Diaper care can present a steep learning curve, particularly for first-time parents who struggle with which diapers to buy, sizes and poop duty. Diaper-related issues, notably rashes or redness, can increase the level of difficulty. Here are some essential diapering tips from Dr Hemlatha Subramaniam, a Paediatrician from Pantai Hospital Sungai Petani, to make the task much more manageable.
Establish a diaper system
Some parents simply split their diapering patrol between night and day, while some fathers take on the task anytime they’re home when it happens. Find a system that works for your and your spouse. A standard diapering routine generally comprises these steps:
- Unsnap onesie.
- Undo diaper.
- Wipe excess away using a diaper.
- Clean with a wet wipe.
- Wrap everything to dispose of in the diaper and discard it.
- Apply cream.
- Put on a new diaper and dress your baby.
TAKE NOTE!
Nappy changes should occur at regular intervals (where clinically appropriate) to avoid irritation to the perineal skin environment.
There are variations in a diapering routine based on skin care regimen and diaper type. Nevertheless, it is important to develop a consistent routine and do it the same way every time.
Choose the right diaper size
Disposable nappies are preferred as they offer various diaper sizes to better fit a child as they grow. Some kids might need a larger diaper earlier, or they might stay in the same size longer than expected. Parents will need to experiment a bit until they find the right brand and size.
As a rule of thumb, diapers should accommodate a kid’s waist with plenty for the tabs to grip on to. When fastened correctly, parents should be able to fit a finger between the waist and the baby without too much effort. Ensure the diapers are snug around the legs.
Leg ruffles are essential
Even if they look cute on your little one, the ruffles around diaper leg holes are not a fashion element – they are there to keep poop and pee inside the diaper, preventing them from leaking down the legs. Ensure the leg ruffles are visible on the outside and not tucked inside the diaper around the legs.
Keep your supplies ready
The key to changing a kid without fuss, whether inside the home or outside the home, is having all the supplies on hand and easily accessible. Nothing makes baby-changing more awful than having to stop in the middle to search for wipes.
Be cautious when using a changing table
While changing tables ensure that an adult doesn’t have to kneel and stoop to change a kid, there’s a huge risk to it: elevating the baby to a height could potentially lead to a disastrous fall. One hand should always be kept on the kid if a belt isn’t available. If the belt is available, use it, but remain super vigilant.
Clean private areas properly
For a baby girl, clean her vulva by wiping front to back. The idea is to remove excrement from the vulva, which will help prevent urinary tract infections. For little boys, you can just wipe their penises with disposable wet wipes or cotton balls. Do not try to pull the foreskin if they are uncircumcised. On the other hand, great care should also be taken when wiping a freshly circumcised penis.
Here are some essential items for thorough cleaning
- Cotton balls or soft disposable towels with warm water are the preferred cleansing method
- A pH-neutral cleanser may be used if stools are dry and difficult to remove
- Wipes should be avoided (if required, they should be free from alcohol and fragrance)
- Barrier creams should be used on all neonates at risk of perineal dermatitis at every nappy change at the first sign of erythema or skin breakdown.
Dealing with diaper rash
Diaper rash can turn nappy change into a nightmare. To reduce the discomfort of your baby’s irritated skin, dab rather than wipe the skin. You can also minimise further contact by cleaning the area with water via a spray bottle filled with warm water. Make sure that the baby’s skin is thoroughly dabbed dry after cleaning.
Diaper rash is very much about controlling moisture. Fortunately, plenty of creams and lotions can help manage the discomfort. Apply an appropriate amount of barrier cream and leave it on. Removing the cream between nappy changes is not necessary. You can just add another layer of cream to the one before. Avoid barrier creams containing plant extracts or fragrances as they can exacerbate the rash. If the rash persists or worsens even after using creams, seek a paediatrician’s opinion.
TAKE NOTE!
Check the perineal area at each nappy change to identify perineal dermatitis and candida infections early.
Dr Hemlatha Subramaniam
Paediatrician
Pantai Hospital Sungai Petani
