How to change a nappy: newborns

Newborn babyOne of the many apprehensions for new parents is how to change a nappy. Many of us would not have had cause to go there before we have our own child, but the truth is that changing a nappy soon becomes second nature, and in reality it soon becomes the easiest day-to-day task of them all. The best thing is that nappy changing is one of those jobs that you might even start fighting over!

The amount a newborn produces in their nappies can be truly alarming, a sort of one-in one-out policy after and often during a feed, so be prepared for a lot of changing.

The First Nappies

The first few nappies can be pretty scary, as they are often thick, sticky and black to dark green in colour, which is called meconium. As he begins to feed on milk, his stools will gradually change colour, first to greenish-brown, then to yellow. Many new parents find these nappies very hard to clean as meconium can be extremely sticky and hard to remove. Unfortunately there is no solution to cleaning these early nappies, but a tip would be to be aware that if it gets on blankets or clothing it is nearly impossible to remove.

Breastfed babies and their nappies

The poo of a breastfed baby is quite loose and covers a beautiful range of colours from yellow-green to bright yellow, and has the consistency of grainy mustard and can smell almost sweet. If the poo is more green than yellow, you should seek advice from your health visitor or midwife. Breastfed babies very rarely have constipation.

Formula fed babies and their nappies

Formula-fed babies produce a more “moulded” poo which tends to be a more browny-yellow colour and more smelly. You will soon get to know your baby’s normal shade, but you will need to watch out for very loose and watery poos which might signify diarrhoea, or hard-pellet like poo which can indicate constipation.

How often do you change a nappy?

It is probably a good routine to change a baby as soon as you can after every poo, for the comfort of both you and your baby, although wet nappies can wait a little longer. However, during the night try not to change your baby unless absolutely necessary as you can make a sleepy baby become a very wide awake baby by changing.

Disposable or washable?

Depending on your preference and environmental views, you should perhaps investigate the pros and cons of using disposable or washable nappies.

It is true that disposable nappies are very “un-green”, producing 800 million tons of paper annually to make and then creating huge amounts of waste as your child will probably use around 4500 nappies before they are potty trained. It costs around £4 for a pack of newborn nappies and on average you will get through about two of these a week.

Washable nappies may not make that much of a difference on a cost basis, and a study carried out by the Environmental Agency in 2005 found that there was “no significant difference between any of the environmental impacts” between reusable and disposable nappies. This is mainly due to the higher level of washing used in washable nappy products.

The reality is that to consider the washable route will require an initial outlay up front for cloth nappies, and a dedication to use them. They do have to be changed more often than packaged varieties, they may need soaking before you wash them and can end up all over the radiators in the house to dry, if you don’t have a drier.

For some new parents this is a dilemma and one that you will have to decide on depending on your personal lifestyle.

How to change a nappy

You will need:

  • a waterproof surface to put your baby on
  • A clean nappy
  • Cotton wool and warm water (for newborns) – wipes can be used on an older baby but use non-perfumed versions
  • Barrier cream for nappy rash
  • A spare change of clothes in case of “up the back” poos.
  • A nappy sack, if you choose to use one
  1. Wash your hands
  2. Lay your baby on his back on the mat, and un-pop his vest. If he’s wearing socks or booties take them off. Babies take delight in kicking away at their dirty nappies, and the mess is easier to clean off bare feet.
  3. Open the old nappy to inspect the contents. To get him clean, you need to lift the baby’s legs (ankles together, with one hand, gently). WARNING: baby boys wee in the air when their penises are exposed, so keep covered with the new nappy or a small towel. Girls do their own, less dramatic versions.
  4. If there’s poo, pull the front part of the nappy down, and use the inside to wipe the worst away from your baby’s bottom. Then use damp cotton wool to clean up. Even wee needs to be wiped away, so your baby doesn’t get sore. For girls, wipe from front to back, so germs don’t go where you don’t want them to. Fold the nappy in on itself, and put aside ready to dispose.
  5. Apply barrier cream if the baby is sore. Talcum powder is no longer recommended, as babies can inhale the dust and suffer breathing problems.
  6. Open the new nappy and make sure it’s the right way up – Velcro tabs at the back, and usually design at the front (for disposables). If your baby still has their cord clamp either fold back the front of the nappy or fasten lower down below their belly button. Some newborn nappies are cut especially low for this reason.
  7. Replace the baby’s clothing
  8. Wash your hands

Nappy rash

At some point, even the most changed baby may get a touch of nappy rash. This is a red, sore area around the bottom caused by the ammonia in urine. It is often down to the sensitivity of an individual baby’s skin, but some types of nappies can make things worse. Here are some treatment tips:

  • Change the nappy every time your baby soils it
  • Let your baby kick with a bare bottom for several minutes a day and put down a towel to soak up any unexpected leaks
  • Use a barrier cream which helps keep bacteria at bay
  • If the rash is not improving after a few days, or has become very raw, your baby may have an infection that needs treatment. Ask your health visitor or GP for advice
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