When should I change the pouch?
Until you get into a routine, it’s only natural to feel a little unsure about when and how to change your child’s pouch. Be assured, this process gets easier with time and practice.
The wear-time of your child’s ostomy product varies a lot, as it depends on your child’s size, activity level and the thickness of stool - it can therefore be difficult to establish the right time to change your child’s ostomy pouch. A good time to change a pouch is usually before a meal or several hours after eating, when the stoma is draining less. However, in order to find the best routine for your little one, you should consult your child’s Ostomy Care nurse or Paediatric nurse about your child’s specific needs.
Do not wait for the ostomy product to leak. If your child feels burning, itching under the barrier or is picking at the baseplate, change the pouch immediately. Burning and itching could indicate leakage, and possible damage to the skin around the ostomy (irritation similar to diaper rash).
Routines are important
Establishing predictable routines for changing ostomy products are important. In order to get a good routine in place, you should plan a regular time to change the ostomy products. The best time to change the ostomy products is when the ostomy is less active (before your child eats or drinks in the morning).
How should I change the ostomy products?
Before you begin removing your child’s pouch system, it can be a good idea to make some simple preparations:
- Gather all supplies:
- Pouch and baseplate (if using two-piece)
- Soft cloth (cotton wool ball or flannel and warm water)
- Ostomy measuring guide, pen and scissors
- Plastic bag for trash
- Pouching accessories (i.e. paste, powder)
Your child’s Ostomy Care nurse or Paediatric nurse will help you decide if additional items will be needed.
- Peel the pouch off in a smooth and gentle way. Accidentally tearing or ripping off the adhesive may injure the peristomal skin and affect the ability of the next pouching system to adhere to your child’s skin. Using an adhesive remover is recommended.
- Use the plastic bag to throw away the soiled pouch.
- Clean the ostomy and the skin around it with a soft cloth and warm water. Do not be alarmed if you see slight bleeding from the ostomy – this is normal and should stop quickly. You don’t need to use soap, cleansers or moistened wipes as this may cause skin problems and keep the barrier from sticking. However, If you do, make sure you use a soap that is oil-and residue-free. Soaps containing moisturizers, oils and deodorants – as well as some brands of baby wipes containing lanolin – will leave a film on the skin that interferes with pouch adherence.
- Check the skin around your child’s ostomy for any redness or irritation. Always check the ostomy as well to make sure it maintains its natural red color. If you see a rash, discoloring on the ostomy (very dark, purple or black) or have other concerns, call your child’s Ostomy Care nurse or doctor.
- Measure the diameter of the ostomy using the ostomy measuring guide.
- Trace the measurement onto the back of the baseplate.
- Cut the opening to match the pattern. Measure to fit the same size as the ostomy. This will help prevent stool from touching your child’s skin and causing irritation.
- Ensure tight contact between the skin and the baseplate by using your hand to put light pressure over the baseplate for two or three minutes. Avoid any moisturizers around the ostomy for better adhesion.
- If the ostomy becomes active, wait for it to take a break and then proceed. Re-cleanse the skin if it becomes wet or soiled.
- Remove the backing from the baseplate.
- Apply the new baseplate by centering the opening over the ostomy. Gently press in place.
- Close the pouch outlet.
- Wash your hands.
Tips & tricks
Consider asking your child if they would like to name their ostomy. Many people do, and it can help your child adapt to life with an ostomy. Some children also have a doll that has an ostomy or put an ostomy pouch on a favorite doll or toy.
Distract your child when changing the pouch. Using a mobile, a toy with music, or a dummy to soothe can be helpful.
Pre-school and school-age: As your child grows, teach him/her simple tasks such as gathering supplies and warming the baseplate. This will encourage acceptance and increase comfort and security with the appliance.