Patient Information Service

Meconium-stained liquor and your newborn baby

What is meconium-stained liquor? Your baby’s digestive system begins to work from early in the pregnancy and starts to make waste products. The solid product is called meconium and is generally passed as the first stool soon after birth, although it can be passed earlier. If it is passed before birth it becomes diluted by the fluid (waters) around the baby and this is called ‘meconium-stained liquor’.

Why has my baby passed meconium before birth? Passing meconium before birth may indicate that baby has been distressed but in babies born after their due date it is generally because their digestive system is mature and does not indicate distress. Between 15 per cent and 20 per cent of babies born at term will have passed meconium during late pregnancy or labour and in the majority of cases this does not become a problem. However, occasionally a baby will inhale meconium either in the late stages of labour or at/just after birth and this can cause a problem called meconium aspiration syndrome (MAS). Although rare (approx 1:1,000 births), it causes respiratory distress (breathing problems) which can be a serious problem requiring admission and treatment in the neonatal unit (NNU).

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Why does my baby need extra observations? If your baby has been born following meconium-stained liquor a paediatrician will generally have been present at, or soon after the birth and assessed your baby’s condition and has established that your baby has shown no immediate signs of breathing difficulties. This means that you and your baby can be transferred to the postnatal ward. However, breathing difficulties may not be immediately apparent and it is recommended that your baby is regularly checked for up to 12 hours (two hours for light meconium or 12 hours for significant meconium) to ensure that symptoms do not develop. If you had a homebirth and baby was born with significant meconium-stained liquor then NICE recommends that you and your baby be transferred to the postnatal ward so there is immediate access to paediatricians if there is any cause for concern.

What observations are carried out? The checking is non-invasive and can be carried out, with your permission, at the bedside. We appreciate that you may have planned to go home soon after the birth and/or may not want these additional observations but we would recommend that these observations are undertaken in the hospital where trained professionals are available should your baby’s condition give cause for concern.

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The recommended observations are: • oxygen saturations • chest movements and nasal flare • skin colour • feeding • muscle tone • temperature • heart rate and respiration. The midwife and/or nursery nurse will discuss her findings with you and no further action is needed if your baby’s observations are within the normal ranges. However if there is any cause for concern this will be discussed with you and a paediatrician will be consulted if appropriate. If the observations remain within normal ranges after the recommended time then no additional action is needed. This means that if you had booked a domino delivery your baby can be discharged by a midwife and if you booked a hospital delivery your baby will be offered the routine newborn check at/after the observations have finished as usual. Although it is most unlikely that your baby will develop symptoms after 12 hours, if your baby develops any breathing difficulty or becomes unwell after you have gone home you can contact your midwife/GP or come to Accident and Emergency as indicated.

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Patient Information Service If this leaflet does not answer all of your questions, or if you have any other concerns please contact the postnatal ward on: 01702 385130.

www.southend.nhs.uk For a translated, large print or audio tape version of this document please contact: Patient Advice & Liaison Service (PALS) Southend University Hospital NHS Foundation Trust Prittlewell Chase Westcliff-on-Sea Essex, SS0 0RY Telephone: 01702 385333 Fax: 01702 508530 Email: [email protected]

Written by Caryn Himsley and PIPMS women and children’s business unit Reviewed and revised December 2014 Leaflet due for revision December 2016 Form No. SOU2992 Version 3