Parental knowledge, management practices, and worry regarding infant bowel habits in Palestine: a cross-sectional study

Infant stool frequency, consistency, and color vary widely during the first year of life. Misinterpretation of normal bowel variation may contribute to parental worry, unnecessary healthcare consultations, and potentially inappropriate management practices. This study assessed parental knowledge, intended management practices, stool-related worry, and associated factors among parents and primary caregivers of infants in the West Bank, Palestine. A cross-sectional study was conducted between March and May 2026 among parents and primary caregivers aged 18 years or older who were caring for infants from birth through 11 completed months of age. Participants were recruited using convenience sampling through paper-based and online questionnaires. Knowledge was assessed using nine factual statements, producing a total score ranging from 0 to 9. Intended management practices, stool-related worry, and desire for additional information were also assessed. Among 369 participants, the median knowledge score was 6.0/9.0 (IQR 5.0–7.0). Fewer than half correctly answered items on mucus, constipation, and green stool. Consulting a doctor was the most common intended response to frequent stools (48.0%) and constipation (42.0%). Stool-related worry affected 63.7%, and 85.9% wanted additional information. Higher knowledge scores were associated with greater odds of worry (adjusted OR per point = 1.20, 95% CI 1.05–1.37), as was household income of 6500–12,000 versus < 1800 NIS (adjusted OR = 4.29, 95% CI 1.51–12.13). Knowledge gaps and frequent stool-related worry highlight potential priorities for caregiver education: normal stool variation, recognition of constipation, warning signs, and safe management. Future studies should evaluate whether targeted counseling improves knowledge and reduces unnecessary worry.