A premature infant (26 weeks 6 days) in an incubator.Meconium is basically a baby or foetus’ first stool. Turd that is, not furniture item. Meconium is waste matter made up of amniotic fluid, mucus, water, bile, epithelial cells and lanugo (extremely fine downy hairs that the foetus sheds at about 33 to 36 weeks). Normally meconium stored in the infant's intestines until after birth. It doesn’t have much odour, it’s basically sterile, but it’s thick and sticky and in my opinion it’s pretty gross. It is perhaps even more gross when the meconium is expelled into the amniotic fluid. Sometimes (between 5 and 20 percent of the time) this happens during labour or delivery. The situation turns from unpleasant to dangerous if the baby inhales the meconium. It is not wise to breathe stools (of any kind).

If a baby has inhaled meconium, doctors will sometimes try to suction it out very shortly after birth. If the baby’s condition remains poor or worsens, he/she will often be placed into a ventilator to be monitored my medical staff and provided with oxygen until his/her lungs recover. This is a pretty good strategy in modern western hospitals. In developing countries, however, this technology is often harder to access and maintain. A team from five countries might have an answer to this challenge and – if we weren’t discussing a baby - it would be entirely intuitive. Dirty lungs? Clean them. Specifically, flush them out with a dilute soapy, detergent-like liquid. It’s known as lavage. The baby is actually disconnected from the ventilator for a minute or so while the lavage fluid is being instilled into the lungs and then suctioned back out.

The idea of flushing out lungs with a soapy solution seems extreme, but it’s not an entirely new concept. There have been studies going back more than ten years examining the effectiveness of the treatment. In their paper (published in The Journal of Pediatrics, 14 October 2010), Dr Peter Dargaville and his colleagues indicate that this technique is effective. In their study, infants who had the lavage treatment were much more likely to survive and far less likely to need ongoing treatment in a ventilator, compared to those who did not receive the lavage.

Dr Dargaville suggests that this treatment could save the lives of thousands of babies worldwide, especially in developing countries. Sightly disturbing, a bit gross, but fascinating and possibly a life saver.