If a newborn is delivered with meconium staining but is responsive, how should they be managed?

When a newborn is delivered with meconium staining and is responsive, the management approach focuses on the baby’s condition. If the newborn is active and does not exhibit any signs of respiratory distress or requires resuscitation, suctioning is typically not necessary. The rationale behind this practice stems from the understanding that an active, responsive newborn is less likely to have significant meconium aspiration.

In these situations, the priority shifts to ensuring that the newborn remains stable and monitored rather than performing unnecessary procedures that could interfere with normal transition and bonding. It is also important to let the baby clear their own airway if they are able to do so effectively. This approach minimizes potential trauma and risk associated with aggressive suctioning and supports the infant's natural physiological processes immediately after birth.

Other methods, such as suctioning at the perineum or immediately suctioning regardless of the baby’s condition, might not be indicated if the newborn is responding well. Therefore, the focus on observation and management aligned with the baby’s activity level and need for resuscitation reinforces the chosen response.