Diaper changing

To parents of young babies, life often seems to be an endless round of changing diapers. Indeed, the average child goes through 5,000 diaper changes before being toilet trained. That statistic is daunting, but it may help to think of this necessary task as an opportunity for closeness and communication with your baby. Your warm words, gentle touches and encouraging smiles help make your baby feel loved and secure, and soon your infant will be responding with gurgles and coos.

Because newborns urinate up to 20 times a day, it's important to change your baby's diapers every two or three hours for the first few months. But you can wait until your baby wakes up to change a wet diaper. Urine alone doesn't usually irritate a baby's skin. However, the acid content in a bowel movement can, so change a messy diaper soon after your baby awakens.

Get equipped

Make diaper changing more comfortable for you and your baby by being prepared with the basics:

• Diapers. Be sure to stock an adequate supply of diapers. You can buy cloth or disposable diapers, or you can use a diaper service, most of which offer a choice of cloth or disposable. You'll need 80 to 100 disposable or cloth diapers a week. If you plan to use disposable diapers, be sure to get the size corresponding to your baby's weight.

If you plan to buy cloth diapers, the number you'll need depends on how often you plan to wash them. For example, if you have three dozen diapers, you'll probably need to wash them every other day. Even if you plan to use disposable diapers, you'll find it helpful to have a dozen cloth diapers on hand in case you run out of disposables. Cloth diapers are also handy to drape over your shoulder or to put on your lap while burping your baby.

• Plastic pants, if you're using cloth diapers.

• Absorbent diaper liners, if you're using cloth diapers.

• Pre-moistened baby wipes. Although a moistened cloth also works, it's hard to beat the convenience of pre-moistened baby wipes.

• A diaper pail. Various types of diaper pails are available. Look for a pail that is convenient, sanitary and holds in odors.

• Baby lotion. It's not necessary to use lotion at every diaper change, but it may come in handy if your baby develops diaper rash.

• A baby wipes warmer. Baby wipes warmers do just that — warm up the wipes to a temperature that's more comfortable for your baby.

• A changing table. Choose a table with a wide, sturdy base that has compartments for storing diaper-changing supplies. Putting the changing table near a wall reduces the chance of a fall.

How to change a diaper

When changing a diaper, use a flat surface — a changing table, a changing pad on the floor, or a crib. If you're using a changing table, be sure to use the safety belt or keep one hand on your baby at all times.

Your baby may urinate when you're changing the diaper. If your baby is a boy, you can avoid being sprayed by covering his penis loosely with a diaper or cloth while cleaning the rest of the diaper area.

Cleanup

After you've removed the soiled diaper, take time to thoroughly clean your baby's bottom:

• Hold the baby's legs at the ankles with one hand during the cleaning.

• Use either a cotton cloth dampened with warm water or a pre-mois-tened baby wipe to wipe your baby's diaper area. Use alcohol-free and fragrance-free wipes to avoid drying or irritating the baby's skin.

• When your baby has a bowel movement, use the unsoiled front of the diaper to remove the bulk of the stool.

• Wipe down and away from the genitals, folding the waste inside the diaper.

• Gently finish cleaning with a cloth or wipe, using a mild soap as needed. You needn't apply lotion, unless your baby tends to develop rashes.

• Lift your baby's lower body by the ankles and slide the new diaper underneath.

Disposable diapers

When changing a disposable diaper, lift the baby's legs and slide the diaper underneath with the tabs under the back. Bring the front of the diaper up through the legs, centering it on your baby. Fit the diaper snugly around your baby's waist and fasten the tabs on either side. For newborns, fold the top of the diaper down so that it doesn't rub against the umbilical cord.

Cloth diapers

If you use cloth diapers, you can fold them several ways. Experiment with different techniques for best absorbency and fit. Fold the side edges in, making shallow folds for a larger baby and deeper folds for a smaller baby. For boys, you may want to create extra padding in the front. Some people find that folding the front narrower than the back allows diaper pins to sit flatter on the stomach and brings the diaper around the legs more tightly.

If you're using diaper pins, you can avoid accidentally poking the baby by keeping the fingers of one hand between the diaper pin and your baby's body until the point of the pin is securely locked in the pin's hood. Cloth diapers should fit snugly because they tend to loosen as your baby moves around. Tuck the edges of the cloth into plastic pants to keep wetness inside.

Diaper rash

All babies get a red or sore bottom from time to time, even with frequent diaper changes and careful cleaning. Diaper rash may be caused by many things, including irritation from stools or from a new product, such as disposable wipes, diapers or laundry detergent. Sensitive skin, a bacterial or yeast infection, and chafing or rubbing from tightfitting diapers or clothing also can cause a rash.

Diaper rash is usually easily treated and usually improves within several days. The most important factor in treating diaper rash is to keep your baby's skin as clean and dry as possible. Thoroughly wash the area with water during each diaper change. While your baby has a diaper rash, avoid washing the affected area with soaps and disposable, scented wipes. Alcohol and perfumes in these products can irritate your baby's skin and aggravate or prolong the rash.

Allow the baby's bottom to air-dry before replacing the diaper, and do what you can to increase airflow to the diaper region:

• Let your child go without a diaper for short periods of time.

• Avoid using plastic pants or tightfitting diaper covers.

• Use larger-sized diapers until the rash goes away.

Use a soothing ointment such as Desitin, Balmex, or A and D any time pinkness appears in the diaper area. Many diaper rash creams and ointments contain the active ingredient zinc oxide. These products typically are applied in a thin layer to the irritated region several times throughout the day to soothe and protect the baby's skin.

Do not use talcum powder or cornstarch on a baby's skin. An infant may inhale talcum powder, which can be very irritating to a baby's lungs. Cornstarch can contribute to a bacterial infection.

To help prevent diaper rash, avoid using superabsorbent disposable diapers, because they tend to be changed less frequently. If you're using cloth diapers, be sure to wash and rinse them thoroughly, and select snap-on plastic pants, instead of those with elastic bindings, for better air circulation. In addition, try using absorbent liners with cloth diapers.

Check with your baby's health care provider if:

• The diaper rash doesn't improve in a few days.

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