Diaper Changing tips

Mama Jennifer was dealing with a baby who was doing a lot of fussing during diaper changes. I LOVE that she searched my blog to see if there was a post that dealt with that. This was not, in fact a subject I had even considered covering in the past. I am always happy to to get topic suggestions and the more I gave it some thought, the more there was to write about. Thanks to Jennifer for the topic suggestion and to the contributors who shared their wisdom on the subject. There is so much new stuff to get used to when you have a new baby. One of the first things to get comfortable with is that you are going to come in intimate contact with an array of bodily fluids (that are not yours) and you will learn not to think twice about it. In my baby boot camp I sometimes tell one of my favorite pee stories. Prior to moving out to San Francisco, my husband and I spent a few years in New York City. Anyone who has experience with hot sticky summers (the reason I can’t ever leave my city by the bay) knows how miserable that weather can be. Our upstairs neighbors had a fairly new baby. This was August and it was sweltering. The little baby boy was in his infant seat, completely naked, getting a little air. The exhausted couple needed to go shopping, but that evening they were making the very last bit of food that they had on hand (Grub Hub was but a future dream.) The pasta was being strained when the baby peed an arcing stream of urine that went several feet across the room and landed directly into the colander of spaghetti. The parents looked at each out in shock and awe, and then said at the same time, “rinse and eat?” which they proceeded to do. The next morning when they told us what happened, we laughed, gave a big yuck, and told them they were nuts; they should have called us, we would have gone out and gotten them food. Here is the thing. We didn’t have kids yet. Every one of their friends who were parents, went over to the “rinse and eat” team immediately. Most of you will get there. Of course, the goal of diaper changing is to keep the pee and poop safely contained and disposed of without getting it all over the place. It has been thirty years, but I still recall the Poopageddon event of Sandy’s first attempt at changing Lauren. In a rookie move, he opened the diaper and didn’t take the step of carefully folding the front over to cover and contain the poop before starting the cleanup. With the soiled diaper open, Lauren managed to get her kicking feet right in there. Her feet, now smeared like a nasty paintbrush, managed to get poop on the walls and just about everywhere else. That was the night of her very first bath in the big tub. Sandy ultimately became much better at the mechanics of diaper changing and swaddling than I ever was. When babies are young, most parents manage to get pretty adept at changing the diapers without too much ado because even though they may fuss, the babies don’t have the motor skills to do anything but put up with it. If your baby really seems to hate it, see if you can make some adjustments. Make sure the room is warm and that the wipes are not freezing cold. There are wipe warmers available on Amazon that are not terribly expensive. Please make sure that the wipes are free of unnecessary ingredients such as scents or alcohol that might cause stinging. Make sure you have everything within reach and ready to use before you start the process (don’t forget the box of tissues for blotting the area dry after using the wipes.) Nurse Heather's tip is to put the clean diaper down first. When all the wiping up is done, you just slide the old one out. Have a washcloth or something right at the ready to protect yourself from getting peed on. Babies love to pee within a moment or two of when the diaper comes off. See if you can put the changing area on a bit of a slant, This might help for those babies who just hate to be completely flat. Dr Schwanke reminded me that there are some changing pads that have an indentation that makes it harder to wriggle around but make the babies feel secure and comfortable. PooPoose-Wiggle-Diaper-Changing-Table Preventing diaper rash is so important: http://nursejudynvp.blogspot.com/2013/08/basic-butt-care-diaper-rash.html Once diaper changes become uncomfortable it is tough to remove the “negative association” associated with the diaper change. My friend Sari, a Cranial Sacral therapist in Arizona, says that parents should consider slowing down the pace dramatically. Our instinct is to hurry up and get it over with, but many babies actually react better to a slow and quiet pace. While you are at it, she loves the upside-down U movement. Gently stroke from the top of the right hip, up to the ribs, across the ribs and down to the left hip. Lift up and start again at the right hip and repeat. This stimulates the direction of the colon and is often relaxing to babies. Have some interesting things nearby for them to look at. Mobiles, and other toys or rattles are good options. Make sure that anything in the changing area is completely washable. And then the babies start to roll... Of course try everything you can to distract them, sing a song and let them hold a toy. How you handle this will have an impact on future diaper changes. You need to be the alpha here. It is okay to be firm and get down to business; the wet or dirty diaper needs to be changed. Your baby won’t be psychologically scarred if they aren’t getting their way. Sometimes if you are firm and matter of fact, they will stop struggling when they realize that fighting and squirming doesn’t get them very far. Then they