How to change a nappy
Some babies have very delicate skin and need changing as soon as they wet themselves, otherwise their skin becomes sore and red. Others can wait until before or after every feed to be changed.
All babies need changing as soon as possible when they've passed a stool (poo) to prevent nappy rash and stop them from smelling.
Getting organised for nappy-changing
Get everything you need in one place before you start. The best place to change a nappy is on a changing mat or towel on the floor, particularly if you have more than one baby. That way, if you need to see to another child for a moment, the baby can't fall. Sit down so that you don’t hurt your back.
If you're using a changing table, keep an eye on your baby at all times. Don't walk away or turn your back.
Always have a good supply of nappies. If you’re using cloth nappies it might take a while to get used to how they fold and fit. Pre-wash them to make them softer. Take care to choose the right size of nappy and cover for your baby’s weight.
You’ll need a supply of either cottonwool and warm water, or baby wipes. It’s also a good idea to have a spare set of clothes handy, especially in the first few weeks.
Getting started changing a nappy
If your baby’s nappy is dirty, use the nappy to clean off most of the poo from your baby’s bottom. Then use the cottonwool and warm water (or baby lotion or baby wipes) to remove the rest and get your baby really clean.
Girls should be cleaned from front to back to avoid getting germs into the vagina. Boys should be cleaned around the testicles (balls) and penis, but there’s no need to pull back the foreskin. It’s just as important to clean carefully when you’re changing a wet nappy.
If you're using cloth nappies, put in a nappy liner then fasten the nappy around your baby. Adjust it to fit snugly round the waist and legs. If you’re using disposable nappies, take care not to get water or cream on the sticky tabs as they won’t stick if you do.
It can help to chat to your baby while you’re changing them. Pulling faces, smiling and laughing with your baby will help you bond and help their development.
Put as much of the contents as you can down the toilet. If you’re using nappies with disposable liners the liner can be flushed away. Don’t flush the nappy as it can block the toilet.
Disposable nappies can be rolled up and resealed, using the tabs. Put them in a plastic bag kept only for nappies, then tie it up and put it in an outside bin. Washable cloth nappies can be machine washed at 60°C, or you could use a local nappy laundry service.
To avoid infection, wash your hands after changing a nappy and before doing anything else.
Your baby’s first poo (or stool) will be made up of something called meconium. This is sticky and greenish/black.
After a few days the poo will change to a yellow or mustard colour. Breastfed babies’ poo is runny and doesn’t smell. Formula fed babies’ poo is firmer, darker brown and more smelly.
Some infant formulas can also make your baby's poo dark green. If you change from breast to formula feeding, you’ll find that your baby's poos become darker and more paste-like.
How often should my baby do a poo?
Some babies fill their nappies at or around every feed. Some, especially breastfed babies, can go for several days or even up to a week without a bowel movement.
Both are normal. It’s also normal for babies to strain or even cry when passing a poo. Your baby isn’t constipated as long as their poos are soft, even if they haven’t passed one for a few days.
Is it normal for my baby’s poos to change?
From day to day or week to week your baby’s poos will probably vary. If you notice a marked change of any kind, such as the poos becoming very smelly, very watery or harder, particularly if there’s blood in them, you should talk to your doctor or health visitor.
Pale poos may be a sign of jaundice. If you're worried, speak to your midwife or health visitor.
Most babies get nappy rash at some time in the first 18 months. Nappy rash can be caused by:
prolonged contact with urine (wee) or stools (poo)
rubbing or chafing
soap, detergent or bubble bath
diarrhoea or other illness
There may be red patches on your baby’s bottom, or the whole area may be red. The skin may look sore and feel hot to touch, and there may be spots, pimples or blisters.
The best way to deal with nappy rash is to try to prevent your baby getting it in the first place. These simple steps will help:
Change wet or soiled nappies as soon as possible. Young babies need changing as many as 10 or 12 times a day; older babies at least six to eight times.
Clean the whole nappy area thoroughly, wiping from front to back. Use plain water or baby wipes.
Lie your baby on a towel and leave the nappy off for as long and as often as you can in order to let fresh air get to the skin.
Use a barrier cream, such as zinc and castor oil.
If your baby gets nappy rash you can treat it with a nappy rash cream. Ask your health visitor or pharmacist to recommend one.
If the rash doesn’t go away or your baby develops a persistent bright red, moist rash with white or red pimples, which spreads to the folds of the skin, they may have a thrush infection.
You’ll need to use an anti-fungal cream, available either from the pharmacist or on prescription from your GP. Ask your pharmacist or health visitor for advice.
Washable (reusable) nappies
There are several types of washable nappies. Some have a waterproof backing and others have a separate waterproof cover.
They fasten with either Velcro or poppers. Biodegradable, flushable nappy liners can be useful as they protect the nappy from heavy soiling and can be flushed away.
If you use disposable nappies it’s worth finding out whether there's a local delivery service. If you’ve opted for washable cloth nappies you could use a nappy laundry service.
The cost of buying and washing cloth nappies for two and a half years will range from around £180 to around £350, depending on the type of nappy you use. Nappy laundry services cost from £6 to £9 a week. The cost of using disposable nappies over the same period ranges from £450 to £750.
A nappy laundry service will take away the soiled nappies and deliver a fresh batch each week. Nappies are washed to hospital disinfection standards and thoroughly rinsed to protect your baby’s skin. The service will supply everything you need, including nappies, nappy covers, liners and lidded nappy bins.