim.

After our team and independent medical experts review your baby’s medical records, we will determine whether a civil suit stands a good chance at success. You may worry that you cannot afford to pursue a medical malpractice case, but with Gluckstein Lawyers, we will only get paid if we are successful in winning you a court award or negotiating a settlement.

Why choose our Meconium Aspiration Syndrome birth injury lawyers?

When your newborn has suffered a serious birth injury, you and your loved ones begin a journey you probably never expected to take. If the injury resulted in your child’s permanent disability, you may grieve for what might have been, but still begin to find ways to help them live their best life possible.

Choosing who will join you on this journey is an important consideration. With our reputation for professionalism, our track record of proven results, and our commitment to full-circle client care, you can trust the team at Gluckstein Lawyers to be there for you in this difficult time.

Our experienced, knowledgeable and skilled lawyers are known for our fierce advocacy on behalf of clients. But, in this time when you are trying to heal from a tragic setback, you can also depend on our team to treat you as we would treat our own family. We will show you the compassion, kindness and attentive care you deserve.

Contact Gluckstein Lawyers today to learn more about what our team can do for you.