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Diaper

Step-by-step guide

Whether you're working with cloth diapers or disposables, our handy step-by-step guide reveals the secrets to diapering success.

PREPARATION

Wash and dry your hands (you can use a baby wipe).

Set up a warm, clean, dry area to change your baby. In the beginning you'll probably use a changing table, but a changing cloth or clean cloth diaper on any soft, warm surface will work, too.

Prepare your supplies, including a clean diaper and plenty of wipes. If you're using disposables, have a plastic bag ready for disposal; if you've opted for cloth, you'll need to include a diaper wrap or diaper pins and plastic pants. If your baby has or is prone to diaper rash, keep some ointment or petroleum jelly on hand.

CHANGING A DISPOSABLE DIAPER

  1. Unfasten the tabs and fasten them back on themselves so they don't stick to your baby, but don't remove the dirty diaper yet.
  2. Wipe away excess poop from his genital area with the corner of the diaper, taking care to cover the penis with a clean cloth if your baby is a boy, so he doesn't pee all over himself (and you) while you're changing him.
  3. Grasp your baby by the ankles and lift his bottom off the changing table.
  4. Fold the dirty diaper in half under your baby, unsoiled side up.
  5. Use a baby wipe or wet cloth to clean your baby's front thoroughly. For a girl, be sure to wipe from front to back. This will help minimize the possibility that bacteria will get into her vagina and cause an infection.
  6. Lift both of your baby's legs and clean his bottom with a wipe or wet cloth.
  7. Swap a clean diaper for the dirty one. The clean diaper's top half (look for the tabs) should go under your baby's bottom, and the other half should come up between his legs (which should be spread as widely as is comfortable for your baby). Try not to bunch the diaper between your baby's legs since it can cause chafing and discomfort. For newborns, avoid covering the umbilical cord (you can get special newborn diapers with notches cut out for the stump). For boys, be sure to tuck the penis down so his urine will flow down into the diaper instead of out the top.
  8. Fasten the diaper at both sides with the tapes, making sure it's snug, but not so tight that it pinches his skin. Check the manufacturer's instructions for specific tips.

Retape the soiled diaper around the contents, put it in a plastic bag, and toss it in the trash. Dress your baby, and wash your hands thoroughly.

That's it -- you're done!

 

DIAPER RASH

What's causing my baby's diaper rash?
Your baby's rash is most likely caused by chafing or wetness, though it can also be the result of a skin infection. Don't panic -- dealing with diaper rash is part and parcel of baby care. In fact, more than half of babies between the ages of 4 and 15 months have at least one diaper rash in a two-month period.

Here's a look at the different kinds of rashes your baby might have in his diaper area:

Wetness or diaper chafing
What it looks like
Some of the skin that rubs against your baby's diaper " most likely the genital area and the surfaces of his thighs and buttocks " might appear red and puffy. Or your baby might have a flat, red rash on those areas.

What causes it
Sometimes just the chafing from a diaper, or chemicals or fragrances in a disposable diaper or detergent, can bother your baby's skin and cause a rash. This type of rash is known as contact dermatitis. More often, though, a diaper rash is the result of wetness. Even the most absorbent diaper leaves some moisture on your baby's delicate skin. And when bacteria from your baby's stool mixes with his urine, it breaks down the chemicals in the urine, forming ammonia, which can be very harsh.

Although a baby left in a dirty diaper for too long is more likely to develop diaper rash, it can strike the bottom of any baby with particularly sensitive skin, even if his parents are diligent diaper changers. And if your baby's taking antibiotics, a side effect could be diarrhea , which can also cause diaper rash.

Yeast (candida) infection
What it looks like

If a yeast infection is to blame for your baby's rash, you'll notice tiny red spots that multiply and mass into a raised, patchy bright or dark red rash with distinct borders. The affected area is red and may be tender or painful, and the rash can creep into the creases of skin around your baby's genitals and legs. It almost never appears on the buttocks alone, but it's possible for it to spread there.

