About one third of the infants with meconium aspiration will require some type of assisted breathing. Meconium aspiration is a leading cause of severe illness and death in the newborn. The infant may have a low Apgar score. Direct visualization of the vocal cords for meconium staining with a laryngoscope in the delivery room is the most accurate evaluation for possible meconium aspiration . The newborn's mouth should be suctioned as soon as the head is delivered.
Further intervention is necessary if there is thick meconium staining and fetal distress.
A tube is placed in the infant's trachea and suction is applied as the endotracheal tube is withdrawn. This procedure is repeated until meconium is no longer seen in the suction contents. If there has been no signs of prenatal fetal distress, and the baby is a vigorous term birth newborn and there is meconium staining of the skin, some authorities recommend no deep suctioning of the trachea for fear of causing an aspiration pneumonia. Occasionally, a saline solution is used to 'wash' the airway of particularly thick meconium. After delivery, the infant is observed carefully.