Daily Activities

Activities of daily living with a trach tube

How can my child eat and drink? 

• After recovering from the surgery, your child’s provider will tell you if/when it’s safe for your child to eat and/or drink. Some children with a tracheostomy can eat and drink by mouth. Others have conditions that mean they shouldn’t eat or drink by mouth. 
• Your child’s provider may schedule a test called a swallow study to see if food and liquid go into your child’s stomach or if they go into their lungs. 
• A speaking valve may help your child with swallowing. They may need to work with a speech and language pathologist to learn how to swallow with a trach. 

Can my child take a bath and swim? 

Children with a trach can’t fully go under water because water would enter directly into their airway through the trach. But most children can splash in water. Some children can swim without going under water. 

Talk to your child’s provider before swimming or splashing. 

Always stay with your child when they’re near water. Don’t let the ventilator (vent) or electric cords get wet. You may want to unplug the vent and use the battery when your child is near water. 

Make sure to monitor the battery charge. Be sure that water never enters their breathing circuit. 

• Bathing: Make sure the water line is well below your child’s waist and avoid too much splashing. Keep soap and water away from the trach tube and their stoma when washing. Consider using a non-slip bathmat in the tub. 
• Showering: Direct the shower spray to your child’s chest level, away from their face. Keep soap and water away from the trach tube and stoma when washing. 

How should I manage my child’s hair? 

• Hair washing: Your child should lay on their back in shallow water or held tipped back in the bath. Wash their hair by spraying or pouring water from a cup. Another method is to use a “shampoo shield” and lean your child forward over the bath or sink. 
• Haircut: Cover the trach tube and vent circuit with a bib. Use an HME with a bib over the trach if they’re not on a vent. 
• Hair styling: Protect the trach tube and vent circuit when using powder, hair spray or any personal care products around your child’s face and neck. You can use a heat moisture exchanger (HME) and a bib to help protect the trach tube. 

Can my child be active and go to school? 

Many children with a trach or trach and vent can go to school. Every school district is different, so your provider will help you decide when/if it’s safe for your child to go to school. 

Talk with your child’s provider about the best level of activity for them. Children with a trach can usually do most activities. 

• Keep all small toy parts or objects away from your child to keep them from being put into the trach tube. 
• We don’t recommend having your child play with dry sand. It may get into the trach. But playing with wet sand under close supervision is OK. Cover the tracheostomy with an HME to help protect the trach. 
• You may need to limit how much time your child spends outside in cold weather. You can also loosely drape a scarf (that doesn’t have a lot of loose fibers) around your child’s neck when they’re outside in cold weather. 

Can my child wear regular clothes? 

Avoid covering the tracheostomy with tight clothing. Avoid clothes that shed a lot of fibers since these could get into the trach tube. If your child is on a ventilator and doesn’t do well coming off it, you could use shirts that button or snap instead of going on over their head. 

What if we need to leave the house quickly? 

Practice packing what you need when you leave the house. A short walk is a good way to start traveling with a trach or tach and vent. Remember to bring your Go-bag wherever you go.

Can my child have pets? 

Long-haired pets and caged birds can cause problems because of the amount of fur/dander or feathers they shed. If possible, keep these pets in different areas of your home. 

What should I know about smoke and fumes? 

Remember that the tracheostomy provides a direct route to the lungs. Cigarette smoke or fumes from aerosol could irritate your child’s lungs. 

We highly recommend that nobody smokes in your home. 

Try to avoid spraying aerosols, like deodorant or furniture polish, in the same room as your child. Dust or dirt can also irritate your child’s trachea and lungs. 

How should I care for the skin around the stoma and neck? 

• The best way to avoid issues with skin breakdown is to perform daily trach care like you were shown at the hospital. 
• Keep a dry dressing under the tracheostomy flange to help prevent pressure-related skin injuries. If your child’s dressing gets saturated due to secretions, you may need to change the dressing more often. 
• Using trach ties that are wide enough to prevent rolling up into neck folds can help prevent skin problems. 
• If your child tends to be sweaty, you can use an antifungal powder. Place it directly onto the underside of the trach ties. That will help absorb excess moisture and avoid a yeast rash. It’s important to keep all powder away from the trach tube. 
• You can use a thin foam dressing under the ties to absorb moisture. 
• Moisturize the area with a non-scented cream or ointment if the skin under the ties gets dry. 
• If the skin is extra dry and peeling, it can be a sign of a yeast rash. A 1–2-week course of an antifungal cream usually improves the skin. Reach out to your child’s provider for a prescription if you need it. 

Where can I learn from other parents? 

Aaron’s tracheostomy page is a parent-to-parent resource: www.tracheostomy.com