start to crawl and pulling themselves up on things. I have vivid memories of chasing little naked butts across the room and learning how to do a diaper with them in a standing position, but is there a better way? Once they are crawling they can start playing games. Perhaps play a game where everyone does a silly dance and when you say “stay still” everyone freezes. Count to a number (your choice, high or low, slowly or quickly) and people can move again. If they learn the ‘stay still game’... just maybe you can play it when you are changing diapers. Counting to ten, if you do it slowly enough, should be enough time to do a quick change. Not that I am equating your little one to a dog, but the stay still command is one that might have other future uses. Nurse Lainey makes an excellent point. Teaching your child to cooperate during a diaper change becomes even more important when you are away from home. Having a child lay still rather than touching nasty surfaces on a rickety changing table in a public bathroom drastically reduces the risk of injury and cooties. NEVER EVER leave the baby on the changing table to step away even for a moment, even if they are strapped in. Make sure you wash your hands AND the baby's hands after each change. Since one of the goals of these posts is to address questions that we get frequent calls about, it is worth mentioning the following: When the diaper is off, it is completely natural for babies to explore the areas of their body that they don’t usually have access to. Make sure that nails are trimmed so that they don’t scratch themselves. If there are any signs of rash or infection, there may be some irritation that is worth the doctor seeing. If their hands are getting in the way of the changing, give them something interesting to hold on to (although, nothing is really quite as interesting as genitalia, but do the best you can.) There are times in the office when the advice nurse team doesn’t have the time to have long chats with parents about issues such as diaper changes. We often refer non medical questions to the folks over at the Parentline. This is a valuable, and currently free, service. I reached out to the very wise Dhara Meghani for her feedback about this topic and she had some worthwhile things to add. Developmentally, for babies 9-15 months or so who are getting to be quite mobile, adding a mirror against the wall where the changing table is can help distract them. They may want to touch/poke the “baby in the mirror,” not recognizing that it’s themselves until about 15 months or so, which can be a fun game to further engage them with something else while you’re changing them. You can ask them to point to baby’s nose, eyes, etc. A similar ‘game’ can be done with other pictures or art on the wall. Some parents may also feel less anxious about potential injuries or falls if they have an especially active baby at this stage by moving the changing area lower or to the floor, as long as this is comfortable for the caregiver. You can still store the changing supplies at a higher level or in a childproof container. Slightly older toddlers thrive on predictability and feel proud when they can help or do something themselves. In this case, letting them know what’s coming up (‘e.g., it’s going to be diaper changing time after we finish coloring’) or walking them through what you are doing during the change can help them get that ‘this is the drill’ and that it’s easier to go and play again when they help by being very still and patient. I also like to remind parents that it’s essential to “catch your child being good” - toddlers especially love being praised even for things that we expect them to do. So with a diaper change, I’d let your little one know it right away when she did a great job laying down, not wriggling around, staying still, handing you the diaper, etc. (it’s important to be specific in your praise so that they are reinforced to do it again!). Thanks to all the readers who shared their tips. Susan says "diaper changes have been among Milo's least favorite things for about a year now, so I'm really looking forward to what you hear from other parents and what you advise as well! That said, I finally struck upon something in the last few months - from when he was about 14 months, or so: enlisting his help. I have him help unfold the diaper, place the fresh diaper where it needs to go, help by remembering/showing me how the fresh diaper goes under his bottom (I like to have the fresh one in place under the dirty one before I open that one up). For Milo, the objections I believe are mostly to do with his strong desire for autonomy and for figuring out how things work and participating in them. I'm actually looking forward to potty training because I think he'll be really into being able to take care of something that's so fundamental and frequently occurring himself." Rachel S. says "When my guy is squirmy and being changed, we sometimes pick a toy or stuffed animal to hold before going on the changing table, or we start a song to sing, or count in either Spanish or English. Sometimes I talk with him and tell him we do it all the time and it’s quick, and if he’s still (sometimes I use the word cooperative) then it goes faster." Amanda and Randall - "Best idea we have for diaper squirm - Randall put a collection of books on the shelf next to the changing table so we do a book rotation. I can't believe it works, but it does. She looks at the pictures and each one buys me about 45 seconds which is sufficient if I move quickly. Plan B - we sing ABCs, but far less effective. Dad's book plan is a better one."