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Wednesday, April 23, 2014
Newborn and Infant Care
Newborn vomiting amniotic fluid
Our granddaughter is vomiting amniotic fluid. She is 19 hours old and hasn`t been able to keep much if anything down. The nurse is talking about draining it with a tube. Please explain this to me.
All babies (fetuses) before birth both swallow and inhale small amounts of amniotic fluid. This is critical to the growth and developing function of the baby's immature lungs and intestines. It also helps to ensure a that there is the right amount of amniotic fluid around the baby, neither too little nor too much.
It's not unusual for babies born by planned caesarean section or after a very quick labor to have excessive fluid in their stomachs and their lungs. It can take 6 or more hours for babies' lymphatic systems and intestines to rid the baby of these excess fluids. Draining the stomach with a thin tube introduced in the mouth, passed through the esophagus and into the stomach is the easiest way to assist the baby if the fluid is in the stomach. A syringe can be attached to the end of the thin tube and gentle suction applied to remove the excessive fluids from the stomach.
There is nothing to be done for the lungs other than to observe the baby for respiratory distress and provide extra oxygen or assisted breathing treatments if needed while the lymphatic system in the lungs pumps out the extra fluid.
Rarely, this also may mean the baby has a defect between the esophagus and trachea or food tube and windpipe. This occurs because these two separate tubes start out as only one single tube and this tube must fully divide and separate to form the trachea and esophagus. Sometimes there is an incomplete separation that allows fluids from the mouth and stomach to spill over into the lungs. This would be suspected if the baby has trouble feeding and feedings tend to come back up and cause the baby to choke and cough. Fortunately, this condition is rare and there are good surgical repairs that can be done for most babies.
By this time, I hope your grandchild has recovered from a bumpy entrance into her family and that all is well. Thank you for your question.
Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University