Gastric Lavage in Vigorous Neonates Born with Meconium Stained Amniotic Fluid

Excerpt

Meconium stained amniotic fluid (MSAF) is an intra-partum circumstance that occurs in 10–15 % of term births and requires medical attention in infants with signs of respiratory distress related to the development of meconium aspiration syndrome [1, 2]. MSAF may have an association with the swallowing of meconium prior to delivery, which may cause feeding problems after birth [3, 4]. Although gastric lavage may purportedly remove meconium from the stomach and reduce gastric irritation, previous observational and randomized clinical studies have not been able to identify a beneficial effect of such a procedure on the prevention of feeding intolerance in neonates born with MSAF [5, 6]. Actually, the harmful effects of gastric lavage (risk for bradycardia, perforation, and aspiration of swallowed meconium) may outweigh the expected benefit in vigorous infants born through MSAF [4]. The study by Ameta et al. [7] confirms previous observations. Although there appears to be a reduction in the feeding problems, the difference is not statistically significant. The American Academy of Pediatrics and International Guidelines for Neonatal Resuscitation that were published more than a decade ago, do not recommend gastric suctioning in neonates born with MSAF [8, 9]. …