A Quick Guide to Colostomy Care for Babies and Children

A colostomy is a surgically created opening (stoma) through a section of the large intestine into the abdominal wall. This method bypasses damaged areas of the intestine and allows waste products to be removed from the body.

 

Reasons for Colostomy in Babies and Children

- Congenital anomalies (anorectal malformations, Hirschsprung disease)

- Necrotizing enterocolitis (NEC)

- Severe intestinal obstruction or perforation

- Traumatic bowel injuries

- Inflammatory bowel diseases

- Rare tumors

 

Daily Maintenance

- Check the stoma and surrounding skin daily (a normal stoma appears pink or red and moist).

- Clean the area around the stoma with warm water only, without using soap or cleanser.

- Make sure the skin is completely dry before applying a protective barrier or bag.

- Empty the bag frequently (when it is one-third or half full).

- Use protective creams recommended by health professionals to prevent irritation.

 

Step by Step Instructions for Changing a Colostomy Bag

 

1. Preparation:

- Prepare a new colostomy bag, adhesive remover, scissors, measuring ruler, barrier cream or powder, waste bag, gloves, soft cloth and warm water.

- Choose a time when your child is calm.

- Wash your hands thoroughly.

 

2. Removing the Old Bag

- Carefully remove the bag from top to bottom.

- Use adhesive remover if necessary.

- Throw the used bag in a separate bag.

 

3. Skin Cleaning and Stoma Control

- Gently clean the area around the stoma with warm water and a soft cloth.

- Check the condition of the stoma (a healthy stoma should be pink or red, moist and not bleeding).

- Dry the skin thoroughly by gently patting it dry.

 

4. Measuring the Stoma

- Measure the size of the stoma with the measuring ruler.

- Cut the opening in the bag to be approximately 2 mm larger than the size of the stoma.

 

5. Preparing the Skin

- Apply the protective cream or powder recommended by your doctor.

- Make sure the skin is completely dry before applying the new bag.

 

6. Attaching the New Bag

- For better adhesion, slightly warm the adhesive with your hands or a hair dryer at low temperature.

- Carefully place the bag around the stoma and seal it.

- Press gently on the adhesive for about a minute.

 

7. Control of Adhesion

- Check that the bag is sealed properly, without wrinkles or gaps.

- Make sure the child is comfortable.

 

Bag Change Success Tips

- Heat the adhesive slightly for better adhesion.

- Use toys, songs or stories to keep your child calm.

- Try to change the bag at the same time of the day.

- When you leave home, make sure to take spare supplies with you in case of emergencies.

 

Bathroom and Shower

- Water does not damage the stoma; it does not enter it.

- Avoid using soap around the stoma as it may prevent the bag from adhering.

 

Light Bleeding

- Light bleeding during cleaning is normal and usually stops quickly.

- If bleeding does not stop or becomes severe, consult a doctor immediately.

 

When to Change Your Colostomy Bag

- For babies and young children, the bag is usually changed every 2-3 days.

- If the bag leaks or is uncomfortable, replace it immediately.

 

Factors Affecting Bag Adhesion

- Hot and humid weather shortens the life of the bag.

- Moist or oily skin negatively affects adhesion.

- Growth and weight changes may require regular check-ups and bag size changes.

- Physical activity and swimming may require more frequent bag changes.

 

Management of Complications

- Skin Irritation: Prevented by regular cleaning, protective cream and correct bag selection.

- Bleeding: Light bleeding is normal; consult a doctor in case of heavy or persistent bleeding.

- Infection: If there is redness, swelling, foul odor, discharge or fever, go to the doctor immediately.

- Bowel Leaking Out or Into the Stoma: Seek immediate medical attention.

- Leaks: Recheck the size and sealing of the bag.

 

Nutrition and Hydration

- Eat a balanced diet and ensure adequate fluid intake as recommended by your doctor.

 

Clothing and Comfort

- Choose soft, comfortable clothes.

- Special equipment recommended by colostomy bag manufacturers can help keep the bag comfortable and secure.

 

Emotional Support

- Support your child by making age-appropriate explanations.

- Encourage independence gradually.

- If necessary, seek psychological support or family support groups.

 

Activities and Lifestyle

- Encourage age-appropriate activities by taking the necessary precautions.

- Use protective equipment while swimming or doing sports.

 

Regular Checkups

- Visit your doctor regularly to monitor your health status.

- Take notes of maintenance processes and your questions.

 

Situations in which you should consult a doctor immediately

- Severe or persistent bleeding

- Intense pain or swelling

- Ongoing vomiting, refusal to eat or drink fluids

- Prolonged diarrhea

- Sudden changes in stoma color or shape

- Signs of severe skin irritation or infection