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Most children are not potty trained until 2 or 3 years old.

Until then, they use about 6 to 10 diapers a day, which adds up to 2,000 to 3,000 diapers a year. These tips below can help each diaper change go more smoothly for you.

Types of Diapers

Cloth and disposable diapers both have distinct advantages and disadvantages. One is not better than other. Each family should decide what works best for them — some families use both kinds of diapers. The chart below displays some pros and cons of cloth vs. disposable diapers.

Cloth Diapers

Pros

  • Reusable
  • Less expensive than disposable
  • Can use a delivery service
  • May help heal diaper rash because cloth allows baby's skin to breathe
  • Available in different textures and absorbencies
  • Gentle on baby's sensitive skin

Cons

  • Time consuming to wash
  • Not easy to use when traveling
  • Cleaning cloth diapers uses energy, water and detergent
  • May leak more often, requiring pants or a diaper cover

Disposable Diapers

Pros

  • Easy to use, discard after one use
  • Convenient for traveling
  • Absorbent material draws moisture from baby's skin, which may prevent diaper rash

Cons

  • More expensive
  • Less environmentally friendly; non-biodegradable material goes to landfills
  • Increased risk for diaper rash since most parents don't change diaper until it is soaked

Steps for diapering your baby

Changing your baby's diaper can be difficult the first few times. Many new parents are uncertain how to hold their squirming baby or how to position the diaper at first. However, it doesn't take long for most parents to feel experienced and confident.

Basic steps to change a diaper:

  • Use a pad or changing table at waist height. This minimizes back strain.

  • Assemble all diapers, wipes, diaper cream and other items within reach. Never leave your baby unattended.   

  • Use a disposable or washable mat to lay the baby down on.
  • Open a clean diaper and set it within easy reach.
  • Unfasten the pins or tabs of the dirty diaper. With one hand hold your baby's legs and with your other hand pull the front of the diaper down.
  • When wiping, never wipe from back to front since it could lead to a urinary tract infection. If there is a bowel movement in the diaper, use the front of the diaper to wipe the stool toward the back of the diaper.
  • Once the dirty diaper is pressed flat under your baby's bottom, use a damp washcloth or wipe to cleanse your baby's diaper area. Make sure to cleanse from front to back.
  • Lift your baby's legs with one hand, and slide the dirty diaper out with your other hand, and set it away from your baby.
  • Set the back of a clean diaper under the baby and pull the front up between your baby's legs.
  • Pin the diaper corners snugly or secure the adhesive tabs at your baby's waist. You should be able to fit at least 2 fingers between your baby's belly and the diaper. If using safety pins, direct the pin toward the sides and away from your baby's belly. To make sure you don't poke your baby by mistake, put one hand under the diaper when pinning. Some cloth diapers have Velcro, so you won't need safety pins.
  • Keep a container near the changing table and dispose the dirty diaper there. A container with a foot pedal operated lid is most convenient. (If possible, dump solid bowel movements in the toilet before disposing the diaper. This reduces odor and keeps the environment fresh.)

If this sounds technical, don't worry. It will become second nature after you have done it a few times.

Some extra tips to make the process smoother:

  • Cover a baby boy's penis with a spare cloth during the diaper change. Otherwise, a stream of urine can make a mess on the changing table,  floor, or even on you or your baby.

  • To prevent your baby from accidentally kicking his feet into a dirty diaper, hold your baby's legs carefully.

  • If the diaper has leaked, you may need to also change your baby's clothes. Or a bath may be necessary if some of the bowel movement has soiled your baby's back or legs.
  • Some babies squirm during diaper changes. Try distracting your baby by singing or chatting with him or her. For an older baby, offer a special toy that is only used at diaper time.
  • If your baby's diaper suddenly starts leaking, try a different brand. Diaper sizes and shapes differ depending on the brand, and a new fit may produce better results.

