Meconium Resources

Meconium Resources


To view the Meconium Testing Panels and Collection Instructions, click here.


Meconium Videos

CCDG Presentation

Watch Video

Maternal Marijuana Use by Joseph Jones

Watch Video

The Importance of Following Forensic Principles in Newborn Drug Testing by Dr. Irene Shu

Watch Video

Meconium Collection Overview

Watch Video

View All Videos




Meconium Infographics

View All Infographics




Meconium Articles

A Moment In Time 02-Feb-2015

Lost Opportunities 02-Feb-2015

View All Articles 




USDTL Meconium Research

View All USDTL Research




Meconium Poster Presentations

View All Poster Presentations




USDTL Meconium Assisted Research

View All USDTL Assisted Research




Meconium Foundational Research

View All Foundational Research




Meconium Slide Presentations

The Importance of Following Forensic Principles in Newborn Drug Testing by Dr. Irene Shu

View All Slide Presentations




Meconium Announcements

Update to Meconium Collection Update to Meconium Collection

12-Aug-2016

To help you have the best possible solutions that science can offer, we are consistently evaluating our processes to keep them ahead of the curve. As science progresses, so do our capabilities. Because of such progress, we have some important updates to the meconium collection process.

Report Change Notification Report Change Notification

18-Apr-2016

Effective July 18, 2016, USDTL will be implementing a new way of reporting quantitative results. In order to satisfy accreditation requirement, the concentrations of drugs exceeding the Upper Limit of Quantification (ULOQ) for any given drug will be reported as > ULOQ (greater than ULOQ). The ULOQ will be provided.

Quantity Not Sufficient (QNS) Explained Quantity Not Sufficient (QNS) Explained

02-Mar-2016

Quantity Not Sufficient (QNS) is a result of not having a sufficient quantity (volume) of
specimen to test for the panels ordered. The amount of specimen required for collection
is directly related to the amount of specimen needed to screen and confirm for the panels we offer. The initial screening uses a portion of the original specimen and the confirmation testing uses another portion of the original specimen. To forensically confirm positives, means running a new test, with a new portion of the original specimen, using a different analytical technique.

Updated Policy Regarding Insufficient Specimen Volumes Updated Collection Instructions Updated Policy Regarding Insufficient Specimen Volumes Updated Collection Instructions

1-Apr-2015

It is our first priority to deliver testing results that provide the most valuable information possible for your substance abuse testing needs. To better accomplish this duty to our clients, we are updating our policy concerning specimens that do not have sufficient volume for both preliminary testing and confirmation. Effective April 1, 2015, confirmatory tests that cannot be completed due to insufficient specimen volume will be canceled on an individual drug class and/or analyte basis. We will report confirmation results for each test for which there is sufficient volume of specimen available, giving you access to more information.

View All Announcements




Meconium FAQs

*Click the green and white plus sign beside each question to view the answer.

Can a hair test be manipulated by the donor?

Yes. Bleaching, perming, dyeing and straightening can affect the outcome of a hair test. Cosmetically treated hair should not be collected.

Can the reported quantitation of drug or metabolite in hair, nail, meconium, umbilical cord, or urine be used to determine the timing of the drug use, how often the donor uses the drug, or the extent of the donor's drug use?

No, when testing a reservoir specimen type, a specimen type where analytes tend to accumulate, you may not backtrack to determine time, dosage, or frequency. The result is positive or negative for the appropriate detection window associated with the specimen type.

Have meconium results been used in court cases?

Yes, meconium results, when determined using two separate, validated laboratory procedures based on different scientific principles (also referred to as "confirmed" results), are forensically defensible. Our laboratory procedures have been scrutinized by laboratory inspectors, and our test results have been upheld in court because we follow strict internationally accepted forensic protocol.

How does using a forensic drug test help the child later in life?

There are several reasons detecting a substance exposed new born is important. Early detection provides many more options than detection at a later stage in the child's life, and

  • Early detection of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and community programs. New programs are showing dramatic improvements in children identified earlier in life.
  • Detection of an exposed child can allow help, intervention and treatment to be offered to the mother, so that exposure during future pregnancies may be prevented.
  • As programs, understanding, and treatments improve, substance exposure detect, at a very early stage can only help the outcome of the child, mother and family.

How many days until I receive results?

Screen negative results will be transmitted to your web portal on the same day in which the laboratory receives the specimen. Screen positive results will be confirmed using a separate technique and reported 2-3 business days after specimen receipt.

How much meconium is needed for the test?

A minimum of 3 grams of meconium (a teaspoon) is normally required. However, for best results, we recommend collection of the entire passage of meconium until the milk stool appears.

How should staff proceed with sending a specimen for testing on premature neonates that often do not stool for 3-5 days?

While these meconium specimens are fine for the routine drugs of abuse, these specimens (due to the delayed passage) should not be testing for FAEE.

May the reported quantitation of drug or metabolite in hair, nail, meconium, umbilical cord, or urine be used to determine the timing of the drug use, how often the donor uses the drug, or the extent of the donor’s drug use?

No. When testing a reservoir specimen type, a specimen type where analytes tend to accumulate, you may not backtrack to determine time, dosage, or frequency. The result is positive or negative for the appropriate detection window associated with the specimen type.

