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If you've never changed a diaper, the whole process may seem somewhat intimidating at first. However, by following these simple steps, you too can be a master diaper changer within minutes. (Please note: The following instructions are for changing a disposable, rather than cloth, diaper.)
Keep in mind that there are different sized diapers for different sized babies, ranging from Newborn up through Size 5 or 6, depending on the brand. Each size is based on the child's weight in pounds, but a certain amount of leeway is needed within each size. At the top end of the weight range for each size, your child may be too large for the recommended size. If in doubt as to which size to buy, choose the larger size. You can always adjust the waistband fasteners a little tighter, whereas with the smaller size, you not only risk the child being uncomfortable, but you also increase the likelihood of leaks, meaning more work for you.
Begin by laying the child down, face up, on a flat, sturdy surface. If a changing table is available, be sure to strap the child down to avoid the chance that he or she may roll off the sides. If a changing table is not available, a sturdy table, couch, or even the floor will work satisfactorily. Just be sure never to leave the child unattended, and don't step away or turn your eyes for even a moment. If you must reach to retrieve an item or dispose of the used diaper, keep a hand on the child at all times. Even young infants have been known to demonstrate the ability to roll over for the very first time just when their caregivers are least expecting it, so it's better to be proactive in preventing an accident than reactive in trying to catch a falling child or minister to an injured child. A slightly cushioned changing pad or even a cloth or paper towel will ensure that the child's bottom only comes into contact with a sanitary surface and will protect the furniture or floor covering if the diaper contents leak.
During the entire diaper changing process, keep an upbeat attitude, and engage the child in a happy interaction. Whether you are singing a nursery rhyme to a newborn or telling a story to a toddler, children of all ages will be more cooperative (and less likely to get themselves into trouble) if they are enjoying a happy rapport and communication with you. In the case of older babies and toddlers, this is particularly important, as they often feel there are many more important activities in which they could be participating. Asking questions, such as "Where's your belly button?" or "Where's Susie's nose?" just might keep them distracted long enough to make your job that much easier.
Do be sure to have all the necessary supplies on hand before you even begin the changing process: a clean diaper (or two), diaper wipes (or sanitary cloths, if wipes are not available), and diaper rash ointment, if applicable.
Begin by unfastening the legs or pants of the child's clothing, removing any necessary articles as you go. For example, if you must remove a child's pants because they don't have snaps, you will likely need to remove the shoes and perhaps even the socks. Then pull any remaining clothing up high enough in both front and back so that they will not be soiled when you remove the diaper.
Unfasten the tapes or fasteners on the waistband of the diaper, and pull the front down. If the child has only urinated, wipe the child's bottom using a diaper wipe, taking care to wipe gently but thoroughly. On girls especially, it is particularly important to wipe from front to back in order to prevent the spread of infection-causing bacteria. And be sure to clean within every fold and crease. With a very young baby, particularly a boy, be sure to watch for sudden urination when the child's diaper is removed. Keeping the old diaper underneath (and covering the genitalia when you reach for the new diaper) as long as possible will help prevent unnecessary messes.
If the child has had a bowel movement, you may want to use the front and relatively unsoiled portion of the old diaper to wipe away as much solid matter as possible. Then use one or more wipes to carefully wipe the remaining bowel movement away, again following the rules for wiping from front to back. Keep in mind that anything that you miss will likely cause a painful diaper rash for the child.
If the child has already exhibited signs of diaper rash (such as redness, blistering, or bleeding in the diaper area), apply a generous amount of diaper rash ointment, always being sure to follow carefully both the manufacturer's directions and the instructions of your pediatrician or doctor. If you are at all in doubt as to whether the child has a diaper rash or some other medical problem, call your pediatrician or doctor at once; do not attempt to diagnose symptoms with which you are unfamiliar. Pediatricians are accustomed to receiving calls from inexperienced new parents and should be more than accomodating in answering your questions.
After wiping the child's bottom, remove the old diaper, and place the unfolded, new diaper underneath the bottom. Keep in mind that the patterned side is the front and the waist fasteners are on the back. Gently pull the front of the diaper through the child's legs, bring it up to meet the level of the back of the diaper, and secure the tapes or fasteners at the waist. Be sure to fasten the diaper snugly enough that it won't fall down, but not so tight that the child is uncomfortable. Check that the elastic on the legs is not bunched up or tucked into the diaper, and then you can put the child's clothes back on.
Place the used wipes inside the old diaper, roll it up, and secure the ends with the waist fasteners. The used diaper may be disposed of in a diaper pail or garbage can, after which you should thoroughly wash your hands with soap and water. (Be sure to leave the child in a safe place while you are doing this, perhaps in a crib or playard, not on the changing table.)
In general, you will want to change a child's diaper every few hours, depending on age, or more frequently if you notice that the diaper is soiled or particularly wet, or if the child has diaper rash. A newborn typically goes through 8 to 12 diapers a day (usually at least one per feeding), while a toddler may only need 4 or 5 diapers a day. It's best to put on a fresh diaper just before an outing, naptime, or bedtime, which will ensure greater comfort for the child and a decreased likelihood that you will have to change a diaper at an inconvenient or undesirable time.
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