Pouching your baby s new stoma

Transcription

1 Pouching your baby s new stoma 1

2 Table of Contents What is a stoma? 2 Temporary and permanent stomas 3 Will the stoma hurt my baby? 4 Making a template or pattern for the bag 5 How to change the stoma bag 6 Care of the stoma and surrounding skin, 7 and appropriate clothing Disposing of the stoma bag and its contents 8 Obtaining your baby s stoma supplies 9 Your stomal therapy nurse 10 Information page 11 Revised by: CAROL STOTT Stomal Therapy Clinical Nurse Consultant Sydney Children s & Prince of Wales Hospitals Sydney, New South Wales Original concept written and developed by Carol Stott: Sydney Children s and Prince of Wales Hospitals, Sydney and Stella Dohle: Royal Children s Hospital, Melbourne. Acknowledgment:

3 What is a stoma? Temporary & Permanent stomas Your baby has a stoma, an opening into either the small intestine or large bowel (colon) created by the surgeon. The stoma may be referred to by the healthcare team as one of the following. A colostomy, is formed when a piece of the colon is brought out through the abdomen and attached to the skin s surface. Initially, the output (stool or poo ) is dark meconium, then yellow curds. Gradually it becomes brown, with the consistency of toothpaste. An ileostomy for this the surgeon brings a piece of the small intestine out through the abdomen and attaches it to the skin s surface. The output (stool or poo ) passed via an ileostomy is liquid and may even look undigested at times (this is normal). A jejeunostomy is also made from a piece of the small intestine but it s taken from higher up. The stool ( poo ) produced is very watery and, again, may look undigested (this is normal). The stools of breast-fed babies tend to be more watery than those of bottle-fed infants. 2 Your baby s stoma may be temporary or permanent, depending on why it was created. It should always look red or pink, so if it changes colour please inform your doctor immediately. The stoma is red or pink because it is made of mucous membrane and has a very good blood supply. You may find when you clean your baby s stoma that there are traces of blood on the tissue afterwards. Don t worry! This is normal, because the blood vessels are close to the surface in all mucous membranes; for example, the inside of the mouth bleeds easily, since it too is a mucous membrane. 3

4 Will the stoma hurt my baby? Making a template or pattern for the bag 5 The stoma itself has no nerve endings, so your baby cannot feel it. It won t become sore if stool ( poo ) sits on it. However, the skin around the stoma does need to be protected and can become sore if the stool is in contact with it for any length of time. That s why you need to use stoma bags. Your stomal therapy nurse will help you to choose a bag that s suitable for your baby and show you how to use it. She/he will also show you how to measure your baby s stoma and cut the bag to the correct size (this is called making a template or pattern). The stoma will be swollen right after surgery but will shrink over the next few days. After that initial reduction it will grow as your baby does. Thus, the template (pattern) will have to be adjusted accordingly, in order to prevent stool (poo) coming into contact with your baby s skin and making it sore. Your stomal therapy nurse will help you do this. 4

5 How to change the stoma bag Care of the stoma & surrounding skin, & appropriate clothing 7 When changing the stoma bag you need to do the following: Gently peel the bag from your baby s skin (an adhesive-remover wipe may be used). Wash the skin around the stoma with warm water. Dry you baby s skin well before applying a new bag; otherwise, the bag won t stick. The stoma bag can either hang at an angle or straight down on your baby s body there s no right or wrong way. It s best not to change your baby s bag immediately after a feed, as this is when the stoma is likely to be more active. The stoma bag can be left on or taken off when your baby has a bath, but most parents prefer to take it off. Do not put anything that contains oil in the bath water, as this may stop the bag from sticking afterwards. When cleaning your baby s stoma and the skin around it, remember the following: Don t use detergents or disinfectants. Baby soap can be used as long as it s rinsed off properly, but a gentle wash with warm water is usually enough to keep your baby s skin nice and fresh. Don t put oils, creams or powders anywhere near your baby s stoma if they get beneath the stoma bag they can stop it from sticking to the skin. You can dress your baby anyway you like. Most parents find that loose, all-in-one garments are the easiest and most comfortable for their child. When you go out make sure you take enough equipment, so you can empty your baby s bag or change it if necessary. 6

6 Disposing of the bag & its contents Obtaining your baby s stoma supplies 9 Because a stoma bag can be emptied at the bottom, it doesn t need to be changed every time it fills with wind or stool ( poo ). After emptying the bag, clean the end of it with warm water before fastening it again. Some parents put the used stoma bag in a nappy-sack to dispose of it; others just wrap it in newspaper and seal it in a plastic bag before putting it in the rubbish bin. Don t flush the used bag down the toilet or burn it. In Australia we are very fortunate to have a government-funded stoma appliance scheme. The scheme is administered by the stoma associations, which charge a yearly fee for this service. After that, all the equipment you need for your baby s stoma is supplied free of charge. Your stomal therapy nurse will tell you about the scheme and associations and give you the necessary forms to fill in. If you are living in New Zealand and require details of how to access stoma equipment please contact your local stomal therapy nurse. 8

7 Your stomal therapy nurse Information Page 11 Stay in touch with your stomal therapy nurse, who is a useful source of help and information. If you live some distance from the hospital in which your baby had the operation, your stomal therapy nurse will be able to put you in contact with another stomal therapy nurse nearer to your home. Once your child reaches 3 months of age, the type of stoma bag you re using for him or her may need to be changed because babies grow so rapidly. Your stomal therapy nurse can help you with this. If your baby s stoma is eventually closed, your stomal therapy nurse can tell you how to prevent skin excoriation on his or her bottom this problem can occur during the first few days after normal stomal closure. Doctor: Telephone Number: Operation: Date Performed: Stomal Therapy Nurse: Telephone Number: Type of Stoma: Type of Stoma Bag: Stoma Association Contact Details: Additional Information: 10

8 12 Notes

9 PO Box 575 Port Melbourne, Victoria 3207 Freecall: Australia Freecall: New Zealand