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Diaper Change: Tips for Diapering Your Baby

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By Anthony Mancini M.D.


Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.



Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.



Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.

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Diapering your baby is as much a part of parenting as feeding, even though it can sometimes seem like a never-ending chore. With a good knowledge of the diapering basics, you'll be able to keep your baby dry and comfortable with no problem at all.

Here's what you'll find in this section:

  The Bare Facts

  Dodging Diaper Rash

  The Urination Drill

  BM Basics



The Bare Facts


Diaper changing is more about common sense than anything else. Your objective should be to keep your baby as dry and comfortable as possible. Before you start, assemble everything you need:

  • A clean diaper
  • Diaper rash ointment or petroleum jelly
  • A soft washcloth and small basin of warm water or a diaper wipe

     

    Remembernever leave your baby unattended on the changing table. Even newborns can roll off and hurt themselves.

    First, remove the soiled diaper. If it's only wet, it's best to rediaper immediately without cleansing or gently wipe your baby clean with a wipe or warm washcloth before diapering. For tips on caring for your baby's umbilical cord stump, click here.

    If your baby has had a BM, wipe her bottom clean with a wipe or warm washcloth and gently pat her dry. Remember to always wipe from front to back, which will help prevent the introduction of bacteria into the urinary tract. There is no need to use soap unless she has a bowel movement that won't come clean with just water. Use only mild soap when necessary; all soaps strip your baby's skin of important natural oils.

    Next, apply diaper ointment or petroleum jelly and put on a fresh diaper. Avoid baby powder — it doesn't help prevent or treat diaper rash and may be harmful if your baby inhales it.

    As your baby gets older, she's likely to fidget a lot more during these delicate diaper changes. You may wish to keep some toys near your changing area to distract her with.

    Diapering Tips for Girls

      • A small amount of blood or discharge is normal in the first few days after birth. Your daughter is simply adjusting to hormonal changes following birth.
     

     

    Diapering Tips for Boys

      • If your son is uncircumcised, don't try to pull the foreskin down to clean. It will loosen by itself in time, and is usually fully retractable by the time he is three.
     
      • Seasoned moms suggest covering your baby boy's penis with a diaper or burp cloth while changing him...to prevent getting a surprise shower yourself!
     

     

    Dodging Diaper Rash


    Babies at risk for diaper rash are babies who wear diapers — in other words, all babies! If you see red, swollen bumps around the diaper area, your baby probably has one of many different types of diaper rash.

    What causes diaper rash? Several factors:



      • Wetness against baby's skin
     
      • Intestinal enzymes in the baby's stool
     
      • Ammonia created when stools and urine combine
     
      • Stiff diapers or irritation caused by excessive cleansing of the diaper area.
     

    Fortunately, there are many ways to prevent diaper rash. Here are the most common:


      • Change diapers frequently.
     
      • Use a super-absorbent disposable diaper.
     
      • Spread a thin layer of zinc oxide cream or petroleum jelly over your baby's bottom as extra protection against wetness. There are diapers available containing diaper-rash-fighting ingredients. Let your baby go without her diaper for a while each day. The air helps promote dryness, and she will love her momentary freedom.
     

     

    When to Change?

    As a parent, you're in the best position to know when your baby needs to be changed. In general, you can expect to change your newborn as many as 10 times in each 24-hour period. It sounds like a lot, but keep in mind that a lot of wet diapers means your baby is getting enough nutrition and is processing it normally. If you choose to use cloth diapers, be sure to change your baby even more frequently, as these don't have the absorbency of disposables.

    As your baby grows, you'll need to change her less often, although still at the usual times: when she gets up in the morning, before or after a feeding, after her naps, and before bedtime. Remember, though, that keeping a dry diaper on your baby will help prevent diaper rash.

    The Urination Drill


    Babies don't follow any urination schedule. Newborns have immature bladder muscles that can't hold urine for any length of time. They can wet their diapers anywhere from once an hour to four times a day and still be within normal range. This goes for older babies as well. In general, however, you can expect to change approximately six wet diapers a day (four to six disposable diapers or six to eight cloth diapers).

    For the first few days after birth, your baby's urine will be very pale, gradually turning a deeper shade of yellow as it becomes more concentrated. You may find a pinkish stain on your baby's diaper as well. This is probably concentrated urine, and as long as your baby is wetting four or more diapers a day, it's nothing to worry about. If this staining persists for a few days, however, or if you spot true blood in the urine or stool, call your health care provider promptly.

    BM Basics


    Your baby's first bowel movement will be a thick, dark-green or black substance known as meconium, which filled her intestines before birth. Once your baby expels this matter, normal digestion will begin, and her stools will get softer and lighter in color.

    The consistency and color of your baby's BMs reflect the menu. Breast-fed babies will have soft, almost runny BMs that look like seedy mustard. Formula-fed babies will have firmer stools that are tan or yellow. Older babies will pass stools that take on the color and consistency of what they most recently ate.

    How often to expect a BM varies with the baby. Some babies have one after every feeding. Others, particularly breast-fed babies, have just one a week. Contact your health care provider if your baby has hard or very dry stools, if she seems to be in pain during bowel movements, or if you notice large amounts of blood, mucus, or water in the stools.

    Because a newborn's stools are usually somewhat runny, it's hard to tell if she has diarrhea. Since you're the person most familiar with her BM patterns, look to see if there's a sudden increase in the frequency of BMs, or whether they're unusually runny or in any way different from normal.

     

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Member comments

Princesslilliah, my daughter is just over a week old and she too poops all the time! sometimes small..

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