A newborn male infant of Hispanic ethnicity is delivered vaginally at 39 weeks to a 34-year-old gravida 3 woman. Maternal prenatal laboratory tests show her to be hepatitis B surface antigen negative, human immunodeficiency virus negative, rapid plasma reagin nonreactive, and group B Streptococcus negative. The mother received routine prenatal care and had no complications during the pregnancy. Her membranes ruptured 9 hours before delivery, and meconium-stained amniotic fluids are noted. Complications during the delivery include shoulder dystocia. The neonate requires routine resuscitation, and his Apgar scores are 5 and 8 at 1 and 5 minutes, respectively. After birth, the neonate attempts to feed but his intake is minimal. At approximately 12 hours, he has multiple episodes of emesis, described as bilious and feculent with increased abdominal distention. He has no bowel movements since birth. Abdominal radiography illustrates an abnormal bowel gas pattern. He is transitioned to nil per os...

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