OSTOMY CARE EDUCATION

FOR PARENT WHO HAVE A

CHILD WITH STOMA
A JOURNEY
WITH SPECIAL CHILD

... Here, we wont talk about stoma care,

but well talk about a special child....
Yours...

I have a good
news. Today, you
can bring home
your beautiful
baby..

Oh God,
how can I
do all those
things...

Ok..weare
ready to go
home

It seems
complicated.
I cant do
that

Courtesy 1st ETNEP

Courtesy 1st ETNEP

1001 questions of scary Moms

about stoma care.

What is stoma? What does stoma look like?

Im afraid to touch it. Can it hurt him/ her?
Can I do that? Its seems complicated.
Can my baby take a bath?
Can my baby sleep on their tummy?
Can I breastfeed my baby?
Can we travel?
.....
I cant afford to buy the supply. Do you have any
suggestion for a cheaper one?

Discharge Planning
Why is it important?
When do you start it?
What do you plan?
Who is involved?
How do you do that?

Do you concern about

these?

How to change the pouch?

Breastfeed? What kind of food they
could eat?
Is it ok to take any medicine while my
baby has a stoma?
What if the baby gets diarrhea?

Changing the pouch

means...

How to open/ close the pouch?

How to peel off the pouch?
What kind of solution do I suppose to use to
clean the skin?
How to measure the correct size?
How to attach the pouch?
What do I have to be concerned while doing
this?
How do you get the supply?
...

Equipment ...
1.
2.
3.
4.
5.
6.

Cutter/ scissor
Pouch and clipper/ tail
Measurement tool
Soft cotton cloth
Soft towel
Any accessories if
needed
7. Baby cloths/ jumpsuit
8. Disposal bag
9. ....

Here we go..

Tips

Infant: Avoid to use agents that are

alcohol based, adhesive remover, skin
protective wipe
6 month 2 yo: choose all-in-one
jumpsuits/ vest for their cloth
2 5 y.o: start to explain about their
stoma, involve in aspect of care
> 6 y.o: gaining independency of care

Make sure the parent knows

about:

The type of stoma

The kind of product they need for their
baby/ child, the type and size of the bag
How will they get the supply

Nutrition for a child with

stoma

...special diet may be necessary due to

other medical conditions, but not
because of stoma...
..........................................................
So, just follow the nature...

Age-appropriate child feeding

0-6 bulan

6-12

1-2 tahun

2-3 tahun

3-5

ASI

Bubur susu
Bubur nasi
Sayur dan
lauk cacah
Buah/ sari
buah.
Selingan
antara 2
waktu
makan

Nasi lembek
Sayur dan
lauk lunak
Buah/ sari
buah
Beri
selingan
antara 2
waktu
makan

Nasi
Sayur, lauk
Buah
Selingan
antara 2
waktu
makan

Sama
dengan usia
2-3 tahun

Sumber: www.bidanindonesia.org, 2011

Ostomate Food Refference Chart

Gas Producing

Odor
Producing

Increased
Stool

Stoma
Obstructive

Alkoholic bav
Carbonated bav
Beans/ Soy
Cabbage
Cauliflower
Cucumber
Dairy product
Chewing gum
Milk
Nuts
Onions

Asparagus
Baked beans
Broccolli
Cabbage
Eggs
Fish
Garlic
Onion
Peanut butter
Strong cheese

Alcoholic bav
Whole grain

Apple peels
Cabbage raw
Celery
Corn
Dried fruit
Nuts
Oranges
Pineapple
Popcorn
Seeds

Cooked cabbage

Fresh fruit
Greens, leafy
Prune
Raw vegetable
Spices

Ostomate Food Refference

Chart
Color Changes

Odor Control

Constipation
Relief

Diarhea
Control

Asparagus
Beets
Food colour
Iron pills
Red jelly
Strawberries
Tomato sauces

Buttermilk
Cranberry juice
Orange juice
Tomato juice
Yogurt

Hot Coffee
Cooked fruit
Cooked vegetab
Fresh fruit
Fruit juice
Water
Warm/hot bav

Applesauce
Banana
Boiled rice
Peanut butter
Tapioca
Toast

Ileostomy Concern

Some foods such as seeds do not digest

well and may not pass the ileostomy
stoma.
Make sure the child chews the food
properly before swallowing.
Drink plenty of fluid

TIPS

New food can be

added to the babys
diet as
recommendation
gradually.
Lactose intolerance is
common thing.
Eliminate it for several
days and try again.
If persistence, change
to lactose free milk

Medication in Stoma
Care

Drugs having affect on stomal action

Treating Constipation

Laxative
Bulk-forming laxative
Stimulant laxative
Osmotic laxative
Fecal softener

Treating Diarrhea

Anti diarrhea
Anti motility drugs

Antasids
Calcium channel blocker (e.g
nefedipine)
NSAID
Diuretic

Ileostomy Absorption
Concern
Altered transit time
through the small
intestine
A large number of
medication are
prepared in the form
of coated tablet or
time release

Provide uncoated tablet

Or liquid form

.... Just inform the physician that your baby

has a stoma when they write a
prescription...

If the baby gets diarrhea

Make sure the parent knows:
1. what does the normal fecal look like?
2. What does diarrhea, causes of
diarrhea?
3. Sign and symptom of dehydration?
4. What do they have to do?

Causes of diarrhea

Diet
Medication
Disease and or obstruction
Other causes such as infection, mal
absorptions

Sign and symptom of

dehydration

Decreased urine output

Less active or unusual sleepy
Has a dry mouth

What does parent has to

do?

Oral fluid replacement (Keep on

breastfeeding)
Stop any new additional food*
Call your doctor, ... soon

Have you heard about

ostomy support group?

What is ostomy support group?

Open to any individual who has

experience ostomy surgery
Having opportunity to interact with people
who have lived with an ostomy
Ability to discuss any issues they concern
Be a self-help group
Providing support for people with ostomy
such as advocates and lobbyists with
government or appliance manufacture

... Do you have ostomy support group in

your town ?

Any Question??

.... As I said, its not only about the stoma .

Its about a special child.... Yours

We love you
lots, Mom...

Refference
Ahrendsen J. ( 2011). Advantages of Breastfeeding. Clarion.
www.breastfeeding.com
Blackley. (2004). Practical Stoma Wound and Continence Management.
Victoria. Research Publications Pty. Ltd
Breckman. (2005). Stoma Care and Rehabilitation. Philadelphia. Elsevier
Brewer. (2002). Diet and Nutrition Guide. United Ostomy Association, Inc.
ConvaTec USA. (2011). Common Questions about Your Child Stoma.
www.convatec.com
Hampton. (1992). Ostomies and Continent Diversions: Nursing
Management. Missouri. Mosby Year Book, Inc.
Holister. (2010). Caring for your Child with Ostomy. www.holister.com
Milne et.al. (2003). Wound, Ostomy, and Continence Nursing Secrets.
Philadelphia. Hanley & Belfus, Inc.
(2011). www.bidanindonesia.org