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Neonatal Aspiration

Neonatal aspiration, also known as meconium aspiration syndrome, is when a baby inhales meconium as they are being born. Meconium is a sticky, stooly substance that, when inhaled with amniotic fluid at the time of birth, can cause meconium aspiration syndrome. Neonatal aspiration can also occur later when formula or breastmilk accidentally “goes down the wrong tube,” aka the oesophagus, and enters the lungs.

All forms of neonatal aspiration are concerning, especially meconium aspiration syndrome, which is a leading cause of illness and death in newborns. This form of neonatal aspiration is more serious than others because meconium stool and amniotic fluid are very sticky and can cause serious breathing problems at birth when they get into the lungs.

Signs & Symptoms

Depending on how and when neonatal aspiration occurs, it can be difficult to spot. Meconium aspiration syndrome, on the other hand, is fairly easy to detect because it happens immediately at birth. Other forms of neonatal aspiration, however, can happen at any time, including in the middle of the night while your baby is sleeping.

Therefore, it is important to watch out for the most common signs and symptoms of neonatal aspiration, including the following:

  • Slow or laboured breathing
  • Bluish tint to the skin
  • Slow heart rate
  • Slow breathing that turns into rapid gasps
  • Excess grunting and groaning
  • Sudden limpness
  • Visible meconium or amniotic fluid near the mouth
  • Difficulty feeding

It is important to spot these signs and symptoms early on. Neonatal aspiration can lead to serious breathing problems, lung infections, and eventually death.

Causes & Risk Factors

There are several different causes and risk factors for neonatal aspiration depending on what type your child has. With meconium aspiration syndrome, the leading cause is stress at the time of birth. Stress can happen if the birthing mother has a respiratory infection or low oxygen levels, causing your baby to breathe deeper than normal. When this happens, they can inhale meconium and amniotic fluid, and it enters their lungs.

When neonatal aspiration occurs at a later time, here are some of the leading causes:

  • The baby has dysphagia, where the muscles responsible for swallowing do not work properly.
  • Your child has a cleft lip or palate, and they cannot take in food properly.
  • Brain or cranial nerve problems result in improperly functioning throat muscles.
  • A medical condition such as Down Syndrome, spinal muscular atrophy, or cerebral palsy.

Diagnosis

If your doctor suspects that your baby has neonatal aspiration or is at risk for it, here are the tests they will use to diagnose it.

  • Pre-birth tests

In some cases, your doctor can detect potential meconium aspiration syndrome before your baby is born. If your oxygen levels or the baby’s heart rate is too low, they will know that you are at increased risk.

  • X-rays

X-rays will reveal if there is meconium or amniotic fluid buildup on the lungs.

  • Blood gas test

If your doctor suspects neonatal aspiration and needs to confirm it, they may perform a blood gas test to check oxygen and carbon dioxide levels.

  • Breath sounds

Using a stethoscope, your doctor can listen to your baby’s breathing. If they detect coarse crackles, gurgles, or other abnormal breathing sounds, it is a sign of fluid in the lungs due to aspiration.

Treatment & Prevention

The key to curing neonatal aspiration and meconium aspiration syndrome is to detect and treat it as early as possible. The sooner you treat the condition, the less likely it is to cause complications.

In severe cases where the baby stops breathing, they may need to be put on a mechanical ventilator to keep them alive. Prior to that, however, doctors will perform suction to get whatever is inside their lungs out. They may also need antibiotics if their aspiration causes a lung infection. If the meconium and fluids are too tight within the lungs, they may need lung percussions to loosen it enough for removal.

 
 
 

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