Promoting positive nappy changingPromoting Positive Nappy Changing

When it comes to nappy changing it's natural to want to get through the task as quickly and efficiently as possible, especially in long day care where chances are you'll be toileting and nappy changing a lot!

However, pause and think for a moment, toilet breaks and nappy change times are a great opportunity to teach kids about hygiene, promote learning and spend time interacting one-on-one with a child away from the group.

It's important to develop positive nappy changing and toileting routines as they form a significant part of a child's daily routine in care. As well as meeting a child's physical needs when you help with them toileting or change a nappy your actions will also help you build a strong and trusting relationship with a child.

Good experiences on the change table will:
  • Give you the opportunity to interact with children and engage in simple play activities such as singing and rhyme games.
  • Help you teach children about daily routine and cause and effect.
  • Give you an early opportunity to teach children about self care, through showing them how to hand wash and dress themselves and by sharing with them the sense of achievement gained through learning these skills.
It is also important to remember that the way that child care professionals react to soiled or wet nappies, toileting needs and accidents give children powerful messages about themselves and their bodies.

Health, hygiene and safety
Supporting children's health and safety by ensuring nappy change practices are hygienic is an important aspect of high quality child care. Health and hygiene policies and practices should be regularly reviewed and kept in line with government standards.

Reminders about policies on hand washing and waste disposal should be displayed around the change and toilet areas to act as a constant reminder for staff.

Nappy changing
Nappies should be changed in a designated area(s) and the change table should have a surface which can be cleaned thoroughly after each change. There should also be a sink nearby so adults and children can wash their hands after a change.

Nappies and change supplies such as wipes, creams and plastic bags should be within arm's reach of adults but inaccessible to children.  A high, child proof cupboard may be the best way to store these items.

To minimise the chances of children falling off the change table carers must keep one hand on the child at all times during nappy changing. A safety harness should be used if available.

Many child care centres use a step to enable children to climb up onto a change table which promotes autonomy and also saves carers the job of lifting every time an older child needs a nappy change. This is an effective system but children need to be supervised and supported when they are using the steps and the steps should be moved or the changing room door closed to prevent intrepid youngsters from using the steps when there is no adult present.

Supporting children during nappy changes
By consistently applying a range of practical strategies child care professionals can work to ensure toileting and nappy change experiences are positive for kids. These include:
  • Slowing down and allowing children to take their time so they feel relaxed.
  • Using correct vocabulary to describe words associated with nappy changing and toileting.
  • Allowing children to be active participants in the process and encouraging them to help where it is age appropriate.
  • Being sensitive to the different needs of kids and where possible making small changes to the nappy change routine to take into account these needs.
  • Changing nappies when they need to be changed rather than just at set times and encouraging children to communicate when they need a change. 
  • Talking with children while changing the nappy using correct vocabulary and respectful language; communicating with children during the process helps them understand what is going on and what will happen next.
  • Focusing on making a nappy change time a positive experience for the child by taking into account their comfort and feelings while doing the change.
  • Encouraging families to dress children in clothes which facilitate quick and easy nappy changes.
  • Never showing displeasure or negativity towards a child who has a dirty nappy, no matter how smelly or messy it is.
Creating an effective space
Ensuring the environment you conduct nappy changing is pleasant, well set up and accessible will have a significant impact on the success of nappy changing. Considering how much time child care professionals spend changing nappies it is worth investing a little time and effort to create a great space.

Consider the following aspects when assessing the effectiveness of your change area:
  • Is the nappy change area positioned to enable adults to continue supervising other children if they need to?
  • Is all the equipment associated with nappy changing easy to keep clean, maintained to a high standard and replaced when worn?
  • Is the change mat big enough for the biggest kids to lie on and comfortable?
  • Is the environment attractive and odour free and pleasant for children and adults to be in?
  • Are all the supplies topped up, easily accessible to adults and out of the reach of the children?
  • Are the sinks easily accessible (both adult and child size) with plenty of soap and water set at a good temperature?
While nappy changing might be one of those jobs child care professionals just want to get done so they can move onto something more pleasant, focusing on making some small improvements to the nappy change routine can significantly enhance a child's experience in care. Nappy changing is a great opportunity for some one-on-one bonding and offers experiences to teach kids about self awareness and self care. Working on making the nappy changing in your service the best it can be will ensure it is a positive experience for kids and will hopefully make it a more bearable experience for the child care professionals too!

Source: Positive toileting and nappy changing by Anne Stonehouse®
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