Step-by-step guide to diapering your baby

Alison Gilmour has changed a diaper or two in her lifetime. As a mother of four and the Nursing Unit Administrator in the Women and Infants Ambulatory Health Program at Mout Sinai Hospital in Toronto, she’s compiled step-by-step instructions for Best Wishes on how to get the job done right. It may take some practice, but here’s what you need to know:

You may need to change your baby’s diaper 10 to 15 times a day. If your
baby is sleeping, you can
wait until he/she wakes up to
change the diaper.

1. Wash your hands before
   and after each change. 
2. Have all necessary items
   close at hand, such as clean
   diapers, wet washcloths or
   wipes and clean clothes.
3. Put your baby on a flat,
   soft surface, such as a change
   table or on the floor.
4. Keep one hand on your
   baby at all times.
5. Watch out for a bowel
   movement squishing up your
   baby’s back as you lay him/
   her down.
6. After removing the diaper,
   wipe the diaper area with a
   warm wet washcloth or baby
   wipes (non-scented).
7. Pat the area dry or allow to
   air dry.
8. While the baby is passing
   meconium for the first few
   days, you may find it helpful to
   use a thin layer of petroleum
   jelly at each diaper change.
   This will make it easier to
   remove the meconium from
   the skin.
9. Do not use powder or
   cornstarch. A puff of powder
   near the baby’s face can cause
   choking or difficulty breathing.
10. When using disposable
    diapers, ensure that the elastic
    edges surround the baby’s leg
    and are not lying flat against
    the diaper. You can do this
    by running your finger along
    the inside of the diaper along
    your baby’s thigh and pulling
    the elastic out to fit snug
    against the skin.
11. Until the umbilical cord
    falls off, keep the diaper
    below the umbilical area by
    folding the diaper down if
    need be. Some newborn diapers
    have a special cut out for
    this purpose.

To clean a girl

• Wipe from the front to
  back to prevent germs from
  her bowel movement from
  getting into the urinary tract.
• Clean between the outer
  folds of the labia.
• There is no need to clean
  inside the vagina.

To clean a boy

• Wash the area well and
  clean from front to back.
• Do not pull the foreskin
  back when cleaning the
  penis.

Dealing with diaper rash

Diaper rash begins as red,
inflamed skin and can lead
to raw, open areas of skin.
Rashes can be caused by:

• irritation from the dampness
  of urine or a bowel
  movement on the skin. 
• reaction to soap, perfumes
  or oils.
• a yeast infection that can
  be spread from the mother
  or from stool.

Steps to avoid diaper rash

• Wash your hands before
  and after changing a diaper.
• Keep skin dry by changing
  the diaper as soon as it gets
  wet or soiled.
• Allow the area to air dry
  for a short time before putting
  on the clean diaper.
• Avoid using soap. Wash
  the diaper area with warm
  water and dry well.
• Apply a thin layer of
  petroleum jelly or zinc-based
  cream.
• Avoid perfumed wipes and
  using airtight plastic pants
  over the diaper.
• Before placing the baby
  in the bath, clean the diaper
  area when removing the
  diaper. Then, when bathing
  the baby, wash the diaper
  area again as the last step.

Call your health-care provider
if your baby has not had a
dirty diaper in two days or
if your baby is not having
at least three wet diapers a
day.

Alison Gilmour RN, BScN, MN, PNC (C) NUA, Women and Infants Ambulatory Health Program, Mount Sinai Hospital

Originally published in ParentsCanada: Best Wishes, Spring 2012.