Change a Diaper

• TASK: Change a diaper in order to ensure the cleanliness and health of a baby.
• CONDITIONS: Given a baby with a soiled diaper, a fresh diaper, several baby wipes, baby powder and/or diaper cream.
• STANDARD: You must be able to remove the soiled diaper, clean the baby, and put a clean diaper back on the baby.

​Changing a soiled diaper can be a messy business depending on your experience. You will likely get poop or pee on you at some point. This is ok. Use a baby wipe to clean yourself up as best you can, finish changing the baby, then you can do a more thorough job of cleaning yourself.

If it helps, think of changing a diaper as an act of rescuing the baby from the very real risk of getting diaper rash. That way, you’re not just cleaning up a poopy baby, you’re saving the baby from harm. Or you can just suck it up, do the right thing, and take care of your kid.

Preparation
Arranging the supplies that you’ll be using to accomplish this task before you begin can greatly aid in making things go smoothly. I’ve found that it’s most convenient to have all of the supplies on the side of my strong hand. I’m right-handed so I have the baby on the left and the supplies on the right. I use my left hand to lift the baby’s legs up and my right hand to do most of the work of cleaning.

In addition to simply having all the supplies on the right side, I like to arrange them in the order that I’ll use them with the wipes closest to me and the new diaper farthest from me. Doing this isn’t critical, but I find that having a routine helps me get things done.

Remove the Soiled Diaper
The first thing you have to do is open the diaper. Doing this will release the stink and give you the first glimpse of what you’re dealing with. For the first several days of life, a newborn will produce a substance called meconium which is a black, sticky tar-like substance. Don’t worry, that’s normal. You’ll clean that stuff up just like anything else that comes out of a baby’s bottom. It just looks very different.

After opening the diaper and inspecting the task in front of you, quickly close the diaper again. Exposure to the cool air can trigger a urination response in the baby. Closing the diaper again after a brief exposure will protect you from being peed on.

Give the baby about 30 seconds to finish any peeing and then open the diaper up again. At this point, the baby’s bottom should still be on the back half of the diaper and the front half should be in your hand and relatively clean. If the front half of the diaper is free of poop, hold the baby by both ankles and lift it so that it’s bottom is off the back half of the diaper. Use the clean front half to give a first wipe of the baby’s bottom.

Once the front half of the diaper is all used up, pull the whole diaper away from the baby’s bottom and leave it lying closed and out of the way. You should still be holding the baby’s legs in the air with your other hand so for the moment all you should do is move the diaper out of the way so that you can keep working. Using the dirty diaper as a temporary garbage can for the soiled wipes helps keep things tidy.

Clean the Baby
While holding the baby by the ankles and lifting it’s bottom off the changing table, it’s time to take hold of the wipes and start cleaning the outside of it’s cheeks. After making the first pass with a wipe, fold it over and make a second and third if you can. Once the wipe is all used up, place it on the dirty diaper and continue wiping. Once you’ve cleaned the baby’s bottom cheeks, lower the ankles and move them so that the baby’s knees are near it’s chest. This will cause the baby’s cheeks to spread and give you access to it’s crack

With baby girls, it’s important to wipe from front to back away from their genitals. With baby boys, it’s not so important, but it’s good to be in the habit so I’d recommend front to back for them as well.

Wipe along the baby’s crack until it is free of any remaining poop using the same wipe-and-fold technique you used to clean the baby’s cheeks. Once all the poop has been removed, you can apply either baby cream or baby powder to the baby’s bottom to help ward off diaper rash. If you’re using cream, you can use one more wipe to apply it or, if you trust your cleaning work, simply use your finger.

Put On a Clean Diaper
With a clean and powdered or creamed baby, the next step is to put a clean diaper back on. Open the diaper and stretch it so that it will lay as flat as you can get it to. Also, open the attachment flaps on the back side.

Lift the baby’s legs back into the air and slip the diaper under its bottom. Lay the baby back down and spread its legs so that you can fold the front half up towards its belly. Hold the front half of the diaper down and bring the flaps from the back half forward so that they attach to the front side. You can peel them off and reattach them as necessary until you get them to be relatively even.

Many diapers have a frilly edge around the legs. After attaching the diaper, make sure that the frill is not trapped in the lining to give you the best chance of not having a blow-out. If the frill is tucked in, the seal is weakened and poop can escape.

Clean Yourself
Once your baby is all cleaned and diapered, you can clean yourself up too. While this seems like a fairly self-explanatory step, I put it here to emphasize that it’s OK to get baby poop and pee on you when you’re changing them. Sure, it might be gross and, while it might be hard for people without kids to understand, it’s not a big deal. When it happens, give a quick wipe so that you can keep working without making more of a mess, and stay on mission.