This topic is about managing frequent appliance leaks for an 8-year-old girl with an ileostomy, especially after she has experienced a growth spurt. The parent has noticed that the appliances, which used to last 2-3 days, now only last 8-24 hours. Despite no changes in activity, diet, or appliance type, the family is struggling with this issue and is seeking advice to extend the wear-time of the appliances.

Here are some helpful suggestions:

- Re-assess the size and fit of the appliance after a growth spurt.
- Consider a larger flange or pouch size, as the child's growing abdomen and stoma may have outgrown the current size.
- Use the backing paper from each new wafer to trace and adjust the hole size, as even a small difference of 1-2 mm can be significant.

- Consult with an experienced ostomy nurse, either in person or through photographs.
- A nurse can measure the stoma, identify leakage pathways, and recommend products specifically for children.
- If the first consultation doesn't help, don't hesitate to seek advice from another nurse.

- Explore different products and brands.
- Request free samples from companies like Coloplast, ConvaTec, and Hollister to try different combinations.
- Consider moldable barriers that fit snugly around the stoma without needing to be cut.
- Evaluate whether convex or flat wafers are more suitable, as body contours change with growth.

- Improve the seal around the stoma.
- Use a barrier ring or snug "donut" under the wafer for a tighter fit.
- Reinforce the edges with tape or flange extenders, such as Brava XL Tape Extenders by Coloplast.
- Other manufacturers also offer barrier strips and extenders.

- Strengthen overall adhesion.
- Ensure the skin is completely clean and dry; use a hair-dryer on low or wait longer after showers.
- Apply gentle heat to mold rings and wafers, using hand warmth, a hair-dryer, or an empty tape spool.
- In hot weather, a roll-on deodorant around (but not under) the stoma opening can help.
- Ostomy belts or wraps can keep the appliance pressed firmly against the abdomen and reduce edge lift.

- Follow a routine/application checklist shared by others:
1. Use an adhesive remover wipe to take off the old wafer.
2. Wash the skin and rinse well.
3. Optionally, use a skin-prep wipe and allow it to dry fully.
4. Place a barrier ring for a snug fit.
5. Apply the flange/wafer and secure it with warmth.
6. Attach the pouch and add tape extenders and a belt.

- Monitor external factors.
- Pull-ups and warmer weather may trap moisture, so consider breathable covers or more frequent checks for skin dampness.
- Be aware of new skin sensitivities; some find Coloplast wafers soothing due to their zinc content.

- General encouragement.
- Frequent appliance failures in children are common during growth phases. Persistence, trying different products, and seeking professional guidance usually lead to a workable solution.