Meconium aspiration is actually primarily an in utero event. Due to stress (for example placental insufficiency, chorioamnionitis, abruptio placenta) or sometimes unkown reasons, the fetus passes the meconium in utero. The continued stress or distress than triggers fetal gasping and (in utero) the baby inhales the mixture of amniotic fluid and meconium. Depending on the severity of the meconium aspiration and the severity of the primary process (the factor causing the baby to pass meconium and gasp in utero) the baby can be affeted severely, mildly or anywhere in between. One of the problems caused by mec aspiration is that the meconium inactivates the lung surfactant, a substance which each and every one of us needs to breath normally and survive! Clinical and animal studies have found that giving the baby with mec aspiration either recombinant or bovine surfactant (replacing the inactivated surfactant) may significantly decrease morbidity and mortality. In other words, the babies do better if given surfactant. Your sister's child needs breastmilk just as much as anyone else in a NICU! However, there are no studies on the effects of human milk vs. formula on the outcomes of newborns with meconium aspiration. Danny Hirsch, MD, FAAP, CLC Director, Lactation Institute of Westchester Attending Neonatologist Westchester & Sound Shore Medical Centers Assistant Professor of Pediatrics New York Medical College Valhalla, NY, USA [log in to unmask] *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html