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Nappies and Changing

Nappies are now produced in a wide variety of styles and sizes, but your basic choice will be between disposable and fabric makes. Whichever method you choose you’ll still use the same changing equipment, and the general techniques for cleaning and caring for your baby’s bottom will be the same.

Changing a nappy

You should change a nappy whenever you notice that it is soiled or wet. The number of times the nappy needs to be changed will vary from baby to baby and from day to day. However, you will probably always change the nappy when your baby wakes in the morning, when she is put to bed at night, and when she’s been given a bath. In addition, you’ll find that your baby will need to be changed after every feed. This is because of the gastrocolic reflex which stimulates the elimination of faces when food is taken in.

Where to change a nappy

Always change your baby on a soft, warm, . waterproof surface; changing mattresses are ideal for this. Usually made of a foam-filled, waterproof material, they have a slightly raised edge to prevent the baby from rolling off. They can be placed on whatever surface suits you best — floor, table or bed. As your baby gets older and starts to roll and wriggle while you change the nappy, you may find it safer to change the baby on the floor or on a low bed, whether or not you use a mattress.

Putting on a nappy

Putting on nappies, even your first ones, will be easier if you are well prepared. Make sum that you have everything that you need within easy reach. The last thing you want to discover halfway through changing the nappy is that you’ve left the baby lotion in the bathroom and the clean nappies downstairs.

There is no need to wash your baby’s bottom with soap each change: just gently wipe away most of the faces with a nappy corner then clean the baby’s bottom with oil or lotion. If your baby has only wet the nappy, use a water-soaked flannel or cotton wool. You don’t need to use talcum powder: in fact, I disapprove of it. Powder can become caked and irritating in the skin creases, increasing the risk of nappy rash. When you change your baby, watch out for any redness and take the appropriate action immediately.

Nappy changing sequence

  1. Remove the baby’s dirty nappy. Use the front to clear any faces of the baby . Fold it over so that the faces can’t fall out, and place the nappy to one side of the changing mat.
  2. Clean the baby’s genital area, bottom and top of the legs, as shown below.
  3. Put on a clean nappy using one of the techniques.
  4. Dress the baby.
  5. Put the baby somewhere safe (like a cot or a baby bouncer), then deal with the dirty nappy . Wash your hands.

Nappy rash

Because passing urine is automatic, your baby’s bottom will often be in contact with a damp nappy. Urine, if left for any length of time in a nappy or on the skin, is broken down to ammonia by bacteria from the baby’s stools. Ammonia is an irritant: it burns the skin and results in nappy rash. Nappy rash can range from a mild redness to an inflamed area of broken skin and pussy spots. The bacteria which produce nappy rash thrive in an alkaline medium. The stools of bottle-fed babies are alkaline, unlike those of breast-fed babies which are acid. For this reason, bottle-fed babies are more prone to nappy rash. To minimize the possibility of nappy rash occurring:-

  • Change your baby’s nappy regularly: never leave your baby lying in a wet nappy.
  • Put a one-way disposable nappy liner next to your baby’s skin. This allows urine to pass straight through to be absorbed by the nappy below, and so keeps the skin dry.
  • Use a fairly thick barrier cream. There is no need to buy an expensive one. Simple zinc oxide or a proprietary nappy cream are usually good enough if applied generously.
  • Leave the baby’s bottom open to the air whenever you can. Let the baby kick happily without a nappy after a bath or at feeding time. Just slide a nappy underneath her bottom to catch any mess.
  • Pay particular attention to washing nappies. Make sure they are well washed and rinsed to remove all the ammonia
  • At the first sign of broken skin start using a special cream for the prevention of nappy rash. I always found one which included titanium salts especially good.
  • At the first hint of nappy rash stop using plastic pants. These help to keep the urine close to the skin and promote the formation of ammonia.
  • Stop washing the baby’s bottom with soap and water. They are drying to the skin and can cause it to become cracked.

Treatment of nappy rash You may find. despite your precautions, that your baby develops a sore bottom. If you are satisfied that your baby doesn’t require specific treatment, then the most successful remedy will be a combination of the tips listed above, plus a few more, below.

  • Change the nappy more frequently.
  • At night, use a disposable pad inside a terry one for extra absorbency. This is especially useful for older babies who are sleeping through the night and will therefore not be changed from evening until morning.
  • Do not apply barrier creams when changing the nappy as this prevents air getting to the skin. Although it also keeps the skin dry it is more important that the skin be well aired when your baby has nappy rash.

DISPOSABLE NAPPIES

If you can afford them, disposable nappies are the answer to every parent’s prayers. There is no cleaning, washing or drying involved – you simply put on the nappy and then discard it when it is wet or dirty. A disposable nappy is also much easier to put on the baby as it needs no elaborate folding. nappy pins or plastic pants. In fact, even from the beginning you’ll feel more at ease using them because there will be no risk of hurting the baby with a pin.