What causes it
If your baby's skin is irritated -- by wet diapers, for example -- the yeast that normally occurs in his body can get into the cracks in his skin and flourish, causing a rash. And babies on antibiotics sometimes get candida infections because antibiotics reduce the growth of the healthy bacteria (which helps keep the yeast in check) as well as the problem bacteria. Some babies with thrush also develop a yeast diaper infection. If that happens, your doctor can prescribe a fungal medication to use in the diaper area.

Seborrhea
What it looks like
Seborrheic diaper dermatitis isn't common, and it isn't pretty. If your baby has it, you'll see a big, red, raised, rough, greasy rash extending from his lower abdomen to his groin.

What causes it
We don't know for sure. For some time, experts believed that seborrheic diaper dermatitis -- like cradle cap -- was caused by overactive oil glands in the skin. (Some experts believe these glands are stimulated by hormones that your baby received from you just before birth.) But further research has resulted in less agreement about what causes it.

Bacterial infections
What it looks like

If your baby has oozing yellow patches or pus-filled pimples, he may have a bacterial infection such as impetigo .

What causes it
Bacteria cause these types of rashes. While it's not an emergency, you should call your doctor right away if you think your baby's rash is a bacterial infection. She may prescribe a topical or oral antibiotic.

What's the best way to treat diaper rash?
The best remedy is to keep your baby clean and dry by changing his diaper frequently. Using a barrier ointment " one that forms a protective layer on the skin " after every diaper change can help protect your child's skin from stool and urine. If the weather is warm and he can play outside or in a room with an easy-clean floor, leave his diaper (and ointment) off for as long as possible every day to allow the air to speed healing. Consider letting your baby sleep bare-butt, with a plastic sheet under the cloth sheet, to help clear his diaper rash.

If your baby has especially sensitive skin, avoid commercial diaper wipes that contain alcohol, fragrance, or other chemicals. Some parents keep a squirt bottle or thermos of warm water and cotton balls at the changing table for easy, gentle cleanups.

A mild case of diaper rash should clear up in three or four days if you're diligent about keeping your baby's bottom as dry as possible. If the rash looks as though it may be infected (has blisters or open sores), persists, spreads, or otherwise gets worse, talk with your baby's doctor. She may prescribe an antibiotic for infection or a cream or ointment for the rash. For a diaper rash caused by a yeast infection, your doctor may prescribe a fungal medication to use in the diaper area.

How can I prevent diaper rash?
Here are some good preventive measures:

  • The best defense against diaper rash is a dry bottom, so change your baby's diaper as soon as possible after it becomes wet or soiled.
  • Clean your baby's genital area thoroughly with each diaper change. Pat your baby's skin dry; don't rub it.
  • Coat your baby's bottom with a thin layer of protective ointment. There are several good barrier ointments on the market, including petroleum ointment and white zinc oxide (which is thicker and good for protecting very sensitive skin). It's okay to use plain petroleum jelly as a barrier, but it rubs off easily. Skip the talcum powder , though, as your baby can breathe in the dust and harm his lungs. Cornstarch is a time-honored and safe remedy for treating diaper rash, but its effectiveness is purely anecdotal.
  • When your baby starts solid foods , introduce only one new item at a time, and wait a few days between introductions. That way it'll be easier to determine whether a diaper rash is the result of a food allergy , and you can cut out the offending food from his diet.
  • Don't secure diapers so tightly that there's no room for air to circulate. Clothing must fit somewhat loosely to let your baby's bottom breathe. Avoid airtight fabrics, like tight plastic pants, too.
  • Avoid washing diapers with detergents that contain fragrances, and don't use fabric softeners -- both may irritate your baby's skin. Use hot water and double rinse your baby's diapers. You might also add a half-cup of vinegar to the first rinse water, to eliminate alkaline irritants. If you use disposables , try switching brands to see if that helps.
  • Breastfeed your baby as long as you can. Your baby's urine plus the alkalinity of his stool can cause skin irritation, which may make him more prone to diaper rash. Breastfeeding can be helpful because it lowers the ph of your baby's stool, making it more acidic. Breastfeeding also boosts your baby's resistance to infection, in general, and makes him less likely to need antibiotics, which can also contribute to diaper rash.
 
 
 
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