By Jan Murray

Sometimes awkward, frequently smelly and always necessary, changing bubs nappy is a task many new parents approach with some apprehension or even repulsion. Remember though, if you don’t get it right the first time there will always be another time to perfect the skill!

When changing bubs nappy you will need to choose a change area that is stable, big enough to lay bub flat and preferably at a height that doesn’t require you to bend down too low. Back pain from strained ligaments is common in parents who bend and stoop day in and day out. Whether you choose disposable nappies or cloth varieties with absorbable inserts, bub will need to be changed every three to four hours during the day and four to six hours overnight. Change times will however be influenced by bubs sleeping habits as you wouldn’t wake them to do it.

The stimulation of a nappy change helps newborns complete a feed as they often doze off before they have had enough to drink. Changing newborns about ten minutes into a feed can give their tummy a chance to settle and offers that added burst of alertness to complete the feed. Babies who suffer Gastric oesophageal reflux pain also benefit from a nappy change while having only a half full tummy.

When to Change a Nappy:

Definitely change bubs nappy as soon as an off odour fills the room or when you notice a brown/yellow substance rising over the back of his nappy or oozing out the sides of his nappy and down his leg or when you hear a mighty explosion and sense the warmth in your lap during a feed. A new nappy is always welcomed after a bath or a massage or first thing in the morning when the nappy bub is wearing is so heavy it hangs around his knees.    

How to Change a Nappy:

Before you start to change bubs nappy, lay out a change mat or go to the changing area in your home. Open out a disposable bag for dirties and have some wipes, cotton balls, water and a new nappy handy. Have available other creams as required.

Boys:

When wiping baby boys, gently lift up the scrotum and wipe. Baby boys, who are not circumcised, do not need to have the foreskin pulled back to clean the tip of the penis. This can cause harm and regular bathing will be enough to keep this area clean.

Girls:

A baby girl’s genital area is delicate and does not need to be wiped deep into the inner folds. The white substance (Smegma) in this area is a natural lubricant which stays there - it doesn’t need to be wiped away. Gently hold the labial folds apart and wipe the area in a downwards direction to avoid urinary infections from faecal contamination wiped into a little girls short urethra.

Avoid Nappy Rash:

Urine and faeces contains chemicals that transform into ammonia over time. When this ammonia is left in contact with bubs skin for long periods it can burn and even blister her sensitive skin. At times when bub is ill, teething or has ingested foods high in acid her skin may burn faster. Have you ever opened bubs nappy and been faced with a bright red, moist and shiny genital area and like most parents, felt responsible and guilty for her damaged skin? Don’t panic - nappy rash can disappear as suddenly as it appears when the right healing measures are taken. It’s when leaving the excoriated area unattended that secondary infections and spreading develops.

Help bub’s red bottom heal by increasing the frequency of her nappy changes. Change every two to three hours (providing she is awake) during the day and whenever she wakes overnight. Wipe the genital area with soft wipes or cotton wool balls wet with normal saline or warm boiled water with a little added sea salt. If nappy rash is severe don’t even wipe just use splashes of warmed salty wash. Air-dry the genital area for about 10 minutes while bub is lying on the change mat and move her into the sunlight for sun-kicks a couple of times a day (before 10am and after 3pm is the safest sun). Before you put her nappy back on apply barrier cream. There are many suitable brands of barrier creams available on the market - choose one with no fragrance or mineral base as these can do further harm.

Babies are prone to developing nappy rash in hot weather and when they wear non-breathable polyester outer layers. An airless, warm and moist environment is perfect for Candida Albicans fungus, better known as Thrush to thrive. A nappy rash infected with thrush will not clear with regular cleansing and barrier creams, in fact, it will often spread onto bubs tummy and bottom in bright red patches. A thrush nappy rash can also become infected with bacteria. Seek professional advice if your bub has nappy rash that doesn’t heal with regular washing, airing and barrier creams within a few days.

This information is of a general nature and does not take the place of individual professional help.

More detailed information about caring for a newborn can be found in ‘mum & baby together we learn’