Even if you’ve chosen to use the fabric variety, keep a stock of disposables in the house. They’re a useful back-up if you’ve run out of your usual nappy. or if your baby develops a rash because of your washing methods. They are much more practical than fabric nappies if you’re traveling – they are easier to change when you have little room. and you don’t have to carry as many accessories with you. Also, if you go visiting, used disposables can be thrown away in a suitable receptacle; fabric nappies, which may be both sodden and smelly, will have to be taken home with you to be washed. Disposables are also practical for toddlers as they are less bulky for them to walk with and are neater looking than fabric nappies.

However, certain factors have to be balanced against their time-saving practicability. Because they can only be used once, you have to make sure that you have a constant supply at home. To save your energy, buy them in as large a batch as possible: wholesalers and discount warehouses are ideal for this, especially as their prices for bulk purchases are cheaper. You could alternatively find a firm which delivered disposables to you.

Types available

There are basically two styles of disposable: two-piece and all-in-one. The two-piece nappy consists of an absorbent pad which slots into specially designed plastic pants. These pants are either T-shaped tie-ons or popper pants. Most parents find the tie-ons more suitable for newborns and small babies. The pads are available in a standard size which can be used with the pants, as a nappy, or inside a fabric or all-in-one nappy to provide extra absorbency. Graded pads are available in varying sizes and thicknesses, and fit newborns to toddlers. Rolls of pad, which you cut to the size you want, are also available. The plastic pants can be re-used. The two-piece nappy is cheaper to buy than the disposable all-in-one.

As their name suggests, all-in-one disposables function as nappy, liner and pants, but in a single unit instead of three. They are available in a variety of sizes, suitable for newborns to toddlers, and in a range of styles. The best have elasticated legs for added protection against leaks. They all have a plastic outer covering and an absorbent inner layer topped with a one-way nappy liner (see left), and are secured with adjustable adhesive tabs. They are the most expensive variety of disposable nappy.

CHANGING TIPS

  • If you’ve torn the adhesive strip to remove a nappy, only to find that the nappy is clean, you can use a strip of household masking tape to re-seal that nappy. The same applies if the tape fails to stick.
  • If your baby has a stomach upset or a very sore bottom and you’re therefore having to change the nappy very regularly, use disposable pads. This works out cheaper.
  • Even although they have a oneuay liner. it’s useful to put a paper liner in, too. This means that any faces can easily be lifted out with the liner and put down the lavatory.
  •  lf you use all-in-ones without elasticated legs. you can gently pull out the leg area for a better lit.
  • Keep a supply of fabric nappies just in case you run out of disposables.
  • At night try putting a standard pad inside an all-in.one disposable for extra absorbency.
  • If you split open the back of an all-in-one disposable, you will he able to slip a disposable pad between the padding and the plastic layer for extra absorbency.
  • If you’re really worried about leak sand you’re going out, you could put a pair of tie-ons over the all-in-one.

Disposing of a disposable All disposable nappies are designed to be thrown away: the whole of an all-in-one nappy, plastic backing included, can be discarded; in a two-piece nappy the pants are retained and the pad is replaced.

However, despite many manufacturer claims to the contrary, you will have to find an hygienic alternative to flushing them down the lavatory — they have a 100% success rate of getting stuck at the S-bend. I suggest that you flush off as much faces as possible under the lavatory spray, wring out the excess water and put the nappy in a strong plastic bag. Garden refuse bags are ideal. When it comes to throw the bag out make sure that it is firmly secured at the neck.

FABRIC NAPPIES

Although initially more expensive to buy than all-in-one disposables, fabric nappies work out cheaper over the years. Made of terry toweling or muslin, in a variety of styles, they have to be rinsed, sterilized, washed out and dried after use and therefore involve much more labour than disposables. Because they have to be washed regularly you will need a minimum of 24 nappies. Obviously, the more nappies that you can afford to buy the less frequently you’ll have to do the washing (and the larger and therefore more economical your batches will be). Buy the best quality that you can afford. They’ll last longer and be more absorbent.

Terry squares

These traditional nappies are thick and absorbent and will fold into a variety of shapes according to your baby’s size and needs. Buy them ready-hemmed to avoid fraying when they are washed. They are more absorbent than the majority of disposables and are therefore very suitable at night. They can be bulky on very small babies and newborns.

Shaped terry toweling

These T-shaped nappies are made of a softer, finer toweling than ordinary squares and have a triple-layered central panel for added absorbency. They are shaped to fit neatly around the baby’s legs and are more straightforward to put on.

Muslin squares

These are about the same size as toweling squares but they are soft and filmy. They are ideal for newborns because they are so comfortable against their skin. However, they are not very absorbent, and have to be changed frequently.

Nappy liners

These are placed inside the nappy and go next to the baby’s skin. The best variety is made of a special material which lets urine pass through but remains dry next to the baby’s skin. This minimizes the risk of a sore bottom due to friction or moisture. They also catch most of the faeces and prevent the nappy from getting badly soiled. When it comes to changing the nappy. the liner can be lifted out with any faeces and dropped down the lavatory.

