Abstract
In Reply.— I am intrigued by Dr Karlowicz's proposal that vigorous babies may be insidiously aspirating swallowed meconium. He states it is "imperative" to remove meconium-stained fluid from the stomachs of depressed neonates. Although it seems reasonable that an infant could regurgitate and aspirate meconium-stained gastric contents, I am unaware of any reports which support this conjecture. Most standard neonatology, perinatology, and pediatric textbooks do not recommend "emptying" the stomach to prevent aspiration. Furthermore, the few resources recommending gastric suctioning do not reference any investigations or anecdotal reports supporting the procedure.
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