If your child has a problem that affects their intestine, they may need a stoma. A stoma or ostomy is an opening that's made on the belly (abdomen) for the discharge of body wastes. The intestine is attached to this new opening. It gives a new way for stool and mucus to leave the body. It's important to help care for your child's stoma at home. You can help your child adjust to having a stoma.

During surgery, the colon or part of the small intestine (ileum) is removed or cut. A small opening is made in the wall of the belly (abdomen). The end of the intestine is attached to this opening. The end of the intestine is folded like a small cuff. This is the stoma.

To make a stoma, the surgeon may use one end of the bowel, a loop of the bowel, or both ends of the bowel. Waste (stool and gas) then leaves the body through the stoma. It empties into a bag. You will be taught how to care for this.

A stoma is needed if your child has a problem with their intestine. This problem may be due to:

• A health problem at birth (congenital) such as intestinal malrotation.
• An illness that affects the intestine such as congenital anorectal malformation, Hirschsprung disease, necrotizing enterocolitis, and IBD (Crohn or ulcerative colitis).
• An injury or surgery that affected the intestine.

A stoma is temporary when it's used to let the intestine heal after illness or surgery. A stoma is permanent when the intestine is damaged or a large part has been removed.

Before you and your child leave the hospital, you'll be given home care instructions. You may meet with an ostomy nurse. You'll need to help your child care for the stoma and the skin around it. Follow all instructions given by your child's doctor and ostomy nurse. Make sure to:

• Keep the stoma and the skin clean. Protect the skin from moisture and contact with stool. This helps to prevent skin soreness and wounds. Clean the skin around the stoma with warm water, mild soap, and a washcloth. Pat dry after cleaning.
• Empty the stoma bag regularly. This is usually needed after every bowel movement. Get familiar with your child's bowel habits. Learn the amount and texture of stool that's normal for your child.

The stoma shouldn't cause pain for your child. But it may take some time for them to get used to it. You can help your child by encouraging them to go back to a normal routine.

• Your child can be active like other children. Check with your child's doctor about what physical activities are okay for your child.
• Your child can go back to a normal diet unless told not to by the doctor.
• Your child can wear the same clothing as before. Stoma bags are designed to lie flat against the body. The bag can fit under clothes where no one sees it.
• Meet with your child's caretakers or teachers and speak with them about your child's needs. Make sure they know how to contact you or your child's doctor in case of a problem or emergency.
• Keep extra care supplies for your child's stoma at home and at school.
• The psychological and social impact a stoma has on a child is real. It may impact their self-image and confidence. Be aware of how your child responds and seek addition help if needed. Ask your doctor for resources.

Contact the doctor right away if your child has any of these:

• Skin around the stoma that is red, oozing, bleeding, or broken
• Skin around the stoma that itches, stings, or has white spots
• Stoma that swells, changes color, or bleeds without stopping
• Stoma that becomes flat or sinks below the skin, or sticks out more than usual
• Cramping or abdominal pain
• Showing signs of dehydration like having bowel movements that are more watery or that occur less often than usual, low urine output, and lethargy.
• Bloody or black stool
• Fever of 100.4°F ( 38.0°C) or higher, or as directed by the doctor