Wilson & Hockenberry: Wong’s Clinical Manual of Pediatric Nursing, 8th Edition

Patient Teaching Guide

This section may be photocopied and distributed to families.

Source: Wilson D, Hockenberry MJ: Evolve resources for Wong’s clinical manual of pediatric nursing, ed 8. Copyright © 2012, Mosby, St Louis.

Caring for the Child with a Colostomy

The child has had surgery that has changed the way in which he has a bowel movement. An opening was made in the abdomen, and the bowel was attached to the skin. This allows the bowel to empty through the opening (stoma) instead of the rectum. Therefore the area must be kept clean to prevent the skin from becoming irritated. An ostomy appliance (pouch) is placed over the stoma to collect the stool.

You will need to do the ostomy care for the infant and young child. The child can assist according to his developmental level. For example, the child can gather the equipment and hand you supplies. As the child grows, allow him to increase his responsibility for the care of the ostomy. By the age of 8 or 10 years, most children can do the care by themselves.

Ostomy care should be taught to other people who will be caring for the child. At school, tell both the child’s teacher and the school nurse so that adult help is available if needed. An extra set of clothing can be kept at the school in case the ostomy appliance leaks. This will help spare the child any embarrassment.

Dress the child in loose-fitting clothing that does not press on the colostomy. Bib-type overalls or dresses are preferable to pants. The overalls or dress will cover the ostomy and avoid the elastic waistband on pants, which may irritate the ostomy.

Call your health professional at _______ (phone number) if any of these occurs:

• Bleeding from the stoma more than usual when cleaning it

• Bleeding from skin around stoma

• Change in bowel pattern

• Change in the size of stoma

• Change in color of stoma

• Temperature above 100.4° F

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