Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; Laboratory of Microbiology, Wageningen University & Research, Wageningen, The Netherlands.
J Pediatr. 2023 Oct;261:113559. doi: 10.1016/j.jpeds.2023.113559. Epub 2023 Jun 16.
To summarize available data on defecation frequency and stool consistency of healthy children up to age 4 in order to estimate normal references values.
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.
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.
Young infants (0-14 weeks old) have softer and more frequent stools compared with young children (15 weeks-4 years old).
总结 4 岁以下健康儿童排便频率和粪便稠度的现有数据，以估算正常参考值。
系统评价包括横断面、观察性和干预性研究，发表于英文期刊，报道了 0-4 岁健康儿童的排便频率和/或粪便稠度。
共纳入 75 项研究，涉及 16393 名儿童和 40033 次排便频率和/或粪便稠度测量。根据排便频率数据的直观检查，将其分为两个年龄组：婴儿（0-14 周龄）和幼儿（15 周至 4 岁）。婴儿的平均排便频率为每周 21.8 次（95%CI，3.9-35.2），幼儿为每周 10.9 次（CI，5.7-16.7）（P<.001）。在婴儿中，母乳喂养（HMF）婴儿的每周平均排便频率最高（23.2[CI，8.8-38.1]），其次是配方奶喂养（FF）婴儿（13.7[CI 5.4-23.9]），混合喂养（MF）婴儿（20.7[CI，7.0-30.2]）。硬便在婴儿中很少见（1.5%），而在幼儿中则很常见（10.5%），且随着年龄的增长，软便/水样便的频率会降低（婴儿为 27.0%，幼儿为 6.2%）。与 FF 婴儿相比，HMF 婴儿的粪便更软。
与幼儿（15 周至 4 岁）相比，婴儿（0-14 周龄）的粪便更软、更频繁。
