Infants with a stoma

The type of stoma your child has will be determined by the reason for the surgery. With a colostomy and ileostomy, the opening is made from a portion of the intestine. For a urostomy, the opening is made somewhere along the urinary tract.

As a parent, it is important to understand the type of ostomy your child has.

• A colostomy is the most common type of stoma for an infant or child. It is an opening into the colon or large intestine. When undigested food enters the colon, water is absorbed. The stool is stored in the colon until it is passed from the body. Stool (bowel movement) comes out of the colostomy. It may be liquid or solid in consistency. Gas is common.
• An ileostomy is an opening into the ileum which is part of the small intestine. The small intestine contains digestive enzymes which break down food to help with digestion and absorption of nutrients. The output from an ileostomy is a stool - similar to the colostomy. One major difference is that the output from the ileostomy also has the digestive enzymes. Although these enzymes are normally present in the small intestine, they can cause irritation or damage if the stool comes into contact with the skin.
• A urostomy is an opening into the urinary system. The urinary system is made up of the kidneys, ureters, bladder and urethra. The kidneys filter and produce urine. The urine travels from the kidneys down the ureters and into the bladder for storage before it is eliminated from the body. Urine comes out of the urostomy stoma. The urine may also contain some mucus.

Taking your child home from the hospital.

Taking your child home from the hospital after stoma surgery is exciting and maybe a little bit scary. Here are a few things to review prior to discharge that can make your transition to home a little easier.

Be sure you watch the procedure for changing a pouch, more than once if possible. You should also have a chance to change it yourself before your child goes home. Take the opportunity to empty your child’s pouch when the Stomal Therapy Nurse is around. You may not feel like an expert yet, but your confidence will build with practice.

Be sure to have written step-by-step instructions on your child's pouch change procedure. The STN will arrange a discharge kit and supplies. The STN will arrange your child’s application to join an Ostomy Association so that all ongoing supplies for your child’s stoma care will be easily accessed.

Make a list of all the key phone numbers. This list might include: Stomal Therapy Nurse, doctor, and Ostomy Association. Be sure to have information about scheduling follow-up visits, medications and other care your child needs such as wound care.

Your child's pouching system.

The skin barrier is the waxy part which sticks to the skin and fits right around the stoma. It protects the skin from contact with stool, urine or enzymes. It is not a tape, but, like tape, it holds the pouching system in place.

The pouch is the plastic bag that collects the stoma discharge. It is made of a material designed to contain the odour.

Accessories are optional items. Each of these serves a specific function and is used only when indicated. Examples of accessories include barrier rings, barrier paste, odour eliminators or ostomy belts. Use these products if directed by your Stomal Therapy Nurse.

In order for your child to receive appliances on the Stoma Appliance Scheme, they must have a Medicare card and be a member of an Ostomy Association. If they do not have an Ostomy Association, you can find one here. 

Emptying your child's pouch.

• Empty the pouch when it is 1/3 to 1/2 full of gas, stool or urine. If it gets too full, it may leak or not last as long. It is always a good idea to empty the pouch before nap time and bedtime or trips in the car. After emptying, wipe the bottom of the pouch before closing. A tissue or baby wipe works well for cleaning the bottom of the pouch.
• If you use disposable nappies, you can simply empty the pouch contents into the nappy when you are changing your baby’s nappy. Occasionally, your child’s doctor may ask you to measure the output. If you are using a two piece pouching system, you may find it easier to snap off the pouch to empty it. Take off the full pouch and snap on an empty one.
• If your child is an infant, it might be easier to empty the pouch if you angle the pouch to the side when you apply it. If your child is older and walking, angling it straight up and down is better for pouch filling and emptying.
• If you have a toddler or young preschooler, they may be ready to sit on the toilet when you empty their pouch. A potty seat will help so they are comfortable. Placing some toilet tissue in the water of the toilet bowl prevents splashing as the contents are emptied.
• You do not have to clean out the inside of the pouch when the child is wearing it. Putting water into the pouch and rinsing it out may actually weaken the skin barrier seal and reduce wear time. If the stool is difficult to get out of the pouch, you may consider using a lubricating deoderant. This product makes the inside of the pouch slippery so that the contents empty more easily. It also has the benefit of eliminating odour. Do not substitute other products such as cooking oil, baby oil or soap as they can weaken the pouch seal.
• It's generally not a good idea to use commercial nappy wipes when cleaning the skin around the stoma as some of these wipes contain ingredients that can affect the skin barrier adhesion. Plain, warm water is a better option for cleaning this area.