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Ostomy Care, Child


About this topic


An ostomy is an opening from the belly to the outside of the body. It lets your child get rid of the bodys waste products. The opening is called a stoma. If the opening is coming from the small bowel, it is an ileostomy. If it is coming from the large bowel, it is a colostomy. Sometimes, the opening comes from the bladder and then it is a urostomy. A special pouch attaches over the opening to catch the body's wastes. ‚  
There are many reasons why your child might need an ostomy. This procedure is done to treat: ‚  
  • Block in the bowel and removal of part of the bowel
  • Cancer
  • Crohn's disease
  • Diverticulitis
  • Bladder or kidney problems

Your child may have an ostomy for just a short time. This is often needed when the bowels or bladder need to heal. In more serious cases, the ostomy may be permanent. ‚  
Having an ostomy may be a challenge for you and your child to accept. It may be hard to deal with. Learn how to take care of your child's ostomy. This may help you adjust to your child's condition. ‚  

General


In most cases, your childs urine or stool will drain directly into a small plastic pouch. The pouch is worn outside the body, but under your child's clothing. The pouch protects from odor and wetness. You will need to learn how to care for your child's pouch and skin. ‚  
Taking Care of the Pouch ‚  
Empty the Pouch ‚  
  • Wash your hands before and after touching the pouch.
  • Pour out the contents of the pouch when it is 1/3 to 1/2 full. Avoid emptying the pouch when it is near full.
  • For young children, empty the pouch into a diaper. Older children can sit on the toilet and place the pouch between their legs. Remove the opening clip of the pouch and empty the body wastes into the toilet. Sometimes, it is easier to sit facing the back of the toilet.
  • Clean the end of the pouch with a moist paper towel or baby wipe. You may also rinse the pouch with water and drain the water. Close the end of the pouch by replacing the clamp.
  • For urostomy, empty the pouch first thing in the morning. Do this before you give your child anything to drink in the morning.

Change the Pouch ‚  
  • You will need to change the whole pouch system every 3 to 5 days. You may need to change it more often if there is leakage around the site.
  • Gather all the supplies and wash your hands.
  • Gently take off the old pouch and any protective barriers.
  • Look at the stoma. It should be red and moist looking. Gently clean the skin around it with warm water and pat dry.
  • The new barrier will not stick if your child's skin is wet. If needed, use a small amount of skin barrier powder.
  • Use the measuring grid to measure the shape and size of the stoma. This will be used to mark the opening into the pouch barrier. The size should be just where your child's skin and stoma meet.
  • Trace the right size opening on the pouch barrier. Use scissors to cut an opening in the pouch barrier. Take extra care not to cut the pouch.
  • Center the new opening of the pouch over the stoma. Make sure it fits well on all edges. Trim the barrier if needed.
  • Remove the protective backing. Place the barrier on the skin around the stoma and press down for 30 to 60 seconds. You may want to save the protective backing as a template for the next pouch change.
  • Close the bottom of the drainage bag with a clamp.

Take Care of Your Child's Skin ‚  
  • Wash your hands before and after touching the stoma. Clean the stoma and skin around it with warm water. Do not use products with oil or perfume to clean the stoma.
  • It is normal for the stoma to bleed slightly when you clean it.
  • If the skin around the stoma becomes sore, remove the pouch and clean the skin.
  • Dry the stoma before replacing the pouch.
  • The doctor may suggest other creams, powders, or different bags if your child is having problems with leaks or sore skin.
  • Increased body heat may cause the barrier to loosen more quickly. Check the barrier more often if your child is active and in warm, humid weather.


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Will physical activity be limited?


Your child should not have to limit activity. Ask your doctor about the best activities for your child. Empty the bag often to lessen spills or leaking. This may make activities easier for your child. ‚  

What changes to diet are needed?


Talk with the doctor about the best diet for your child. ‚  

What problems could happen?


  • Skin irritation
  • Hernia
  • Bleeding
  • Infection
  • Ostomy stops working or becomes blocked
  • Weight changes

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain or numbness, redness and pus at the stoma site.
  • Very bad belly pain
  • Change in skin color of the stoma
  • Very bad upset stomach and throwing up
  • Very hard stools or stool from ostomy becomes thick like sludge
  • Black, tarry, or bloody stools or bloody urine
  • Bad skin irritation or sores on the skin
  • Injury to the stoma
  • No urine or stool coming out
  • Health problem is not better or your child is feeling worse

Helpful tips


  • Join support groups to get to know other people who have coped with the condition.
  • If you are going to travel, bring extra supplies to avoid problems.

Teach Back: Helping You Understand


The Teach Back Method helps you understand the information we are giving you about your child. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚  
  • I can tell you about my childs condition.
  • I can tell you how I will take care of my child's ostomy.
  • I can tell you what I will do if my child has a rash or sores around the stoma.

Where can I learn more?


American Cancer Society ‚  
http://www.cancer.org/acs/groups/cid/documents/webcontent/002870-pdf.pdf ‚  
American College of Surgeons ‚  
http://www.facs.org/patienteducation/skills/complete-booklet.pdf ‚  
United Ostomy Associations of America ‚  
http://www.ostomy.org/ostomy_info/#miscellaneous ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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