The limitations of standard baby poo charts

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Key points

  • Standardised baby poo charts are a handy topline tool that may help you determine where your child sits on the broad spectrum from constipation to diarrhoea.
  • Using images or illustrations to show the range between healthy and unhealthy poo becomes highly subjective and may lead to a misdiagnosis around your baby's health.Most charts are largely based on adult poo, and don't account for differences in appearance of adult versus baby poo nor do they show the differences between breastfed versus formula-fed infant poo.
  • A baby's poo will look different depending on their diet (and their mother's diet if they're breastfed), so the range of what is considered "normal" - looking poo is not always reflected in these charts.
  • Standard charts provide some detail into your baby's general health but shouldn't be relied upon to determine whether your child's poo is healthy or unhealthy.

 

Do you find yourself searching the internet for terms like “what should baby poo look like?”, "what does baby diarrhoea look like?”, "why is baby poo green?” or "how to help a baby poo"?

Maybe you often seek out explanations for the unusual appearance of your infant or child's stools, like “blood in baby poo”, or “yellow watery diarrhoea in babies”, wanting to understand whether you should be concerned about your baby's poo appearance or habits.

All these terms are commonly searched – which goes to show, you're not alone in analysing your baby's pooing habits to determine if they're healthy and normal.

When you do look up answers to search terms and questions like these, you'll come across various standardised stool charts and trackers. These tools can provide a quick, easy way to compare your baby's poo against a bunch of images you see on-screen, leaving you to figure out what your baby's stools reveal about their health status. However, while these internet charts and trackers may be useful for analysing an adult's stool consistency and health in some cases, their usefulness and practicality is limited when it comes to assessing a child or baby's poo accurately and easily.

Here are some limitations of standardised poo charts or trackers.

They're can be limited in scope

Standard Stool Charts present you with several graphics representing different types of poo. You decide which image or illustration  most closely resembles your baby's poo.

 You've probably already experienced some of these first-hand, but babies can produce green poop, watery poop, yellowish poop, diarrhea, the list is endless.  

Every one of your child’s poos are different. There are even differences between the poop of breastfed versus formula-fed infant poos - which  are not always accounted for in  standardised stool charts.

The subjectivity of standard poop charts

Recently stool charts have developed to provide additional detail about the colour and volume of infants’ and children’s poos. Some involve three different visual scales, requiring you to assess consistency, volume and colour. These charts can be overly complicated and time-consuming for parents, nurses and healthcare professionals to use in regular circumstances.

The development of more recent poo charts

There can be a lot of variety in what is classified as a “normal”-looking poo in breastfed infants. A mother’s diet and any medications she’s using can affect the appearance of her baby’s poo.

A "normal” poo can range in colour, from yellow to greeny-gold or brown. Most of the time breastfed baby poo is fairly runny, with a similar consistency from pumpkin soup to toothpaste. Remember, while your baby’s poo may appear quite runny, diarrhoea is rare in breastfed infants and may turn their poo green, with mucus present and  a foul smell.  Similarly, breastfed babies don't often experience constipation, and their poos should remain soft.

The verdict on standard poop charts

Every person will interpret and describe stool characteristicsdifferently. This can lead to inconsistencies when interpreting the results of standardised stool charts. Yet the more complex alternatives take more time to choose the right image, making it less simple to  easily assess the “normalcy” of your child’s poo. 

The frequency is often not included

Existing stool charts and standardised trackers typically only detail basic characteristics, like the consistency of stools. They do not always account for other important factors like the frequency of a baby's poos.

It can be difficult to determine whether a one-off ‘abnormal’ poo is cause for concern. If stool charts don’t allow for tracking and ongoing comparison over time, it can make it difficult to be sure whether you need to seek medical advice.

Does one watery poo indicate diarrhoea? Does one hard or pebbly poo suggest your baby is constipated? Is green poo an immediate cause for panic?

