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Elimination and How to Diaper

Angela Oswalt, MSW

Like all living creatures, babies take in nutrients and fluids, and their bodies break them down, keep what they need, and get rid of the waste products through urination and fecal elimination. After the first few weeks of life, babies should be wetting six to eight cloth diapers or three to five disposable diapers a day. This urine output should be monitored to make sure the baby is getting enough fluids. As well, during the first six weeks of life, formula-fed infants may have one to three bowel movements a day, mostly firm and tan in color. Breast-fed infants may have more frequent bowel movements, often one after every feeding. As well, the stools of breast-fed babies can be different colors and consistencies, depending on Mom's diet. After the first six weeks, babies will have fewer daily bowel movements. Each baby is unique and can have a different elimination pattern and still be healthy. Caregivers should consult the baby's doctor if they have any questions or concerns. As babies grow older and become toddlers, their bodies continue to mature and their bowel and bladder capacity grow, allowing more time between diaper changes. This physical maturation is necessary to allow for potty training, which typically beings around the age of three.

How to Diaper

Preparation is the key to smooth diaper changes for everyone involved. Prepare a safe and clean changing area. At home, use a changing table with a soft and easily cleaned pad on top, or use a towel or blanket spread out on a clean spot on the floor. To be prepared away from home, carry a changing pad that can be spread on the changing tables in most public restrooms or on the floor or bed at a friend or relative's house. Having these pads assures parents and caregivers of a clean and comfortable place to change their baby wherever they go. Before the actual diaper change, have clean diapers, wipes, diaper rash cream, a spare towel, and a special toy within easy reach.

Caregivers can choose which type of diapers they want to use on their babies, cloth or disposable. Each has its benefits and drawbacks. Cloth diapers are cheaper, but their use creates more laundry, is less convenient away from home, and requires the use of sharp pins. They are also more prone to leaking. Disposable diapers are much more convenient and come in a large array of styles, but they are more expensive over time and create non-biodegradable waste in landfills. Parents should choose diapers depending on their lifestyle, preferences, and the needs of their child.

Babies may squirm and resist diaper changes, especially as they get older and stronger, because they do not like to be restrained or they just like to move and explore. Keep babies still and interested by reserving a special toy, song, or game only for changing times. The more caregivers can engage their babies mentally and emotionally during this time, the smoother the change will be. This is another prime opportunity for caregivers to bond and to build trusting relationships. No matter what parents do to keep their babies calm and still during changing time, they should always have at least one hand on them at all times to prevent any falls or injuries. If a baby or toddler is extremely squirmy, change diapers primarily on the floor to prevent falls from the changing table.

Begin the diaper change with good hand washing. To change a baby's diaper, remove the bottom half of the infant's clothing. Baby "onesies" that snap between the legs make diaper changes especially easy. Then remove the old diaper and quickly examine the contents in order to monitor the baby's health and digestion. Next, gently wipe the bottom clean with baby wipes to remove any urine or fecal matter. Be careful to wipe from the urethra toward the anus (front to back) and never in the opposite direction, to prevent germs from fecal matter infecting the urethra or vagina. Baby wipe warmers can make wipes feel better than cold wipes for cleaning. Some babies have sensitive skin that may react to baby wipes, so caregivers can also use a washcloth dampened with warm water.

Allowing babies to dry a few seconds before putting a diaper back on can help discourage diaper rash. Baby powder is no longer advised because inhaling the powder can be damaging for babies. During this period of the time when babies are diaper-free, caregivers should be prepared to be sprayed, because babies often like to urinate while naked and free. A towel over the shoulder can be the best defense for this type of incident. If babies are suffering from or often suffer from diaper rash, liberally apply a diaper rash cream containing zinc oxide to the infected area to help discourage wetness and irritation and to help the healing process. Then stretch out a clean diaper under the baby and fasten it in place. Dispose of wet or soiled diapers, and be sure to wash your hands or use a liquid hand sanitizer before resuming other activities.

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