Caring for Your Child's Stoma (Colostomy)

Your child had a stoma created through surgery. The stoma lets your child pass stool and gas. Learn about the stoma and how to care for it. You will also learn what to do if you have issues with the stoma and when your child can go back to his normal activities.

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About the stoma

• A stoma is an opening between part of the intestine and the abdominal wall (stomach area). It lets stool and gas exit the body into a pouch. A stoma is also called an ostomy.
• Stool and gas will pass naturally through the stoma. Your child does not need to strain or push. Your child had a colostomy. This means the stoma is between the abdominal wall and large intestine.
• The stoma will be swollen right after surgery. The stoma will get smaller as it heals.
• The stoma feels no pain. It feels like the inside of your cheek. But, it might bleed if it’s rubbed too hard.

About the pouch

• Your child will wear a pouch to collect stool and gas. She will wear the pouch at all times.
• The pouch is sealed tightly against your child’s skin. If the seal is tight, it should not leak or smell. If it does smell, check if there is a leak. Check if the clip or Velcro® is dirty or if the end of the pouch is not sealed.
• Water can make the seal loose and cause leaks. If your child bathes or swims, you might need to change the pouch sooner.
• Skin redness and irritation are usually caused by the pouch seal not fitting correctly. Stool leaking onto the skin can also cause skin irritation.
• On a day when you are planning to change the pouch, your child can take a shower or bath without the pouch. The stoma might be active (pass stool or gas) during the shower or bath. Water and soap will not hurt the stoma.

Stoma care do's and don'ts

Do

• Always carry extra supplies. This can include pouches, stoma powder and extra clothes in case of a leak.
• Empty the pouch when it is 1/3 full (almost halfway) full of stool or gas. Change the pouch if it leaks or if the skin is red, itchy or burning.
• Change the pouch 3-4 times a week. Change it in the morning or before breakfast. The stoma is less active at that time.
• Have your child take a stool softener. This keeps stool soft and moving, especially while taking pain medication. Ask your child’s surgeon how often your child should take a stool softener.
• Check the skin around the stoma for redness or irritation. The skin around the stoma should not be red, raw, swollen or burning.
• Keep in touch with your child’s stoma nurse. The nurse can teach you about the stoma and how to change the pouch. The nurse can also adjust the pouch size as your child grows.

Do not

• Do not let your child lift or carry anything heavy after surgery. The surgeon will tell you when your child can lift or carry things.
• Do not let your child soak in the bath or swim until the incision is healed. The incision is where the surgeon cut into the skin.
• Do not rinse the pouch. It can make the seal around the skin weak and cause leaks. It can also bother the skin.
• Do not use baby wipes on the skin around the stoma. They can make it harder for the next pouch to seal tightly.

Clothing and seatbelts

• Have your child wear loose clothing for 2-3 weeks after surgery. Clothing should not be tight against the stoma.
• For babies, onesies can help keep him from pulling the pouch off.
• Seatbelts should not press or rub against the stoma or the pouch.

Activities and going back to school

• It can take a few weeks or months for your child to feel like going back to his/her normal activities. She might feel tired for 3-6 weeks after surgery.
• The surgeon will tell you when your child can go back to his normal activities.
• It’s normal for your child to feel nervous about going back to school, traveling or playing with friends and family. Talk with your child’s stoma nurse or child life specialist for ideas on how to help your child feel more comfortable.
• You might need to change the pouch sooner if your child takes a bath or swims on a day when you change the pouch. Water can loosen the seal on the pouch and cause leaks.
• Empty the pouch before your child bathes or swims.

Cleaning leaks and treating skin irritation

Leaks

• Leaks can happen if the pouch is not sealed tightly or if your child’s skin is irritated. Leaks can also happen if the pouch is full of stool or gas.
• Tell your child that leaks happen. Leaks are nothing to be embarrassed about. Here is what to do if the pouch leaks:
1. Have your child stand as still as possible. Use a paper towel to clean up the leak.
2. Remove the old pouch. Clean the skin with gentle soap and water.
3. Gently pat the skin dry.
4. Put on a new pouch.

Skin irritation

Leaks can bother your child’s skin. Here is how to treat skin irritation:

1. Remove the old pouch. Clean the skin around the stoma with water.
2. Gently pat the skin dry.
3. Apply stoma powder. Rub in the stoma powder. Brush away the extra powder. Dab the skin with 3M® Cavilon No Sting Barrier.
4. Let the skin dry. Put on a new pouch.

If your child’s skin is still irritated, call the ostomy nurse.

When to call the stoma nurse

• If the skin around the stoma is red, itchy or burning for more than 2 days
• If you have trouble putting on the pouch or keeping a tight seal on the pouch
• If you are worried or have questions about anything

When to call the doctor

• Your child has a fever higher than 102°F(38.3°C)
• There is heavy bleeding from the incision (where the surgeon cut into the skin) through the dressing or the stoma
• New redness, swelling, pain, pus or a foul smell from the stoma or incision
• Your child has stomach, pain, upset stomach, vomiting or very bad diarrhea
• Your child has no stool for more than 1 day
• The stoma changes color from red to black

Rev. 6/2017