Sir.—The article by Sepkowitz1 in the October 1987 issue of AJDC left the impression that suctioning the meconium-stained infant at birth is simply defensive medicine and has no clinical merit. In our institution, the motivation for performing routine suctioning is to prevent the meconium aspiration syndrome, not fear of legal action. We have found these techniques to be effective, safe, and relatively simple and inexpensive.2
While Dr Sepkowitz decried this practice because he believes it is purely defensive medicine, he did not analyze his data for efficacy in the reduction of mortality. He reported three deaths from meconium aspiration among 1532 live births for the years 1973 through 1982. He did not mention the number of deaths from meconium aspiration among the 402 live births in the years 1983 through 1985, but he did report an improvement in the neonatal mortality rate.
During a comparable period from