Meconium Staining & Terminal Meconium

Dear Michele,

I am sorry to hear how upsetting a time you and son must have had shortly after his birth. Certainly, it seems that your son experienced a number of complications that can occur during and shortly after birth, but before I answer your questions, let me first concentrate on the significance of meconium at birth.

Meconium
Meconium is the normal black, tarry stool that babies have for the first couple of days after birth. This stool is simply a lot of dead cells and swallowed amniotic fluid, which must pass before the regular breast-fed or formula-fed stools take its place. Usually, meconium does not pass until after the baby is born. This is the most relevant thing to say. There are a number of exceptions to this which include two important ones:

1. The post-mature baby: Babies born after 40 weeks of pregnancy have a higher chance of passing meconium while still inside mum. (Babies born on time or even before 40 weeks may also pass meconium, but it is more likely to happen where the baby is past the due date).
2. The baby who experiences some stress while still inside Mum. This "stress" may simply be from a long labour, perhaps infection, or the cord being compressed in some way. Stress is not necessarily a bad thing, but simply something that causes the baby's body to work a little harder to maintain adequate oxygen.

What's the big deal about meconium?
Meconium is a good thing when it arrives after the baby has been delivered. Problems can occur with meconium when it is present in the amniotic fluid before delivery. This thick gooey material can get lodged in the airway if the baby inhales it during delivery. And if enough is inhaled, it may settle in the lungs, making it very difficult for the baby to get enough oxygen by breathing after delivery. Fortunately, most of the time, when meconium is present in the amniotic fluid, the baby has no trouble with it.