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Babies need frequent nappy changes, but how often they need changing depends on how sensitive their skin is.
Some babies have very delicate skin and need changing as soon as their nappy is wet, otherwise their skin becomes sore and red. Other babies can wait to be changed until before or after every feed.
All babies need changing as soon as possible when they’ve done a poo (stool) to prevent nappy rash. Young babies need to be changed as many as 10 or 12 times a day, while older babies need to be changed at least 6 to 8 times.
Before you change your baby’s nappy, wash your hands and get everything you need in one place, including:
- A changing mat or towel
- Cotton wool and a bowl of warm water or fragrance and alcohol-free baby wipes
- A plastic bag or bucket for the dirty nappy and dirty cotton wool or wipes
- Barrier cream to protect your baby’s skin
- A clean nappy (and liner and cover if you’re using cloth nappies)
- Clean clothes
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 help another child for a moment, your baby can’t fall. It’s best done sitting down so you don’t hurt your back.
If you’re using a changing table, keep an eye on your baby at all times. You shouldn’t rely on the straps to keep your baby secure. Never walk away or turn your back.
Older babies may try to wriggle away when you’re changing them. You could give them a toy or use a mobile to distract them.
It’s just as important to clean your baby fully whether they have wet themselves or done a poo.
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 cotton wool and plain warm water (or baby wipes) to remove the rest and get your baby clean.
Clean the whole nappy area gently but thoroughly and make sure you clean inside the folds of skin. Girls should be cleaned from front to back to avoid getting germs into their vagina. Boys should be cleaned around the testicles (balls) and penis, but there’s no need to pull back their foreskin.
If it’s warm enough, let your baby lie on the changing mat without a nappy on for a while. Wearing a nappy all the time makes nappy rash more likely.
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. If you’re using cloth nappies, put in a nappy liner and then fasten the nappy. Adjust it to fit snugly around the waist and legs.
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.
Try not to show any disgust at what’s in their nappy. You don’t want your baby to learn that doing a poo is something unpleasant or negative.
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 don’t have to be soaked before they’re washed, but you may choose to soak them to help get the stains off. Check the washing instructions first. Cloth nappies can be machine washed at 60C, or you could use a local nappy laundry service.
There’s no evidence that using washing powders with enzymes (bio powders) or fabric conditioners will irritate your baby’s skin.
Wash nappies that are dirty with poo separately from your other washing. You’ll probably have enough nappies to make up a full load anyway.
To avoid infection, wash your hands after changing a nappy before you do anything else. If your baby is old enough, they can wash their hands with you as it’s a good habit to get into.
Your baby’s first poo is called meconium. This is sticky and greenish-black. Some babies may do this kind of poo during or after birth, or sometime in the first 48 hours.
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 your baby’s poos become darker and more paste-like.
If you have a girl, you may see a white discharge on her nappy for a few days after birth. It’s caused by hormones that have crossed the placenta to your baby, but these will soon disappear from her system. These hormones can occasionally cause slight bleeding like a mini period, but in both cases it’s nothing to worry about.
In the first 6 weeks after the early days, babies should poo 1-2 times a day, larger than a £2 coin,
It’s normal for babies to strain or even cry when doing a poo. Your baby isn’t constipated as long as their poos are soft, even if they haven’t done 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 definite 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.
If you suspect your baby may be constipated you can find out how to help give relief here.
If your baby’s poos look pale, this can be a sign of liver disease. Speak to your health visitor or GP if you notice this.
Definition: Constipation is a decrease in the frequency of bowel movements; characterised by the passing of hardened stools which may be large and associated with straining and pain.
Breastfed babies are rarely constipated as breast milk is almost 100% completely digested and utilied by baby’s growing body. Breast milk leaves little “leftovers” to cause constipation. Many breastfed babies do have infrequent bowel movements however this does not mean that they are constipated.
Formula fed babies may have constipation more often than breastfed babies. Unlike breast milk, formula is not as easily digested nor is it as completely absorbed and used by a baby’s body.
Infant constipation isn’t common. However, your baby might have infant constipation if he or she has hard or pellet-like bowel movements or bowel movements that appear difficult to pass, causing your baby to arch his or her back or cry. Or infrequent or less frequent bowel movement.
If your newborn seems constipated, contact your Health Visitor or GP for advice. Keep in mind that the normal amount of bowel movements an infant passes varies depending on his or her age and what he or she is eating. Infants also have weak abdominal muscles and often strain during bowel movements. Infant constipation is unlikely if your baby passes a soft bowel movement after a few minutes of straining. Infant constipation often begins when a baby starts eating solid foods.
Faecal impaction may be possible if there is:
- A history of severe symptoms of constipation.
- Overflow soiling.
- A faecal mass palpable on abdominal examination.
You can help relieve constipation in infants with:
- A warm bath
- Bicycle legs: place your baby on her back and lightly hold her legs in a half-bent position. Gently begin to move your baby’s legs as if she is riding a bicycle.
- Tummy massage: Gently massage and rub baby’s tummy in a clockwise direction. Place your hands at baby’s navel and massage in a circular motion, moving your hand(s) out and away from the centre of baby’s belly.
Disposable and cloth nappies come in a range of shapes and sizes. The choice might be confusing at first, but with trial and error, you will be able to work out which nappies suit your baby best as they grow.
Disposable and cloth nappies have different pros and cons, so you will need to consider things like cost, convenience and the impact on the environment when you choose what to buy. For example, disposable nappies are very handy, but washable cloth nappies work out cheaper if you add up the costs over the years your baby is in nappies.
Some cloth nappy brands and local councils offer free samples for you to try out. If you use cloth nappies, you may want to sign up for a nappy laundry service that will take away the dirty nappies and deliver a fresh batch each week. You can also hire washable nappies.