Parent & Baby Series- Tips from a Paediatric Nurse

Hi Everyone,

My name is Michelle and I’m a paediatric stoma care nurse in Leicester Hospital as well as within the community. My day- to-day role entails looking after babies and children who need to have a stoma formed. I often meet the children and parents and caregivers prior to surgery to offer support and talk about the type of stoma they’re having and give reassurance, information and advice. The support I offer continues through the child’s hospital stay and I then follow up with care at home.

Most babies have stomas formed within the first 6 weeks of their life, which can cause extra stress on parents. Adjusting to newborn life can be difficult and learning to care for a child’s stoma may add more pressure. This can be a frightening time and I always feel it’s important to listen to parents and caregivers, allowing them to express their fears and worries so that I can give them reassurance. Alongside having discussions on how they will manage, the first step is explaining why this has happened to their baby.

A recurring conversation that I have with parents is that some of them struggle with bonding, especially in the early days when the baby is born and rushed off to surgery. It’s important to me to remind parents that their child is not any different from anyone else, as all children are individuals. Often if I can, I will try and match parents with other parents who are going through the same experience for mutual support, although this isn’t always possible. It has been beneficial for sharing practical tips for coping.

I wanted to share 5 tips that I always share with caregivers to ease their minds:

1. Don’t get upset if the pouch leaks: the reasons can be multifactorial so it’s important to seek advice.

1. Tummy time is a vital part of the babies’ development, parents often worry about hurting the stoma, however a usual time of 10-15 minutes is fine as long as baby is happy. Ensure the pouch is emptied first to prevent any leaks or bursting of the pouch so that the surface is soft for tummy time. I recommend putting a soft blanket underneath if the floor is quite hard, or to protect the flooring in case baby's stoma leaks.

1. Regularly check the template on the stoma pouch throughout the first 6 weeks. The stoma will reduce in size, so it is important for the template to be checked and altered to the size of the stoma / mucous fistula. The hole should be a snug fit around the stoma.

1. Check the baby’s abdomen to see if any obvious creases or scars are present or have developed as the baby will be growing and the abdomen will change shape. If there are creases/scars, then seek advice. Your nurse may suggest things such as stoma paste, ring /washer or using a different appliance.

1. Leaks can be reduced for babies with a stoma and mucous fistula by using a solidifying agent into the pouch this will aid in thickening of the faeces. Advice and guidance can be given about this.

My role enables me to work closely with meet with so many people and care for them on their journey. Being out in the field has made me realise that there isn’t enough information out there for carers of children with a stoma. SecuriCare are working to change that and I’m so happy to be able to share my knowledge to help educate and comfort parents and carers on how they can best help a child with a stoma, as well as look after themselves and process their own emotions.