What is meconium ileus?

Meconium is the first stool (bowel movement) that a newborn has. This stool is very thick and sticky. Meconium ileus is a bowel obstruction that occurs when the meconium in your child's intestine is even thicker and stickier than normal meconium, creating a blockage in a part of the small intestine called the ileum. Most infants with meconium ileus have a disease called cystic fibrosis.

Diagnosis

The earliest signs of meconium ileus are abdominal distention (a swollen belly), bilious (green) vomit and no passage of meconium. Your child's doctor will order an X-ray of your child's abdomen to find out if she has meconium in her intestines.

Treatment

If a doctor suspects that your child has a meconium ileus, she won't be given anything to eat or drink and will be fed through an intravenous (IV) line, a small tube that's inserted into a vein. A small tube — called a nasogastric (NG) tube — will also be placed through your child's nose and passed into her stomach to help remove excess air and fluid.

The medical team may try to break up the meconium blockage with medicines given to your child through an enema. If the medicine doesn't break up the meconium, she may need surgery.

If your baby needs surgery for meconium ileus, she'll have a bowel resection and ileostomy placement.

Bowel resection surgery

Your child may need a bowel resection, a surgical procedure that brings part of the small intestine out to the surface of the abdominal wall. This creates an ileostomy, which is temporary. The bowel can be reconnected once your child's ileus is gone.

Follow-up care

After the operation, your child will go to the Newborn/Infant Intensive Care Unit (N/IICU).

Your child will have a small incision on her abdomen, which will be covered with a gauze dressing. She'll also have an NG tube to help empty her stomach. Your child may have an ileostomy. You will learn how to care for the ileostomy before leaving the hospital.

Your baby's healthcare team will give her pain medication, as needed. When your child first comes back to her room after surgery, she'll need narcotic medications, such as morphine or Versed, which she'll get through her IV. After a few days, acetaminophen (TYLENOL) should relieve her pain.

Your child will also receive antibiotics after surgery to prevent infection.

Your child will be ready to go home when her incisions are healing nicely, she doesn't have a fever, and is able to drink, urinate and have a bowel movement. This is usually in one to two weeks.

Once your baby is home, she may drink formula or breast milk. You can give her acetaminophen (TYLENOL) — according to her doctor's instructions — to relieve any pain she's experiencing. The thin tapes over the incision (called STERI-STRIPS) will fall off on their own.

Your child can have a tub bath one week after surgery.

When to call the doctor

Be sure to call your child's doctor if:

• Your child develops a fever greater than 101 degrees F under the arm
• You notice that your child isn't urinating as often as usual (decreased number of wet diapers)
• Your child is vomiting and unable to eat
• Your child's surgical incision is swollen or bleeding