Nappy pins

Specially-designed for fabric nappies, these pins have a self-locking head which makes it impossible for them to come undone accidentally. Buy at least twelve.

Plastic pants

These pants, which come in several designs, are used over fabric nappies to prevent wet or dirty nappies soiling clothes or bedding. Buy six initially. You’ll need to replace them as they get old and unusable.

Folding nappies

Not long ago, most parents were taught to use the simple triangle or rectangle methods. Although these methods were easy to fold they were not very efficient. The triangle was baggy around the legs. and the rectangle. although absorbent, was very bulky and was only suitable for small babies. I therefore suggest that you use the methods which I consider to be the best. By best I mean the most absorbent and the neatest. I suggest that you use the triple absorbent fold for your newborn. It has good absorbency because of its central panel and it is also very small and neat when on. Another method you could use for a newborn baby is the nappy skin. Put a muslin nappy on the baby then lay the baby on an open terry square. Fold it around the baby like a skirt and secure it at one side with a nappy pin.

When she grows too large for the triple fold use either the kite or the parallel method — whichever suits you best. The kite is probably easier to adapt to your growing baby as you can adjust how much you fold in to the centre to give the depth of the nappy.

Nappy washing and sterilization

Nappies must be thoroughly washed to remove all traces of ammonia and fecal bacteria which would otherwise cause irritation and possible infection . Special nappy sterilizer are now available which make this process much easier and less time-consuming. With this method the nappies are soaked in a sterilizing solution for a specified length of time and then only the soiled nappies are washed with powder; the wet nappies are thoroughly rinsed. Whenever you wash nappies use pure soap flakes or powders.

Avoid strong detergents and biological enzyme powders as these will irritate the baby’s tender skin. If you have to use a fabric conditioner because the toweling has become stiff make sure that you rinse it all out; despite manufacturers’ instructions to the contrary, this too can cause irritation. Unless the nappies are very stained, or have become rather grey. there is no need to boil them. Hot water is sufficient for both rinsing and washing after using sterilizing tablets. Never add coloured clothing to the sterilizing solution — the colour will run. Even if the clothing has been soiled, just remove the worst of the mess, rinse the item and then wash as normal.

Nappy washing routine

To balance the chores of feeding, changing and nappy washing, try to develop a routine whereby you wash the nappies in sufficiently large loads. The prerequisite of this routine is a large supply of nappies — I suggest no less than 24. In order to sterilize the nappies you will need two plastic bins: one for soiled nappies, one for wet ones. They should be large enough to hold at least six nappies, plus solution, and they must have lids and strong, reliable handles. Don’t, however, buy such a large bin that you can’t carry it fully loaded to the washing machine or bath. Special nappy bins are sold but any bin of a decent size with a lid is suitable. Bins designed for beer making are ideal and they are also quite cheap.

Each morning fill the bins with the required amounts of water and solution. Rinse a urine-soaked nappy in cold water, squeeze out the excess moisture and put it into the bin. Remove as much faces as possible down the lavatory then hold the soiled nappy under the water as you flush it to remove the excess. Wring out the nappy and submerge it in the solution. After the required time, wring out both sets of nappies. Rinse the urine-soaked ones thoroughly in hot water before drying them. Put the soiled ones through the hot programme of a washing machine then rinse and dry them. Alternatively, wash them out in a bath with hot water.

Washing plastic pants

If they become soiled or wet they should be washed in warm water with a little washing-up liquid. If the water is either too hot or too cold the plastic hardens and becomes unusable. Pat the pants dry after washing and leave them to air before using. One way of softening them is to tumble dry them with a load of towels.

USING NAPPIES

A one-year-old child still urinates automatically but because the bladder can hold an increasing amount of urine she’ll be dry for longer periods. You will there-fore use fewer nappies—on average 50 per week as opposed to the 80 used on a newborn. If you hesitated to use disposables before because of the price you may consider them now. Another reason why they become more practical now is that they’re neater and less bulky than fabric nappies. This is important because your increasingly mobile child will find it difficult to walk with a cumbersome wad of nappy between her legs. If you use fabric nappies. fold them in the least bulky way — use either the kite fold or a shaped terry. When it comes to changing the nappy you’ll find your toddler far less willing to lie still. Make sure that you’ve got some books or toys as distractions or you’ll find that each change becomes a battle ground. Clothes which give easy access to the nappy save your time and energy, so buy dungarees which have poppers or zips in the crotch, or use pants which you can just pull down quickly.

At some time during the third year your child will probably gain conscious control over the bowel and bladder muscles and your days of frequent nappy changes should be over. When your child stays dry during naps you can start leaving off that nappy Once again, I’d suggest that you use disposables. As part of your toilet training you may also want to use trainer pants which can be pulled down quickly when your child tells you that she wants to go to the lavatory. These are basically plastic knickers lined with toweling. They’re comfortable to wear and provide some protection against the inevitable accidents which will occur. Buy at least six to begin with, because they’re not absorbent.

 

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