By Anthony J. Mancini, MD
Diapering your baby is as much a part of parenting as feeding. 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
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
Remember — never 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 re-diaper immediately without cleansing, or gently wipe your baby clean with a wipe or warm washcloth before diapering.
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 avoid introducing 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 might be harmful if your baby inhales it.
As your baby gets older, she's likely to fidget a lot more during 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 3.
- 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!
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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'll love her momentary freedom.
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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 a 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.
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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, 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.
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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, especially 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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Anthony J. Mancini, MD, is professor of Pediatrics and Dermatology and head of Pediatric Dermatology at Northwestern University's Feinberg School of Medicine and Children's Memorial Hospital.