When to Call your Baby's Doctor

Call your healthcare provider for any rash that is worrisome. This includes when:

  • The rash lasts, without improvement, for 3 days or more
  • The rash has sores or blisters, larger than 1 inch across
  • The rash turns bright red, solid, raw, or bleeds
  • Blisters, boils, pimples, sores or crusts appear
  • Your child's sleep is affected
  • The rash grows beyond the diaper area
  • Your child's mood changes, including fussiness and irritability
  • Your child develops a fever

Diaper Rash Treatment

Most babies will get a diaper rash at some point, whether they wear cloth or disposable diapers. Causes include rubbing from the diaper and skin contact with bacteria, ammonia and moisture. It is easier to prevent rashes than to cure them. Treat your baby's rash by doing the following:

  • Change diapers frequently.
    The key is to keep the diaper area clean and dry. Check your baby's diapers often and change them as needed. Check your baby's diapers every hour if your baby has a rash.
  • Gently clean baby's skin.
    Washing with soap in a constant and abrasive manner can strip your baby's delicate skin of its natural protective barrier. Wash thoroughly but gently, including the skin folds. Diaper wipes can irritate or burn your baby's skin if he or she has a rash. Instead, you can place your baby in a basin or tub of lukewarm water for several minutes during each diaper change. This both comforts and cleans your baby's diaper area. Or you may pour warm water from a pitcher or use a squirt bottle to cleanse. Don't use soap for each diaper change. If there is stool that is hard to remove, then a mild soap is OK. Wash carefully and rinse well. To be extra gentle, you may use baby oil on a cotton ball to cleanse.
  • Pat dry or let air dry.
    Pat your baby's skin dry with a very soft cloth or leave diapers off for a while and let skin air dry. You can fasten the diaper loosely to encourage air movement and dress your child in breathable clothing. It can help to punch holes in disposable diapers to let air in.
  • Products for your baby's skin.
    Petroleum jelly protects your baby's skin. It is gentle even on sore, reddened skin, and is easily cleaned. Several other ointments are also available. Ask your baby's doctor what he or she recommends and see what works for your baby. However, be cautious with powders. Do not let your baby breathe them in. Do not use talcum powder since there is a risk of pneumonia. Powders may keep moisture close to the baby's skin and make the rash worse. In general, powders are not recommended. Ask your baby's doctor before using diaper powder or home remedies such as cornstarch.

Urine and Wet Diapers

Babies wet several diapers a day. Sometimes, it is difficult to tell if a disposable diaper is wet. The number of wet diapers is a helpful sign of how much your baby is drinking. Each day, your baby should have at least 7 wet diapers. If your baby does not have this many wet diapers a day, he or she may not be taking in enough fluid.

A baby's urine is typically clear and yellow-tinged. A change in the odor and color of urine may mean there is a problem. Signs your baby may not be getting enough fluid include dark yellow or even a pinkish colored urine.   

If you have concerns about the color, quantity, or odor of your baby's urine, call your baby's doctor.

Bowel Movements and Dirty Diapers

Meconium is the name of a newborn's first bowel movement. Meconium is dark brown to greenish-black in color and sticky. Your baby may have several meconium and transitional bowel movements before your baby's bowel movements become loose and yellow.

At first, breastfed babies typically have frequent bowel movements, sometimes with every feeding, and some even in between feedings. Often, these bowel movements are yellow, seedy, and loose. Formula-fed babies have thicker bowel movements that are light brown and more firm.

Sometimes babies become constipated. Breastfed babies can go many days between bowel movements after the first few weeks of life and rarely become constipated. Your baby may be constipated if he or she has firm or formed, hard stools that occur only once a day or less than once a day. Constipation may cause your baby to strain or fuss. However, all young babies will grunt and strain during a bowel movement. This happens because the muscles of the rectum and anus are not yet fully coordinated enough to relax as stool passes through. You should contact your baby's doctor if you think you baby is constipated.

Your baby has diarrhea if he or she experiences a distinct change in bowel movements, such as very runny or watery bowel movements. Call your baby's doctor if this occurs.

Chat with your baby's doctor about the frequency and appearance of your baby's bowel movements.

Shane Stephenson, MD

Methodist Physicians Clinic HealthWest

Dr. Shane Stephenson is a family medicine physician practicing at Methodist Physicians Clinic HealthWest. His goal is prevention and wellness for those he treats. Through his own experience as a teenager with his dad, he knows that if there is an illness that it doesn't only affect the one with the diagnosis, but the whole family is affected in different ways. He cares about the whole family of his patients and wants to be there for them. For ParentSavvy, Dr. Stephenson writes about ...

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