Infant Ostomy Care and Yeast Infection Tips

So, my little guy is about 3 weeks old and fresh out of the NICU with his colostomy bag. They were struggling to keep a bag on him for more than a day in the unit and he’s only gotten more raw since coming home. I actually took his bag right off and have been manually keeping him clean and dry trying to heal him up but his pediatrician thinks he may have a yeast infection where the wafer was. What can I use to clean that up (preferably natural) that won’t burn his raw skin? Or could even potentially help heal his raw skin? 

No idea on the yeast infection but hats off to you and raising a baby with an ostomy. You sure he’s not allergic to the sticky stuff in the wafer? He’s got really sensitive skin being that young.  Good luck. 

Hi BBB,

Don't know much about pediatrics, but for raw peristomal skin in adults, the thing to use is aluminum acetate powder mixed in water. The most common brand is Domeboro, but there are other generics as well. Most of the larger drug stores carry it; I get mine at CVS, or you can order it from Amazon for next-day delivery. This will soothe the skin and reduce inflammation, but won't address the underlying yeast issue, if that's what it is. Your doctor really should have swabbed the area and sent the culture to the lab for analysis, as a lot of peristomal skin issues look the same but have different causal factors. And most of the meds for each cause won't fix the other causes, so it's best to know what you're really dealing with.

If it is a yeast-type infection, there's a ton of OTCs for that, from Vagistat (not Vagisil) to athlete's foot or jock itch sprays and powders. But some yeast infections aren't topical and are coming from within the skin... so again, best to know what you're dealing with.

One note on the Domeboro (or any aluminum acetate)... if your child has an allergy to metals, aluminum acetate may cause additional irritation. Most folks have no issue... but there are always outliers. The other best thing for irritated skin is air, if that's possible. I'm sure others who've dealt with pediatric ostomies will chime in and offer you some more (hopefully better) advice.

;O)

Athlete's foot sprays sting infected areas. Just saying. 

Any chance your baby boy is a Cleveland Clinic/UH Rainbow/ or Akron Children’s grad? ☺️

Did y’all have an ostomy nurse visit him or just his NICU ones?

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Yes, they do... but that means it's killing the fungus! The most common active ingredients in these sprays, powders, or lotions are clotrimazole, miconazole, tolnaftate, or terbinafine... and they all can have the side effect of stinging. But it doesn't last long and feels good once it stops and your skin calms down. So pick your poison... but the fungus won't go away by asking it nicely. This is one of those cases where a little pain provides a lot of gain. Note that some antifungals also come as a non-OTC oral tablet... but that's a discussion to be had with your doctor.

;O)

Your Pediatrician should know that prescription Nystatin powder is what’s used for yeast infections on the skin & peristomal areas.  It does not sting or have any negative effect on adhesion.  

Best of luck!

Clean and dry well, then use a light dusting of antifungal foot powder (in lieu of stoma adhesive), dry brushed off well so it appears nothing is on the skin surface, then cover with skin protectant blow-dried very well.

Then proceed with appliance application.

By the way, Flonaze, including generic versions, works great to stop burning and stinging if used as a skin protectant. Just spray vertically into the cap and pour around the stoma, spreading out to cover adhesive areas.

Hi Kas,

  You're right, as long as the fungal infection is Candida based.  Nystatin doesn't work all that well on Malassezia (pityrosporum) yeast, which is also common on peristomal skin...........for that either Fluconazole or Itraconazole would be recommended.  So BBB really needs to find out what the culprit is.  

;O)

I actually wondered this myself as I have sensitivities to the different adhesives and such, but the pediatrician looked at it yesterday and said the patterning looked more like yeast. But he is raw and it's clear into his groin at this point and it just breaks my heart! He's such a little trooper though.

Akron Children's grad 😁 We had an ostomy nurse who taught me how to change the bags and whatnot, but he was already starting to get raw while he was still in the hospital, and he was going through multiple bags per day because they wouldn't stick well. They just kind of thought it was because he was so small when I expressed concern, but it's getting worse, and my next appointment isn't for a few days. I can't stand seeing any baby, but especially my baby, like this :(

Yes,  you are correct.  I guess I should have said that the Pediatrician should swab to see what the organism is first.

Did they give you an ostomy nurse number to call? When you say his next appt is that with his pediatrician or does he have a GI Dr/other specialist overseeing the ostomy?

Any chance your son has already seen a dermatologist at Akron?

I had a pediatrician tell me one of my kids had ringworm for 6 months. Took him to a dermatologist at the same pediatric health system… eczema which is also linked to my child’s asthma which the general pediatrician should have connected. Don’t be afraid to push for answers that will help your baby ☺️

Do they have you using any tape on the sides of the flange/wafer? If so, what color is it? 

No, the next appointment is with surgery and ostomy. He has not seen dermatology. All the materials they gave me are made by Coloplast, and I keep reading that perhaps I should try Hollister products? I don't know. There is a tape; it's like frosted clear and rounded, so it traces right along his wafer line. I have had his bag off of him for 2 days now and have just been keeping him clean and covered with some jelly on the stoma so nothing sticks to it, and I will say that a lot of redness and such is going away and the raw spots are getting a gooey scab cover as it tries to heal. I took someone's advice and put a little bit of OTC yeast infection paste on the blotchy part, and it does seem to be clearing it up a bit. I'll probably try to give him another day of air and the cream and see how well he heals.

Do you have a number or way to message the ostomy nurse? 

When you say baby’s skin was irritated where the wafer was, is it redness everywhere the surface of it touched his skin? Not irritation from leaking?

Hollister may not be the best for skin sensitivities… my skin is really sensitive, I had to use to pink silicone tape that they use in the NICU.  I was the most allergic to Hollister out of the 7 brands I tried.

There is a blue silicone tape too I did ok with over time after I graduated from the pink 😀

Is the tape silicone?

I just wish we would all remember that we are all different and what is bad for one is perfect for another. Advice is great as long as it's the right advice. Please BBB, get all the supply companies to send you free of charge all their products to try, but see a dermatologist in the meantime. Poor little feller, I hope you get the right outcome soon. Regards, IGGIE