TY - JOUR
T1 - What are Normal Defecation Patterns in Healthy Children up to Four Years of Age? A Systematic Review and Meta-Analysis
AU - Baaleman, Desiree F.
AU - Wegh, Carrie A.M.
AU - de Leeuw, Tessa J.M.
AU - van Etten – Jamaludin, Faridi S.
AU - Vaughan, Elaine E.
AU - Schoterman, Margriet H.C.
AU - Belzer, Clara
AU - Smidt, Hauke
AU - Tabbers, Merit M.
AU - Benninga, Marc A.
AU - Koppen, Ilan J.N.
PY - 2023/10
Y1 - 2023/10
N2 - Objective: To summarize available data on defecation frequency and stool consistency of healthy children up to age 4 in order to estimate normal references values. Study design: Systematic review including cross-sectional, observational, and interventional studies published in English, that reported on defecation frequency and/or stool consistency in healthy children 0-4 years old. Results: Seventy-five studies were included with 16 393 children and 40 033 measurements of defecation frequency and/or stool consistency. Based on visual inspection of defecation frequency data, a differentiation was made between two age categories: young infants (0-14 weeks old) and young children (15 weeks-4 years old). Young infants had a mean defecation frequency of 21.8 per week (95 % CI, 3.9-35.2) compared with 10.9 (CI, 5.7-16.7) in young children (P < .001). Among young infants, human milk-fed (HMF) infants had the highest mean defecation frequency per week (23.2 [CI, 8.8-38.1]), followed by formula-fed (FF) infants (13.7 [CI 5.4-23.9]), and mixed-fed (MF) infants (20.7 [CI, 7.0-30.2]). Hard stools were infrequently reported in young infants (1.5%) compared with young children (10.5%), and a reduction in the frequency of soft/watery stools was observed with higher age (27.0% in young infants compared with 6.2% in young children). HMF young infants had softer stools compared with FF young infants. Conclusions: Young infants (0-14 weeks old) have softer and more frequent stools compared with young children (15 weeks-4 years old).
AB - Objective: To summarize available data on defecation frequency and stool consistency of healthy children up to age 4 in order to estimate normal references values. Study design: Systematic review including cross-sectional, observational, and interventional studies published in English, that reported on defecation frequency and/or stool consistency in healthy children 0-4 years old. Results: Seventy-five studies were included with 16 393 children and 40 033 measurements of defecation frequency and/or stool consistency. Based on visual inspection of defecation frequency data, a differentiation was made between two age categories: young infants (0-14 weeks old) and young children (15 weeks-4 years old). Young infants had a mean defecation frequency of 21.8 per week (95 % CI, 3.9-35.2) compared with 10.9 (CI, 5.7-16.7) in young children (P < .001). Among young infants, human milk-fed (HMF) infants had the highest mean defecation frequency per week (23.2 [CI, 8.8-38.1]), followed by formula-fed (FF) infants (13.7 [CI 5.4-23.9]), and mixed-fed (MF) infants (20.7 [CI, 7.0-30.2]). Hard stools were infrequently reported in young infants (1.5%) compared with young children (10.5%), and a reduction in the frequency of soft/watery stools was observed with higher age (27.0% in young infants compared with 6.2% in young children). HMF young infants had softer stools compared with FF young infants. Conclusions: Young infants (0-14 weeks old) have softer and more frequent stools compared with young children (15 weeks-4 years old).
U2 - 10.1016/j.jpeds.2023.113559
DO - 10.1016/j.jpeds.2023.113559
M3 - Article
C2 - 37331467
AN - SCOPUS:85165896616
SN - 0022-3476
VL - 261
JO - Journal of Pediatrics
JF - Journal of Pediatrics
M1 - 113559
ER -
