Your Child's Ileostomy: Changing the Pouch

Soon after your child's surgery, stool will start to pass from the stoma. At first, a nurse will change the pouch. Before going home, you and your child will need to learn how to change the pouch. Key things to remember:

• You/your child will need to change your pouch every 2 to 3 days to prevent leakage and skin irritation.
• The pouch should be emptied whenever it is 1/3 full.
• When changing the pouch, you/your child must always wash your hands for at least 20 seconds before AND after caring for the ostomy pouch (hum “Happy Birthday” twice if you need a timer).

To change the pouch, follow the steps below.

Start by gathering what you/your child will need:

• Plastic bags
• Clean towel
• Paper Towels
• Extra skin protection, if desired
• Scissors (if needed)
• New pouch

Step 1. Remove the used pouch

• If your child uses a drainable pouch, empty it first.
• Open the Velcro closures or remove the clamp and set it aside (if applicable).
• Have your child sit on or next to the toilet.
• Start at the upper edge of the skin barrier. Carefully push the skin away from the barrier with one hand.
• Slowly peel back the skin barrier with the other hand.
• Peel all the way around the skin barrier until the pouch comes off. Seal the pouch in a plastic bag.
• Then put it in a second plastic bag. Throw it away in a trash bin.

Remove pouch

Step 2. Clean around the stoma

• Wipe any stool off the skin around the stoma with a paper towel
• Gently wipe/clean the skin with warm tap water and wet paper towel.  Wash right up to the edge of the stoma.
• Pat the skin dry with a clean towel.
• Do not use soap, treated body wipes or lotions when cleaning the skin around the stoma.
• After cleansing, apply no sting barrier film to protect the skin.
• Stoma powder can also be used for extra protection if needed for any skin irritation.

Clean around stoma

Step 3. Put on the new pouch

• If your child does not use a pouch with a precut skin barrier, size and cut the opening to leave a 1/8-inch space around the stoma.
• Slowly peel the backing off the barrier and carefully place it over the stoma.
• If your child is using a 2-piece pouch, snap the pouch onto the barrier.
• Start at the bottom and work your fingers around the flange.
• Press the barrier against the skin. Hold and warm the barrier for 2-3 minutes with your hand over it.
• This will help to activate the adhesive and help mold the barrier to your child's skin.
• Secure the Velcro closures shut or clamp the tail of the pouch (if applicable).

Put on new pouch