The role of aspiration of meconium in producing respiratory disease in newborns, and its treatment, remain controversial. These issues have been reviewed in 19891 and 19922 in detail. In regard to causing respiratory disease, about 35% of infants born in the presence of thick meconium have meconium present below their vocal cords. However, only about 10% of these infants have significant respiratory dysfunction.1,2 Even the severity of their roentgenographic findings does not correlate well with their degree of respiratory distress, and fewer than half of those with abnormal chest roentgenograms have respiratory problems.3,4 Hence, a wide spectrum of respiratory symptoms may be associated with the presence of meconium in the trachea and the roentgenographic findings of patchy infiltrates. Applying the diagnostic term meconium aspiration syndrome (MAS) to this triad suggests a cause-and-effect relationship between the meconium and the respiratory symptoms in all of these infants. This