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What’s in a nappy?

What should my baby’s stools look like?
Your baby’s stools will be sticky and greenish/black at first (called ‘meconium’). They will then change to a yellow or mustard colour which do not smell in a breastfed baby.

Stools of a bottle-fed baby are darker brown and more smelly. Some infant formulas can also make the motions dark green. Breastfed babies have quite runny stools. Bottle-fed babies’ stools are firmer. If you change from breast to bottle feeding you will find the stools become darker and more paste-like.

How often should my baby’s bowels be opened?
Some babies fill their nappies at or around every feed. Some, especially breastfed babies, can go for several days, even a week, without a bowel movement. Both are quite normal. It is usual for babies to strain or even cry when passing a stool. Your baby is not constipated if the stools are soft when passed, even if the bowels have not been opened for a few days.

Is it normal for my baby’s stools to change?
From day to day or week to week, your baby’s stools will probably vary a bit. But if you notice a marked change of any kind, such as the stools becoming any of the following – very smelly, very watery, very pale, or becoming hard, particularly if there’s blood in them – you should talk to your doctor or health visitor.

Nappy changing

Some babies have very delicate skin and need changing the minute they wet themselves if they’re not to get sore and red. Others seem to be tougher and get along fine with a change before or after every feed.

All babies need to be changed when they’re dirty to prevent nappy rash and because they can smell awful!

Getting organised

  • Get everything you need for changing in one place before you start. The best place to change a nappy is on a changing mat or towel on the floor, particularly if you’ve more than one baby. If you sit down you won’t hurt your back and, as your baby gets bigger, he or she can’t wriggle off and hurt him or herself. If you’re using a changing table, keep one hand on your baby at all times.
  • Make sure you’ve a supply of nappies. If you’re using terries, ask a friend or your midwife to show you how to fold and pin them. Experiment to find out what suits you best.
  • You’ll need a supply of cotton wool and a bowl of warm water or baby lotion, or baby wipes.
  • Make sure you’ve a spare set of clothes. In the early weeks you often need to change everything.

Getting started

  • If your baby is dirty, use the nappy to clean off most of it. Then, using the cotton wool, a mild baby soap and warm water, baby lotion or gentle baby wipes, clean girls from front to back to avoid getting germs into the vagina. Boys should be cleaned around the penis and testicles (balls). Don’t pull back the foreskin when cleaning the penis. It’s just as important to clean carefully when you’re changing a wet nappy.
  • You can use a barrier cream, which helps to protect against nappy rash, but it’s usually enough just to leave your baby’s skin clean and dry. Some babies are sensitive to these creams and some thick creams may clog nappies or affect the ability of disposable nappies to absorb wetness.
  • Avoid using baby powder because it can make your baby choke.
  • If you’re using a terry nappy, fold it, put in a nappy liner if you wish, pin it with a proper nappy pin that won’t spring open; or you could use a nappy with velcro fasteners. Then put on or tie on plastic pants.
  • If you’re using disposable nappies, take care not to get water or cream on the sticky tabs as they won’t stick. You can now buy extra tabs to stick disposable nappies (or sticky tape will do).

Nappy hygiene

Put as much of the contents as you can down the toilet. If you’re using terries with disposable liners the liner can be flushed away, but don’t ever flush a nappy down the toilet because you’ll block it.

Disposable nappies can be rolled up and resealed with the tabs. Put them in a plastic bag kept only for nappies, then tie it up and place it in an outside bin.

Terries must be washed and sterilised. You’ll need a plastic bucket with a lid, which must be refilled every day with clean water and sterilising powder made up to the manufacturer’s instructions.

Each nappy must be soaked in the steriliser following the instructions and then a load can be washed every day. Use very hot water and avoid enzyme (bio) washing powders and fabric conditioners, which can irritate your baby’s skin. Make sure the nappies are very well rinsed.

Remember to wash your hands after changing a nappy and before doing anything else in order to avoid infection. It’s worth remembering that the polio virus is passed in a baby’s stools for a month after each polio immunisation. Tell your childminder or babysitter, or anyone else who is likely to change nappies during this time, to be extra careful about washing their hands after changing the nappy and disposing of its contents as there is a very small risk of the virus causing polio in an unimmunised person. They may wish to have a polio booster themselves.

We are indebted to Health Promotion England for their help in compiling this section.