plugged

did you know that while a fetus floats around in utero, it makes poop?

this poop, is called MECONIUM. unlike normal poop however, meconium, is odorless and is blackish in colour, viscous and sticky like tar, and almost sterile as it is largely made up of stuff the fetus ingested, e.g epithelial cells, amniotic fluid, mucus and lanugo (which btw is fetal hair...also seen in teratomas). 


normally, it is stored in the fetus's intestines and excreted postpartum. sometimes it is expelled into the amniotic fluid or during labour (i suppose when this happens, the fetus is literally scared shitless about coming out into the world...hee~).

if a newborn fails to poop out its meconium within 48 hours, you should immediately be worried about two things: Hirschsprung's disease and cystic fibrosis.

Hirschsprung's disease is a condition where the enteric plexus ganglions are absent causing a lack of peristalsis, which leads to obstruction and then dilation of the colon up to the formation of megacolon.

in cystic fibrosis, the meconium is thickened and it congests the lumen of the intestines, a condition known as meconium ileus. this is often the first sign of cystic fibrosis.

the area proximal to the area of obstruction caused by meconium is distended and the infant will present with a distended stomach and vomiting.

a negative digital rectum pretty much confirms Hirschsprung's disease. mind you, it can also be a sign that the baby did poop out something, but you just missed it...so you would need to assess then whether or not the baby is excreting normal poop now that it has started being fed milk and if that's a negative as well, along with the other symptoms mentioned above, you'll need to first work on emptying the baby's obstructed bowel and then getting a confirmatory biopsy and referring the case to a surgeon.

for cystic fibrosis, the parent may complain that the infant tastes 'salty' when they kiss its skin. however, only 20% of cases of cystic fibrosis present at infancy with meconium ileus. most of the time, the symptoms appear later on in childhood, with respiratory problems and symptoms of malabsorbtion.