Oxygen and other urgent actions were needed as soon as an apparently normal birth went wrong last year, a Coroner says.
But Chris Devonport has ruled that if more had been done it probably would not have saved Jayzarn Tu Kaha Robert Simeon, who died four-and-a-half hours after being born at Palmerston North Hospital in July last year.
Mr Devonport said a loss of oxygen before the birth resulted in the contents of the baby's bowel - known as meconium - being expelled into amniotic fluid which then entered his lungs, posing a severe health risk.
But that wasn't apparent until 28 minutes after the birth, when Jayzarn first appeared pale, sparking a range of unsuccessful actions to save him.
Mr Devonport said more urgent action was needed, but it is likely that the boy would have died.