Infantile sputum (meconium) is the name given to the first stool of a newborn baby, which is greenish-black in color. Usually babies excrete it within 12 to 48 hours, but for some the excretion occurs in the womb, which can lead to a condition called meconium aspiration syndrome.
What is puerperal meconium?
Infantile saliva or meconium is the name for the baby’s first bowel movement. This accumulates in the intestines of the unborn baby as early as between the tenth and fourteenth weeks of pregnancy. From this time on, the fetus occasionally absorbs amniotic fluid, which contains sodium, potassium, sugar, proteins, trace elements, skin cells and hairs. This is subsequently used to form the puerperal fluid. It also contains mucous membrane cells, mucus, intestinal cells and thickened bile. Usually, the first stool is odorless and very viscous. Until the middle of the second trimester, the meconium is still white in color; the greenish-black color is due to the so-called biliverdin, which is a degradation product of the red blood pigment. The term meconium comes from the Greek language and means something like “poppy juice”. The term puerperal meconium is probably due to the consistency of the stool, which sticks to the child’s skin like pitch and is very difficult to remove. Strictly speaking, however, infantile saliva is not yet a real stool, since the child’s intestine must first take up its functions. It takes over this activity with the first intake of food, which then replaces the infantile saliva with normal digestive products.
When should infantile saliva be excreted?
Normally, infantile saliva is excreted within a period of 12 to 48 hours after birth. In any case, excretion should be done by four days after birth, otherwise health complications may occur. If the baby’s saliva is not excreted, this may be due to an intestinal obstruction, a narrowing in the intestine, cystic fibrosis or a transport disorder. However, blockage can also occur due to certain medications (ganglion blockers, opiates, magnesium sulfate) taken during pregnancy.
Tips to promote the discharge of puerperal secretions
The discharge of the first stool can be promoted by breastfeeding. The first breast milk produced immediately after birth is particularly suitable for this purpose. This milk is yellowish and thick and contains a lot of protein, antibodies and minerals, but little fat, and is easily digestible. If the baby’s saliva is excreted relatively quickly, the risk of neonatal jaundice may also be reduced.
Infant saliva in amniotic fluid
Sometimes, the baby’s saliva is secreted while the baby is still in the womb. The amniotic fluid is then cloudy and turns greenish, and the reason is usually a transfer or pure very long birth. Before the 37th week of pregnancy, meconium discharge is almost never seen, because the intestinal peristalsis is still very low. Another trigger can be an illness in the mother or in the child, which then puts the unborn child under stress. As a consequence, the oxygen supply decreases and the blood flow to the intestine decreases. As a result, intestinal motility may occur and the baby’s urine may be excreted. Other causes that can lead to premature meconium excretion are: Drug use by the mother, pathological changes or malformations of the umbilical cord. Intrauterine growth retardation (insufficient fetal growth) may also favor this circumstance.
When complications arise: meconium aspiration syndrome.
Amniotic fluid containing meconium occurs in about ten to twenty percent of births between 38 and 42 weeks of pregnancy. Meconium aspiration syndrome, on the other hand, is much less common. If meconium is present in the amniotic fluid, it can enter the baby’s airway in the womb or during birth. This inhalation is called meconium aspiration. When meconium is inhaled, it creates regions in the lungs that are inadequately ventilated, while others become hyperinflated. Although the respiratory gas can enter the alveoli, it does not escape when exhaled and remains in the lungs. As a result, the affected areas become overinflated. Ventilation is uneven, which can also be seen on an X-ray.Some components of the baby’s saliva, such as proteins, enzymes or bilirubin, can lead to damage to the lungs and cause severe shortness of breath or hyperinflated lungs, which is called meconium aspiration syndrome (MAS). Initial signs include a green and viscous amniotic fluid, labored breathing, and discolored skin that may also be covered with puerperal fluid. This condition is life-threatening for the child. In very weak infants, an attempt is made to aspirate the infant’s saliva; in addition, other measures such as resuscitation, ventilation, or antibiotics may be necessary. Feeding should also be done very carefully, as newborns with a MAS often do not tolerate food very well at first. The severity of MAS can vary greatly. For example, newborns may have mild, moderate or severe respiratory problems, which may necessitate artificial respiration. Immediately after birth, children with MAS often suffer from difficult breathing, accelerated breathing, breathing sounds or a blue discoloration of the mucous membranes and skin. Depending on the duration of respiratory distress, cardiovascular depression may also occur. Prematurity does not pose a risk for the occurrence of MAS, and MAS is rarely found in preterm infants.
