Your Child's Colostomy: Changing the Pouch

Your child's healthcare provider gave your child a stoma (new opening for stool to pass from the body) during surgery. Stool starts to pass from the stoma soon after the surgery. Before going home you and your child will need to learn how to change the pouch.

 

Key things to note:

• You/your child will need to change your pouch every 4 to 6 days or twice a week, but you should empty the pouch more often.
• 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

 

 1. Remove the used pouch

Steps to removing the used pouch are as follows:

• If your child uses a drainable pouch, empty it first. Have your child sit on or next to the toilet. Set the clamp aside (if applicable).
• Start at the upper edge of the skin barrier. Carefully push the skin away from the skin 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. Some people empty the pouch into the toilet first. 

 

2. Clean around the stoma

Steps to cleaning around the stoma are as follows:

• Wipe any stool off the skin around the stoma with a paper towel.
• Clean the skin with warm water. Wash right up to the edge of the stoma.
• Pat the skin dry with a clean towel.
• If needed, put on extra skin protection, such as powder and/or skin prep.

 

3. Put on the new pouch

Steps to putting on the new pouch are as follows:

• If your child does not use a pouch with a precut skin barrier, size and cut the opening (no more than 1/8 inch bigger than the stoma) and peel the backing off the skin barrier
• 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 your child's skin with your hand over the barrier and hold it in place for 45 seconds. This molds the barrier to your child's skin.
• If your child uses a drainable pouch, clamp the tail (if applicable) or close the pouch using the Velcro.
• Wash your hands again for at least 15-20 seconds when you are done. 

 

When to call your child's ostomy nurse or other healthcare provider Call your child's healthcare provider right away if your child has any of the following: Skin around the stoma is red, weepy, bleeding, or broken Skin around the stoma itches, burns, stings, or has white spots Stoma swells, changes color, or bleeds without stopping Stoma changes size, becomes even with or sinks below the skin, or it sticks up more than normal Pus, foul-smelling drainage, or excessive bleeding from the stoma A stoma that separates from the skin or looks like it’s getting longer A stoma that is recessing (pulling back) into the belly Bulging skin around the stoma Blood in your child's stool Change in the color of the stoma Fever of 100.4°F (38°C) or higher, or chills, or as advised by your child's healthcare provider Nausea or vomiting Increased pain in the belly or around the stoma No gas or stool made after 24 hours