Ostomy Care for Infants, Children, Teens

Caring for a child's ostomy comes with a few extra considerations compared to caring for an adult's. Because a child's skin is more delicate and their body is still growing, pouching systems, wear times, and product choices all need to be adapted to their age and stage of development. Based on the Wound, Ostomy, and Continence Nurses Society's Basic Ostomy Skin Care: A Guide for Patients and Health Care Workers, here's what to know about ostomy care for infants, children, and teens.

This article is for general information only and isn't a substitute for advice from your child's surgeon, ostomy nurse, or other member of their health care team. Your child's care plan should always come from them.

How Often to Change the Pouching System

Wear time varies depending on a child's age. Pediatric pouching systems are thinner and more flexible than adult systems, and they're typically changed more often:

  • Neonates: the goal is a 24-hour wear time to protect the skin.
  • Older infants and children: the pouching system may be changed every 1–4 days, with an average of 2–3 days.
  • Teenagers: the pouching system may be changed 1–2 times per week, similar to adult wear times.

As Your Child Grows

Children grow quickly, and their stoma size changes along with them. Continue to measure the stoma regularly as your child grows, and resize the skin barrier opening as needed — a barrier opening that's too large or too small for a growing stoma is one of the most common causes of leaks and skin irritation in children.

Choosing the Right Skin Barrier Products

Not every ostomy product used for adults is appropriate for infants and children:

  • Liquid skin barriers and adhesive removers should generally be avoided in infants and children.
  • Paste containing alcohol should be avoided in premature infants, as it can be irritating to fragile skin.
  • Alcohol-free pastes, skin barrier rings, and elastic barrier strips may be used to help fill uneven areas and support the seal.

A Nurse Specialized in Wound, Ostomy & Continence (NSWOC) can help confirm which products are the right fit for your child's age and skin.

When to Contact Your Health Care Team

Reach out to your child's ostomy nurse, surgeon, or doctor if you notice:

  • Leaking or a pouching system that won't stay sealed despite resizing the barrier
  • Red, sore, or broken skin around the stoma
  • A noticeable change in the size, shape, or colour of the stoma
  • Signs of infection, such as unusual odour, swelling, or discharge

If you don't have an ostomy nurse you can reach easily, CanMedDirect's Clinical Support page, developed in partnership with NurseCraft, can help connect you with one.

Reminder: this article provides general information and is not a substitute for professional medical advice. Please consult your child's surgeon, ostomy nurse, or health care worker to determine what's appropriate for your child's specific situation.

Pediatric Ostomy Care FAQ

Pediatric Ostomy Care FAQ

Common questions about caring for an ostomy in infants, children, and teens, based on WOCN's Basic Ostomy Skin Care guide.

It depends on age. Neonates typically aim for a 24-hour wear time to protect delicate skin, older infants and children usually change every 1–4 days (2–3 days on average), and teenagers often change 1–2 times per week, closer to an adult schedule.

Children grow quickly, and the stoma's size changes as they do. A barrier opening that no longer matches the stoma's current size is a common cause of leaks and skin irritation, so it's important to re-measure regularly and adjust the opening as needed.

Not all of them. Liquid skin barriers and adhesive removers are generally avoided in infants and children, and alcohol-based paste should be avoided in premature infants. Alcohol-free pastes, skin barrier rings, and elastic barrier strips are generally considered appropriate options.

Alcohol-free skin barrier rings and pastes can be moulded to improve the seal and fill uneven areas around the stoma. Elastic barrier strips can also be used around the outside edges of the pouching system for extra security.

Reach out if the pouching system keeps leaking despite resizing, if the skin around the stoma is red, sore, or broken, if the stoma's size, shape, or colour changes noticeably, or if you notice signs of infection like unusual odour, swelling, or discharge.