How to Change a Baby’s Diaper
Wash and dry your hands thoroughly and remove any jewelry (like rings) that might abrade or scratch your baby’s delicate skin
Cover the diapering table or surface with a towel, protective cloth diaper, or changing cloth. If the baby is on table from which he or might roll over and fall, keep one hand on the baby at all times. Don't let yourself get distracted, even for a moment. If the changing table has a tummy strap, use it to secure the baby to the table. Make sure the baby’s clean diaper, fresh plastic pants, diaper pins, clean nightclothes, baby wipes, and baby lotion or rash ointment are close at hand before disrobing the baby.
If you hear the baby grunting or a sound of "farting", continue setting up the diaper changing area before changing the baby’s diaper. Give the baby enough time to finish making a mess before changing his diaper!
Distract the baby’s attention while you work. Battery-powered, motorized mobiles hung just out of baby’s reach over his head are my favorite. Pacifiers or a plushy or favorite toy can be useful to divert the baby’s attention too. If you’ve equipped your baby’s nursery with a stereo system, playing nursery rhymes are helpful in calming a baby before a diaper change, especially if he has a diaper rash. Under no circumstances should you give a baby boy a full baby bottle of formula, juice or water immediately before or during a diaper change! If a baby boy receives any fluid just before or during a change, he is likely to "bless" his caregiver with a high arcing "Fountain of Youth", i.e., baby pee! In any case, make sure that baby’s changing accessories like pins, lotion or powder is out of your baby’s reach.
If baby is wearing a onesie or a sleeper, unfasten and tuck the bottom half of the garment behind his back during the diaper change unless you intend to powder his bod with baby powder, if so, remove his garments completely. Remove the baby’s socks to prevent soiling during the diaper change.
Before you remove the baby’s soiled diaper, observe how it was originally secured and whether any tapes or pins have broken loose. Your observations will assist you in planning how to properly secure the baby’s next diaper. Unpin or untape the front of the baby’s diaper and draw it down between his legs to rest on the changing surface. Grasp the baby’s nearest ankle between the thumb and forefinger, allowing the rest of the fingers to support and hold the baby’s other ankle. Lift the baby’s legs and push back to fold the legs such that the baby’s knees approach his chest. This action will lift the baby’s bottom and allow you to easily remove it. Pull the diaper straight out and turn it around 180 degrees, then use the wet front part of the diaper to wipe the majority of the smeared poop from his bottom before folding the mess within the diaper and removing it from the table or changing surface.
If the baby is a boy, cover his little pee-pee with the wash cloth or a cloth diaper to prevent the aforementioned "Fountain of Youth" from showering you during the diaper change. With a diaper wipe or a warm damp washcloth, wipe baby boys’ pubes from back to front and baby girls’ pubes from front to back.
If you used a washcloth or commercial pre-moistened (non-alcohol) baby wipes, then pat the baby’s skin dry with a clean paper towel, toilet paper or a clean cloth diaper. If the baby needs an application of diaper ointment, apply it now from the front of the perineum up to a level two to five inches above the anterior portion of the perineum. (This is the region between the scrotum and the anus in baby boys, and between the posterior vulva junction and the anus in baby girls). Do not use baby powder unless you’re using it to make the baby smell clean and "baby-like". Baby powder does NOT prevent diaper rashes, it only makes a baby smell good!
If you decide to use baby powder, then turn the baby over and give him a "light" dusting of powder on his back, bottom and legs, and rub it in before turning him back over and repeating the process on his legs, abdomen and chest, avoiding the pubes. Talc is a silicon-based, ground mineral (rock) and can cause silicosis if the baby inhales the dust on a daily basis. Cornstarch-based baby powders are somewhat safer, but caution should be exercised in its use to prevent inhalation by the baby. Excessive use of either on the testes can clog the pores on the baby’s pubes and cause the upper layer skin to die. The baby’s bod will slough off the dead skin, leaving a raw, red covering of new dermis that is as sensitive as a newborn’s skin and is exceedingly painful to the merest touch.
If you’re using baby lotion or oil and the baby will be wearing plastic pants over a cloth or disposable diaper, massage the lotion or oil well into the skin of the baby’s pubes and wipe off the excess with a paper towel, toilet paper or clean cloth diaper before diapering the baby to prevent the oils in the lotion or baby oil from damaging the chemical structure of the plastic (vinyl) pants, thus radically shortening the lifetime of the plastic pants.
Slide a clean diaper underneath the baby’s bottom. If you are using disposable diapers, check to make sure that the diaper is oriented correctly. Pull the front half of the diaper up through the baby's legs. If the baby is a boy, "dress" (position) his pee-pee so that it points downwards into the diaper rather than upwards towards his tummy to insure that a (later) large stream of pee won’t escape his diaper to wet his clothes and bed linens.
Note: If the diaper is disposable, fasten each back corner over the front with the provided tapes.
(Important note: if you have used baby lotion, oil or Vaseline on the baby’s skin, wash your hands with soap to remove the oils before touching the adhesive strips on the diaper. The slightest hint of oil on either the plastic of the diaper or the adhesive strip will render the tape useless! An alcohol-based baby wipe is great for removing oils on a caretaker’s hands, but if they are used on a baby with a rash or irritation, the alcohol will be very painful to the baby. Also, be careful not to stick the tape to the baby’s skin, instead of the plastic of the diaper! Many babies are highly allergic to the chemicals that are used to make adhesives and may get painful rashes and blisters.)
If you are using cloth diapers, place your forefinger and second finger of the hand that is not pinning the diaper between the diaper and the baby’s skin to prevent sticking the diaper pin into the baby. Draw the fabric tight over your fingers (the two fingers will also make sure that the finished diapering has enough "ease" to prevent chafing).
In either case, a diaper should be tight enough to prevent leaks but not so tight that it chafes and irritates the baby's skin.
Empty the contents (formed stools) of the soiled diaper into a toilet and flush. Rinse (by dipping) the cloth diaper into the toilet water and place the diaper in the diaper pail with a mild solution of borax pre-wash. (If traveling with cloth diapers, put the soiled rinsed diapers in a plastic baggie until you reach home again.) If diaper is disposable, after disposing of the loose stools in the diaper, fold over the edges and use the tape to form a compact package with the balance of the mess enclosed within before disposing of them in a garbage can.
If using cloth diapers with plastic pants, redress the baby in clean plastic pants. (See the Care of Plastic Pants section of this Website for cleaning instructions.) Then redress your baby in a clean onesie or PJs if he was wearing any nightclothes before he was put down to sleep. Change the baby’s crib sheets and comforter if they are wet or soiled.
Wash your hands once again before returning your baby back to his crib.