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Pouch change: Two piece (using Newborn® pouch and wafer)

When should I change the pouch?

Change the pouch two or three times a week, sooner if the seal is leaking. To prevent leaking, empty the pouch when it is about 1/3 full of gas or stool. Do not allow overfilling.

How do I change the pouch?

  1. Wash your hands with soap and water, or use an alcohol hand sanitizer.
  2. Gather supplies:
    • cotton balls or soft paper towel
    • Eakin® wafer
    • No-Sting® wipes
    • ostomy paste
    • ostomy pattern
    • ostomy powder
    • pencil
    • pouch and wafer
    • pouch deodorant
    • scissors
    • warm tap water
    Note: You may want to squeeze some ostomy paste into a 3-ml syringe to make it easier to apply. Put a cap on the tip of the syringe so it doesn't dry out.
  3. Using the ostomy pattern, trace and cut out the skin barrier wafer.
  4. Cut the center hole slightly (less than 1/16 inch) larger than the stoma. To prevent the edges from rubbing against the stoma, make sure the opening is large enough to fit around the base of the stoma without cutting it.
  5. Remove the backing from the pouch. Apply the adhesive side of the pouch to the non-adhesive side of the skin barrier wafer. Press together.
  6. Remove adhesive backing from the skin barrier wafer. Save the backing as a pattern for next time. Apply a thin line of paste or strip of Eakin around the edge of the center hole. (Ostomy paste is used to "caulk" or seal the space between the pouch and stoma.) Let paste sit for 2 minutes to let alcohol evaporate.
  7. Gently remove the old pouch system, using one hand or a wet cotton ball to press the skin away from the adhesive as the other hand removes the pouch.
  8. Using cotton balls and warm water, clean the skin around the stoma. Pat dry.
  9. Apply ostomy powder to any red skin. Dust off excess.
  10. Optional step: Apply No-Sting to skin around stoma. Let dry.
  11. Apply the pouch, centering the stoma in the opening with the drain end to the side for easy emptying.
  12. Place your hand over the pouch for 1 or 2 minutes. The warmth will help seal the pouch.
  13. Other instructions:
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  14. Put the used pouch in the garbage. You may want to carry a plastic bag with your supplies in case you need to change the pouch while away from home.
  15. Wash your hands again.

What else do I need to do?

Now and then, re-measure the stoma, because the size may change. If the pattern is too small, the skin barrier wafer will cut into the stoma.

Who should I call for help?

Call the wound ostomy continence nurse (WOCN) if:

  • skin around stoma is irritated
  • bumps appear around the stoma
  • skin bulges around the stoma
  • pouch or skin barrier leaks repeatedly
  • stoma appears to be getting longer
  • you have questions or concerns about the stoma

Call the doctor if:

  • child has cramps with little or no stool output
  • the stoma bleeds more than expected
  • stoma turns dark or bluish

Questions?

This sheet is not specific to your child, but provides general information. If you have any questions, please call your clinic.

Children's Hospitals and Clinics of Minnesota
Last reviewed by WOCN 8/2015 

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

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