Q: My wife gave birth to a 10 lb. 1 oz. baby boy on June 15.
According to her doctor, the baby was six days late.
Currently our baby is suffering from meconium aspiration
syndrome. My wife had an emergency c-section; however, our
boy had already taken the meconium into his lungs. He is
being given oxygen through a ventilator and appears to be
having a difficult time at the moment breathing on his own.
It appears the levels he has are relatively rare from the
few articles I have found.
My questions are: What are the percentages of babies that
get this type of syndrome?
What are my baby's chances of surviving without any lung
damage?
What are the survival rates?
If there are any books to read on this syndrome, please let
me know.
-Dan
The father of a big beautiful boy
====
A: Four years ago my grandson was born having aspirated
meconium. He was airlifted to Children's Hospital where he
was critically ill for about 10 days. However, he is a
lively four year old today, and the only lung related
problem he has is mild asthma. He gets a cough when he
catches a cold, but this heals as it would with any child.
-Beryl
====
A: Meconium aspiration is indeed rare but that does not
really matter if your dear baby has experienced it.
Babies are body/mind/spirit beings just as we all are. I
believe parents are most important to determining how well
baby will recover. Your baby needs your touch and to be held
skin-to-skin by you and his mother. Gene Cranston Anderson,
an important nurse researcher, has discovered that babies' T
cells [a way to measure the strength of your son's immune
system] is 50% higher when you hold him next to you skin
(kangaroo care).
Prayer or meditation in accordance with your spiritual
preference can have very important benefits for your son.
Also, the gestation period for humans varies from one person
to another and "term" [maturity] gestation is 38 to 42
weeks. I believe your son's birth six days beyond his "due
date" increased the risk for meconium aspiration only
slightly. Prebirth, babies sometimes pass meconium (the
sterile material in their bowel) before they are born. They
do this if they are stressed and for other reasons we
probably don't understand. Meconium in the amniotic fluid
becomes a problem only following the first breath, and only
if the baby gulps meconium into his lungs before it can be
carefully removed by suctioning before the baby takes the
first breath. I believe babies do not breathe until their
nose and mouth are in contact with air.
The "meconium syndrome" occurs when a baby's blood oxygen
level drops very low because of stress or inability to get
oxygen in his lungs because of mechanical blockage due to
the sticky meconium or because the baby gulped some meconium
into his lungs, blocking off part of his lungs so part of
the lungs could not expand.
Babies I have seen with meconium aspiration have recovered
completely without chronic respiratory illness. I believe
the risk of ongoing health problems for your baby will exist
only if the baby had a very long time when he was not
getting enough oxygen (anoxic for a long time).
Breastmilk is tremendously important for him! If he is still
getting respiratory support, his mother's breastmilk can be
gavaged [Given to him through a small tube placed in his
stomach]. Mother's milk provides great comfort to babies who
are uncomfortable because of the "love hormone" in it
(oxytocin).
-Hetty
====
The baby's dad reports: On June 30 my son was taken off ECMO
support for his respiratory problems. He was in grave danger
prior to this treatment. As of July 2 he was taken off the
ventilator and is receiving oxygen through his nose. His
vital signs are improving by the minute and he was fed some
of mommy's milk. Our son is making a great recovery as I
type this. To anyone who has concerns regarding the
treatment of ECMO, keep the faith; it works miracles, and it
saved my son's life.
With MAS the baby's lungs are coated with meconium and act
like a sealant on the inner lining of lungs, thus
disallowing the lungs to operate properly and in extreme
cases not at all. In the extreme cases such as my son's, the
baby is put on a high frequency ventilator. The child
receives 420 breaths per minute, forcing many small puffs of
air into the lungs in an attempt to penetrate the meconium.
The bad thing is this attempt highly over works the child's
lungs and it too can cause damage (pulmonary hypertension,
inflammation).
ECMO, Extra Corporeal Membrane Oxygenation, is a heart lung
bypass. The ECMO machine is an artificial lung that takes
over for the infant's lungs, allowing the infant's lungs
time to heal. A cannula is inserted into the vein of the
carotid artery and penetrates the right atrium of the heart.
The blood from the heart goes through an external bladder,
through an artificial heart (the pump), through an
artificial lung, through a heating apparatus, then is pumped
back into the right atrium of the heart. When the blood goes
through the artificial lung, it is pumped full of oxygen. So
oxygenated blood is pumped back into the infant, doing what
the infant's lungs would do if not coated with meconium. The
lungs are run on a ventilator at low rates, keeping them
going and allowing them to heal. This procedure is very
invasive. A surgeon has to place the cannula in the neck of
the infant and it is overwhelming to see, especially if you
do not like the sight of blood.
My son is improving all the time and is expected to be home
within a week to 10 days.
-Dan
Reprinted from Midwifery Today E-News (Vol 2 Issue 28 July 12, 2000)
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