Everyday tips

Bathing:

• Your child can take a bath or shower with his or her feeding tube or button, unless your healthcare team advises otherwise. Make sure the cover is securely in place.
• You can take advantage of the bath time to change the nasogastric tube; make sure the skin on the cheek is dry before reinserting the tube after the bath, if necessary.

Ostomy care:

• Clean the skin around the stoma with a small washcloth soaked in room temperature tap water and unscented mild soap (eg, “Dove”). Start on the inside (the area of skin closest to the stoma) and clean outward (the area of skin furthest from the stoma).
• Gently lift the button or the long tube external bolster and clean the ostomy site in the same manner.
• Observe the skin around the stoma; it should be clean, dry, and intact (same appearance as usual: similar to the color of the belly or slightly pinkish). Check for signs of infection (redness, tenderness, swelling, discharge different from the usual yellowish or brownish discharge, bad odour).
• It is normal for a small amount of yellowish or brownish discharge to come out of the stoma. They may become crusty as they dry. You can easily remove them with a cotton swab. Rinse and dry the skin well.
• If your child has had a stoma for less than 6-8 weeks (or other length of time, as recommended by your healthcare team), check with your healthcare team to see if cleaning the stoma site with saline solution is needed. Refer to your healthcare team for the recipe and storage of homemade saline solution, if recommended.
• As with all children, avoid bubble baths and scented oils.
• Do not apply cream or lotion to the skin around the stoma unless recommended by your healthcare team.
• If there is a small amount of milk or nutritional formula leakage, you can place a compress under the button or around the tube on the skin to absorb the leakage and protect the skin; change the compress as soon as it is wet to keep the skin clean and dry. You can purchase button pads, made for children, from many online retailers (eg, www.feedingtubeawareness.org/g-gj-tube-pads/). Discuss this with your healthcare team.

Mouth care:

• Even if your child is not eating, your child’s mouth should be cleaned at least twice a day.
• If your child has no teeth, use a small face cloth or a compress dampened with water and rolled around your index finger, to gently rub your child’s gums and tongue.
• Once teeth start to appear, brush your child’s teeth after each meal and at bedtime. Since young children have a tendency to swallow toothpaste instead of spitting it out, use only the size of a small grain of rice in children under 2 years old and the size of a small pea in children up to 6 years old. Use this time to also gently massage their gums with the toothbrush.
• As your child matures, teach and supervise brushing of the teeth.
• Apply, if required, a hydrating lip balm.

Nasal hygiene:

• In all children, secretions, along with bacteria and viruses collect in the nose. Keeping your child’s nose clean helps prevent lung infections.
• If your child cannot blow his/her nose effectively, refer to your healthcare team for the appropriate technique for nasal hygiene with a saline solution that will allow your child to clear his/her nose properly (recipe and storage of the “homemade” saline solution, quantity to use, how to proceed according to your child’s age, etc.). To this end, you can refer to the brochure published by the Centre hospitalier universitaire Ste-Justine that explains the technique of nasal hygiene: Nasal hygiene.

Swimming:

• Immediately following tube placement, your child can bathe according to the recommendations of the healthcare team.
• Unplug your child from the feeding system and remove the extension set, if in place, before swimming.
• Make sure the tube is securely fastened so that it will not get snagged or ripped off while swimming.
• Make sure the cover on the nasal tube, button feeding port or enterostomy long tube ports is securely closed.
• Consult your healthcare team for recommendations specific to your child.