Standardised charts can't track trends in your baby’s poo habits – and noticing changes to your baby's version of "normal” is the easiest way to detect any causes for concern.

Not all poo charts are created equal.

Common poo charts and trackers definitely have a place in assessing the consistency or health of adult poo , but many are not suited for evaluating a baby's poo. Here's why.

A baby's poop looks different to an adult's

Babies and infants have very different digestive systems and poo characteristics to adults. As you begin introducing solids (or even formula) into their diet, their poo consistency will change significantly – and this transition is not reflected in the categories shown on standardised charts. 

The difference between breastfed and formula-fed baby poo is not accounted for

Most standardised charts don't account for differences in what is considered a “normal” poo for breastfed babies verses formula-fed infants. Breastfed babies tend to produce softer poos, with a greater range of colours and consistencies than formula-fed babies, or older children and adults. What is considered "normal” for a baby's poo is highly varied – and this is not reflected in standard poo charts. 

A baby's diet affects what "normal” poo looks like

Diet also significantly impacts poo frequency and consistency. Given babies are usually only fed breast milk, formula, or a combination of both, this creates poos that look very different to adult poos depicted in standardised stool charts.

A better alternative to standard poop charts

The lack of specificity provided by these generic charts and trackers can cause misunderstanding or unnecessary concern if your baby's poo doesn't fit into one of the categories shown.

Instead of relying on a generalised chart or tracker, you can receive more individualised, tailored information about your baby's poo consistency and appearance using our new Poo Tracker tool. Here are some of the many benefits it offers:

-          The tool houses a huge range of human images of different types of baby poo, consistencies and appearances. You can simply take a photo of your baby's nappy and upload it in real time, and our intelligent algorithm will match it to whichever type of poo in the database most accurately resembles your baby's. With so many different visual examples for the system to match your baby's poo to, you're much more likely to get a closer match than you could achieve with a standard chart – which only offers up to seven  images to choose from.

-          Using a photo you've taken in real time means you don't have to rely on your own judgment and subjective interpretations to match your baby's poo to whichever image you think is most similar to your photo.

-          Our sophisticated algorithm does the work for you.

-          You can also track the habits and trends in your baby's bowel movements over time, making it easier to identify any abnormalities or changes if they arise. Since any changes to your baby's "normal” habits are most helpful in identifying their health status, this makes the Poo Tracker tool very useful in determining whether you should seek the help of a healthcare professional.

This allows you to receive more tailored, thorough and insightful information about your baby's pooing habits. Try our Poo Tracker tool for yourself here.

 

 

Continence Foundation of Australia. Bristol Stool Chart [Internet]. Australia: [publisher unknown]; 2020 [updated 2024 February 09; cited 2024 September 23]. Available from: https://www.continence.org.au/bristol-stool-chart

Ghanma A, Puttemans K, Deneyer M, et al. Amsterdam infant stool scale is more useful for assessing children who have not been toilet trained than Bristol stool scale. Acta paediatricia. 2014;103:91-2.

Huysentruyt K, Koppen I, Benninga M, et al. The Brussels Infant and Toddler Stool Scale: A study on interobserver reliability.  Journal of Paediatric Gastroenterology and Nutrition. 2019;68:207-13.

Vandenplas Y, Szajewska H, Benninga M, et al. Development of the Brussels Infant and Toddler Stool Scale ('BITSS'): protocol of the study. BMJ Open. 2017;7.

Velasco-Benitez, CA, Llanos-Chea A, Saps M. Utility of the Brussels Infant and Toddler Stool Scale (BITSS) and Bristol Stool Scale in non-toilet-trained children: A large comparative study. Neurogastroenterology and motility. 2021:33.

Nutricia has no affiliation with the above authors and organisations.

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REMEMBER: The information on this page is general only. If you have any concerns about your baby’s poo or questions about constipation or any other health concerns, please speak to a healthcare professional, like a Pharmacist, GP or Maternal Child Health Nurse.

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