Aspiration of meconium always brings about respiratory distress, thus for a baby born through meconium stained amniotic fluid, the following steps you be taken immediately after birth:
assess the baby immediately after birth, that is within the first fifteen seconds after birth, before drying the baby. If the baby is not vigorous, perform direct laryngoscopy immediately.
Suction out any meconium that is lodge in the hypopharynx.
After this, intubate the baby's tracheal. Repeat this step until no meconium is obtained again. The maximum time to repeat this step is three times.
Now, apply the normal resuscitation process.
