In the presence of meconium-stained amniotic fluid, suctioning is indicated only if which condition is present?

• A. Immediate suction of the oropharynx and nares
• B. Do not suction
• C. Suction only if respiratory depression occurs
• D. Suction only if meconium stained is present

Answer: (C)

Meconium-stained amniotic fluid raises concern for possible airway meconium, but suctioning is not done routinely at birth. The airway should be managed based on how the newborn is breathing. If the infant is vigorous, breathing well, crying, and with good tone, no routine suctioning is needed. If there are signs of respiratory depression—poor or irregular respiration, apnea, or inadequate oxygenation—then suctioning of the airway is indicated to clear secretions and help ventilation. Start with suctioning the mouth and then the nose if needed, and proceed to deeper airway suctioning only if the infant remains compromised.

The other options don’t fit because suctioning isn’t automatic just because meconium is present, and suctioning unnecessary or excessive for a well-ventilated infant can cause delays and potential harm. Suction is reserved for when respiratory depression or airway obstruction is evident.