Mother tested negative for chemicals on a saliva test, 8 days later, her baby was born and its meconium drug screen showed the presence of methamphetamine and amphetamine. What does this mean?

This is an excellent example of the difference in the time window between meconium and saliva. Saliva will reflect use for up to 48 hours after use of methamphetamine. Meconium reflects weeks of past exposure history. In this case the maternal use did not fall into the time window available from a saliva specimen but the meconium specimen did provide a broad enough window to identify the newborn as methamphetamine-exposed. The take home message is that meconium reflects weeks to months of exposure history whereas urine and saliva provide hours to days of history.

Please describe the meconium test for alcohol.

Meconium testing for FAEE is a test of the non-oxidative metabolites of ethanol called Fatty Acid Ethyl Esters. These metabolites are the chemical combination for endogenous fatty acids present in the blood of a fetus and ethyl alcohol. These new compounds, which only form when the fetus is exposed to ethyl alcohol, are deposited into the fetus’s meconium and can then be detected and quantified from the newborn’s meconium after delivery. The amount of the Fatty Acid Ethyl Esters found in the meconium is representative of the amount of ethyl alcohol the fetus was exposed to during the last half of the pregnancy.

What are the meconium specimen storage requirements?

Drugs and metabolites are stable in meconium for up to 2 weeks at room temperature. However, refrigerated or freezer storage is preferred. Alcohol metabolites, specifically FAEE, are sensitive to hear and light and therefore the PREFERRED shipping method is frozen on dry ice. Since this method is both difficult and expensive, most institutions send at room temperature and realize that the FAEE concentrations may be reduced. USDTL accepts specimens that are shipped at room temperature.

What information can you give on testing of meconium and why some experts state that positivity depends what part of the meconium is sent into labs as to what will test positive?

The single most important element of collecting meconium for drug and alcohol testing is obtaining the entire quantity of meconium that the newborn passes, being careful that it is not to mix in the milk stool. This is extremely important in order to obtain the maximum time window of exposure for the infant. Meconium is a HETEROGENOUS material and each portion passed reflects a different time of gestation. This is due to the extreme viscosity of the meconium mass and the lack of significant mixing in the fetal intestine. If only a portion of the total meconium is collected and sent for analysis, it may reflect a period of abstinence, and an exposed newborn may go undetected.

What is m-OH-BZE?

Meta-hydroxybenzoylecgonine (m-OH-BZE) is a metabolite of cocaine which is often present in the meconium of neonates born to cocaine-using mothers. It is a minor metabolite in adults, but it has been identified as the only cocaine metabolite present in 23 percent of meconium specimen screening positively for cocaine. If a laboratory does not include m-OH-BZE in its confirmation profile, there is a risk of not identifying up to 23 percent of cocaine exposed newborns.


Reference: Lewis D, Moore C, Becker J, Leikin J. Prevalence of meta-hydroxybenzoylecgonine (m-OH-BZE) in meconium samples. Bulletin of the lnt.Ass.Forens Toxicol 1995;25(3):33-36

What is the relationship between alcohol consumed and FAEE levels?

Based on two research studies reported in peer-reviewed literature, the total FAEE levels in excess of 10,000 ng/g show significant ethanol exposure in the newborn. Reference: (Moore C, Jones J, Lewis D, Buchi K. Prevalence of fatty acid ethyl esters in meconium specimens. Clin Chem 2003;49(1):133-136)

What is the turnaround time for testing results?

Turnaround time (TAT) goal is 24 hours for screen negative with an additional 24-48 hours for specimens that require confirmatory testing. TAT begins from receipt of the specimen with valid order into our laboratory.

What is the window of detection for meconium?

Meconium begins to form in weeks 16 through 20 of gestation. Therefore, depending on the gestational age of the newborn, a complete collection of meconium will represent approximately 20 weeks of maternal drug use history.

Why test for fetal alcohol exposure when there is no treatment available?

There are several reasons why diagnosis of alcohol exposure is important. As with any disease, early diagnosis provides for many more options and treatments than detection at an advanced stage.

  1. Early diagnosis of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and treatment programs. New programs are showing dramatic improvements in children identified earlier in life.
  2. Detection of an alcohol affected child can allow help, intervention and treatment to be offered to the mother, so that future FAS and FAE children may be prevented.
  3. When cocaine- and opiate-exposed newborns were first detected, there was no treatment. As programs, understanding and treatments improve, diagnosis at a very early stage can only help the outcome of the child, mother and family.

Why was the mother's urine positive and the umbilical cord tissue / meconium negative?

There are several explanations for this. Different specimen types have varying thresholds for positivity. For example, a single dose of methamphetamine 12 hours prior to collection is highly likely to produce a positive urine result. However, it would be less likely to generate a positive result for a specimen type with a longer detection window such as umbilical cord, meconium or hair.

View All FAQs





contact USDTL

1.800.235.2367

Newsletters, Posters, and Catalogs

Our print materials will keep you up to date on the latest news in drug and alcohol testing.

Request Literature

Request Your Collection Supplies

For your convenience, USDTL provides test collection supplies at no additional charge.

Order Supplies

Resources

View Resources
0