Meconium

Definition

Meconium is the first stool of a newborn, composed of intestinal epithelial cells, lanugo, mucus, amniotic fluid, bile, and water. It is thick, dark greenish-black, and sticky.

Normal Passage

Usually within 24 hours of birth. Failure to pass within 48 hours suggests Hirschsprung disease, meconium ileus (cystic fibrosis), or obstruction.

Meconium Aspiration Syndrome (MAS)

Occurs when fetus passes meconium in utero (sign of distress) and aspirates it, such as presents with respiratory distress, cyanosis, green-stained amniotic fluid. Prevention: suctioning nondepressed vigorous infants not routinely recommended; for non-vigorous infants with meconium, intubation and tracheal suction may be indicated.

Nursing Interventions

Document first meconium passage, for meconium-stained amniotic fluid: have neonatal resuscitation team present. Monitor for respiratory distress. Initial care of vigorous newborn: routine. Non-vigorous: prepare for intubation and suctioning.

NCLEX Relevance

Green-stained amniotic fluid = fetal distress. Monitor for MAS.