DiaperingandToiletingUsediaperchangingasatimeforrelaxed,one-on-oneinteractionwithchildren.

Don'tcommunicatedisgustordisapproval.Handlechildrengentlyasyougoaboutcleaningthemupanddiaperingthem.Talktothechildconstantly.Thereshouldbelotsofeyecontact,smiles,andsocialgames.Pleasantandstimulatingdiaperchangingtimesareespeciallyimportantforyoungerinfants,whoserangeofactivitiesissolimited.

1Healthy Practices: Nutrition and Fitness

DiaperingandToiletingDiaperRash

Germslovewarm,damp,darkplaces,andthereisnoplacewarmer,damper,anddarkerthanasoileddiaper.Youngchildrenindiapersaresubjecttobacterialrashesandyeastinfections,whichlookterribleandarepainfulforthechild. Ifayoungchild'sbottomisstartingtolookirritated,thereareanumberofstepsyoucantaketoclearuptheinfection.

2Healthy Practices: Nutrition and Fitness

DiaperingandToiletingDiaperRash

Keeptheareaasdryaspossible.Changethechildfrequently,cleanthoroughly,andletthebottomdrybeforeputtingonanewdiaper.Iftheparentsgivewrittenauthorization,youcanuseanointmentontheredareatoformamoisturebarrierfortheskin.Iftheconditionpersists,theparentsmayneedtogetaprescriptionantibiotictoclearuptheinfection.

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DiaperingandToiletingDocumentingDiaperChanges

Mostinfantroomcaregiversmarkdiaperchangesonachart.Chartingisausefultool,althoughitisnotrequired.

Therearemanyadvantagestochartinginfants'routineactivitiesthroughoutthedayincludingtheirsleepschedule,diaperchanges,andfeedingtimes.

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DiaperingandToiletingDocumentingDiaperChanges

Chartsarehelpfulto:• Informparentsabouttheirchild'sdayandactivities• Serveasamemoryaidforstaffaboutwhenan

infantwaslastchangedorfed• Providestaffinformationaboutchangesininfant's

routinebehavior,whichmayindicatetheyaresickornotfeelingwell

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DiaperingandToileting

Toileting

Waitforchildren'sphysicaldevelopmentandforthemtodecidetousethetoiletlikethe"bigkids".Thedecisiontostartencouragingachildtousethetoiletshouldoccurwiththechild'sparents.

Basedontheirknowledgeofchildren'shabits,caregiverscanscheduleregulartripstothetoilet.

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DiaperingandToileting

Toileting

Praisechildrenwhentheyhaveasuccessful"event",butdonotcriticizethemifnothinghappensorinsisttheysitlonger.

Helpwipechildrenaftertheyusethetoiletandthenassisttheminwashingtheirhands.

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DiaperingandToiletingEncouragechildrentodecideforthemselveswhethertheyneedtousethebathroom.

Scheduleregularremindersforbathroomtimesduringtheday.Ifyouorparentsexpectchildrentostartusingthetoiletbythemselves,itisimportantthatchildrenweartrainingpantsratherthandiapersorpull-ups.

Theyshouldalsowearclothingthattheycanpulldownandpullupthemselves.Thismakesitphysicallypossibleforthemtosuccessfullyusethetoilet.Italsopromotesindependence,self-confidenceandself-esteem.

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DiaperingandToiletingToilet training must be initiated in consultation with parents:

• Usingpositivereinforcement• Culturalsensitivity• Notusingfoodsasareinforcement• Followingaroutineestablishedbetweentheparentandyou

9Healthy Practices: Nutrition and Fitness

DiaperingandToileting

Diaperingandtheuseofpottychairscarrydistinctriskstothechildcareenvironment.Sincethechangingareaisoneoftheplaceswheregermswhichcausediseasearemostlikelytoliveandspread,theseactivitiesmustbehandledwithextremecareandattentiontosanitation.

10Healthy Practices: Nutrition and Fitness

DiaperingandToileting

Youshouldneverwashorrinsediapersorclothessoiledwithstoolinthechildcaresetting.Becauseoftheriskofsplashingandgrosscontaminationofhands,sinks,andbathroomsurfaces,rinsingincreasestheriskthatyou,otherprovidersandthechildrenwouldbeexposedtogermsthatcauseinfection.

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DiaperingandToileting

Allsoiledclothingshouldbeputinaplasticbag,securelyclosed,andsenthomewiththechildwithoutrinsing.(Youmaydumpsolidstoolintoatoilet.)Youneedtotellparentsaboutthisprocedureandwhyitisimportant.Theyoftenrequestthatdiapersandtrainingpantsberinsedouttoavoidstaining.

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ImportantRulesAboutDiapering• Usetheareaonlyfordiapering.• Setupthediaperingareaasfaraspossiblefromanyfoodhandlingarea.• Providerunningwatersohandscanbewashedimmediatelyafteradiaperischanged.• Constructadiaperingsurfacewhichisflat,safeandpreferablyatleastthreefeetabovethefloor.• Besurethissurfaceisclean,waterproofandfreeofcracksandcrevices.Coveritwithadisposable

cover.Usecheapmaterialssuchaspaperbags,usedcomputerpaper(onthe“wrong”side),rollsofpaper,etc.,orbuydisposablesquaresfromdiscountmedicalsupplycompanies.

• Keepallcreams,lotionsandcleaningitemsoutofreachofchildren.• Nevergiveachildanyofthesetoplaywithwhilebeingdiaperedsinceshe/hecouldbepoisoned.• Useaguardrailorrecessedareaasanextrasafetymeasure.• Alwayskeepahandonthechild.

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Stepswhenchangingadiaper:1. Washhands.2. Gathernecessarymaterial.3. Putdisposableglovesonhands.4. Placechildgentlyontableandremovediaper.5. Disposeofdiaperinahands-freegarbagecanwithalid.6. Cleanthechild’sdiaperareafromfronttoback,usingaclean,dampwipeforeachwipe.7. Applytopicalcream/ointment/lotionwhenwrittenconsentisonfile.8. Removegloves.9. Washhandsorusewetwipe(ifnofecalmatteronhands).10. Putoncleandiaperanddressthechild.11. Washchild’shandswithsoapandrunningwaterorwithwetwipeanddryhandswithpapertowel.12. Placechildinsafeplace.13. Cleananddisinfectdiaperingareaandanyequipmenttouched.14. Washhands.Eachdiaperchangingareaisrequiredtohavepostedinstructionsonthisprocedure.

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ImportantRulesAboutDiapering

NEVERLEAVETHECHILDUNATTENDED

EVENFORASECOND

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