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Infant stool form scale: development and results

Noor Bekkali1, Sofie L Hamers, Johannes B Reitsma

  • 1Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands. N.Bekkali@amc.nl

The Journal of Pediatrics
|December 5, 2008
PubMed

Insights

A new infant stool scale effectively assesses defecation patterns in term and preterm infants. Breastfed infants showed smaller stool amounts than formula-fed infants, with good scale reliability.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Infant Health

Background:

  • Assessing infant stool characteristics is crucial for monitoring health.
  • Existing methods lack standardization for consistency, amount, and color.
  • A reliable tool is needed to differentiate normal and abnormal defecation patterns.

Purpose of the Study:

  • To develop and validate the
  • Amsterdam
  • stool form scale.
  • To assess the scale's utility in distinguishing between term and preterm infants.
  • To evaluate differences in stool characteristics based on feeding type (breastfeeding vs. formula feeding).
  • To determine the interobserver and intraobserver reliability of the newly developed scale.

Main Methods:

  • Development of a 4-point scale for consistency, a 4-point scale for amount, and a 6-category scale for color.
  • Collection of infant data including gestational age, postnatal age, and feeding type.
  • Scoring of 555 infant stool photographs twice by observers to assess variability.
  • Establishment of a consensus database for stool characteristics.

Main Results:

  • No significant differences in stool characteristics were observed between term and preterm infants.
  • Breastfed infants exhibited smaller stool amounts compared to formula-fed infants (P < .001).
  • The scale demonstrated good interobserver reliability for consistency and amount (weighed kappa) and good reliability for color (simple kappa).
  • Excellent intraobserver reliability was found for both observers (kappa values).

Conclusions:

  • The
  • Amsterdam
  • stool form scale is a useful tool for assessing defecation patterns in both premature and term infants.
  • The scale provides reliable and reproducible measurements of infant stool consistency, amount, and color.
  • Findings support the scale's application in clinical practice and research for evaluating infant bowel function.
Abstract

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