Can a meconium plug in an infant be an isolated incident? or is it always associated with some other underlying issue?

Yes: Most infants pass meconium(first stool)shortly after delivery.Meconium plugs(pellets) usually transiently get stuck in large bowel causing some degree of obstruction but usually pass with enema or rectal stimulation.Increased incidence of plugs associated with infants of diabetic mothers and prematures.Sometimes meconium is associated with bowel obstruction in patient with cystic fibrosis.

Word definitions: To be more specific, all infants have a little plug that passes with the initial meconium.Occasionally the plug and some meconium passes before birth as a sign of stress.Meconium ileus is a condition where the meconium is so thick and sticky that it blocks all stool passage and can be a sign of cf. My state state screens for CF as part of its newborn screening program but not all do.