Discharge Instructions: Your Child’s Colostomy
Your child has a colostomy. This procedure involved cutting (and sometimes removing) part of the colon (large intestine). The end of the colon was attached to a small hole made in the abdominal wall. This creates an opening in the skin called a stoma. Stool and mucus pass out of the body through this opening into a holding bag. Depending on the location of the colostomy, your child's stool may be loose to formed. Below are guidelines for home care after a colostomy. The healthcare provider and nursing staff may give you additional instructions for your child. A special nurse called a wound-ostomy-continence nurse will often see patients and families in the hospital to go over questions and teaching.
Care for your child’s healing stoma as you were shown. Ask your child’s healthcare provider for an instruction sheet about stoma care. This will help remind you how to care for the stoma.
Be sure to do the following after surgery:
Care for your child’s stoma as instructed.
Unless told not to, wash the surgical incision(s) with soap and water and pat dry. Your child can shower or bathe as needed, but avoid having water spray right on the incision.
Check the healing incision(s) every day for redness, drainage, swelling, or pulling apart of the skin. Call the healthcare provider if you notice any of the signs listed in the tint box below.
Follow all instructions from the healthcare provider about watching the amount of output into the colostomy bag.
Keep your child from lifting anything heavier than 5 pounds until the healthcare provider says it’s OK.
Keep your child from rough play and contact sports. But let your child be active, such as taking walks. If traveling in a car for long periods, stop often to let your child stretch.
Ask the healthcare provider when your child can return to school. Most children are able to do so within 2 to 3 weeks after surgery.
Give your child any prescribed medicines as directed. Don’t skip doses.
Don’t give your child over-the-counter medicines unless the healthcare provider says it’s OK.
A stoma can be temporary (used for a short time) or permanent. Your child’s healthcare provider can tell you more.
Tell your child’s teachers and the school nurse that your child has a colostomy.
A colostomy bag doesn’t smell and can be hidden under clothing. The bag can be emptied into a toilet in privacy.
A child with a colostomy can still play most sports. Talk to the healthcare provider about your child’s special needs.
Make follow-up appointments as instructed.
When to call the healthcare provider
Call the healthcare provider right away if your child has any of the following:
Excessive bleeding from the stoma
Bulging skin around the stoma
Fever (see Fever and children, below)
Seizure caused by the fever
Redness, swelling, bleeding, or drainage from the incision
Redness, swelling, bleeding, or drainage from the stoma
Change in the color or size of the stoma
Signs of dehydration (excessive stoma output, dry mouth, extreme thirst, or no tears when crying)
Bloody or black, tarry stool
Stool that is more watery than normal for more than 5 hours
Very hard stool
No gas or stool leaving the stoma
Nausea, vomiting, pain, cramping, or bloating
Fever and children
Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.
For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.
Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.
Infant under 3 months old:
Ask your child’s healthcare provider how you should take the temperature.
Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider
Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider
Child age 3 to 36 months:
Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider
Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider
Child of any age:
Repeated temperature of 104°F (40°C) or higher, or as directed by the provider
Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.
March 21, 2017
Routine care of patients with an ileostomy or colostomy and management of ostomy complications. UpToDate
Bass, Pat F. III, MD, MPH,Lehrer, Jenifer, MD,Turley, Ray, BSN, MSN