First meconium passage as a predictor of early breastfeeding success in term newborns

Abstract

Background Early meconium passage is considered an indicator of neonatal gastrointestinal maturity and may influence breastfeeding success. This study aimed to examine the relationship between breastfeeding success and the timing of first meconium passage in full-term newborns. Methods This correlational study was conducted in a maternity unit and included 59 healthy term newborns who were exclusively breastfed. Breastfeeding success was assessed using the LATCH Breastfeeding Assessment Tool during the first (0-1 h), second (1-24 h), and third (24-48 h) feeding sessions. The time of first meconium passage was recorded and analyzed in relation to breastfeeding success. Because no universal clinical cut-off exists, the median value of 7.17 h was used as a data-driven threshold to classify newborns into two groups, and its ability to discriminate breastfeeding success was evaluated using ROC analysis. Continuous associations between meconium passage time and LATCH scores were examined using correlation and linear regression analyses. Results LATCH scores increased significantly across the first, second, and third assessments (p = 0.001; p < 0.01). The median meconium passage time was 7.17 h (range: 2-17.9). Infants with earlier passage (< 7.17 h) showed a significant early improvement in LATCH scores (p = 0.017), whereas this was not observed in those with later passage (>= 7.17 h; p = 0.051). ROC analysis indicated a moderate ability of meconium timing to discriminate successful breastfeeding (AUC = 0.71). Conclusion LATCH scores improve most rapidly during the first 24 h after birth and then plateau, highlighting the importance of this early period for establishing effective breastfeeding. Although meconium passage was within physiological limits and showed no linear association with breastfeeding success, the greater early improvement in infants with earlier passage suggests a link to early feeding adaptation. The moderate discriminative ability of meconium timing for breastfeeding success (LATCH >= 8) in ROC analysis supports this physiological relevance while indicating that the variable should be interpreted with caution and not used in isolation. The data-derived 7.17-hour threshold may provide a complementary cue for identifying mother-infant dyads-particularly those with delayed meconium passage and limited early improvement in LATCH scores-who may benefit from additional lactation support.