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Two different diaper changing methods may be used to minimize the risk of transmitting infection from one child to another or to a provider. One method involves the use of gloves and the other does not. The method you select should be used consistently in your child care setting. Whichever method you choose, you should never wash or rinse diapers or clothes soiled with fecal material in the child care setting. Because of the risk of splashing, and gross contamination of hands, sinks, and bathroom surfaces, rinsing increases the risk that you, other providers, and the children would be exposed to germs that cause infection. All soiled clothing should be bagged and sent home with the child without rinsing. (You may dump solid feces into a toilet.) You need to tell parents about this procedure and why it is important.

The following recommended procedure notes additional steps to be included when using gloves. Gloves are not required, but some people prefer to use gloves to prevent fecal material from getting under their nails. Child care providers should keep their fingernails short, groomed, and clean. Using a soft nail brush to clean under the nails during handwashing will remove soil under the nails. Always maintain a pleasant attitude while changing a child’s diaper. Never show disgust or scold a child who has had a loose stool.

Recommended Procedure for Diapering a Child

  1. Organize needed supplies within reach:
    • fresh diaper and clean clothes (if necessary)
    • dampened paper towels or premoistened towelettes for cleaning child's bottom
    • child's personal, labeled, ointment (if provided by parents)
    • trash disposal bag
  2. Place a disposable covering (such as roll paper) on the portion of the diapering table where you will place the child's bottom. Diapering surfaces should be smooth, nonabsorbent, and easy to clean. Don't use areas that come in close contact with children during play, such as couches, floor areas where children play, etc.
  3. If using gloves, put them on now.
  4. Using only your hands, pick up and hold the child away from your body. Don't cradle the child in your arms and risk soiling your clothing.
  5. Lay the child on the paper or towel.
  6. Remove soiled diaper (and soiled clothes).
  7. Put disposable diapers in a plastic-lined trash receptacle.
  8. Put soiled reusable diaper and/or soiled clothes WITHOUT RINSING in a plastic bag to give to parents.
  9. Clean child's bottom with a premoistened disposable towelette or a dampened, single-use, disposable towel.
  10. Place the soiled towelette or towel in a plastic-lined trash receptacle.
  11. If the child needs a more thorough washing, use soap, running water, and paper towels.
  12. Remove the disposable covering from beneath the child. Discard it in a plastic-lined receptacle.
  13. If you are wearing gloves, remove and dispose of them now in a plastic-lined receptacle.
  14. Wash your hands. NOTE: The diapering table should be next to a sink with running water so that you can wash your hands without leaving the diapered child unattended. However, if a sink is not within reach of the diapering table, don’t leave the child unattended on the diapering table to go to a sink; wipe your hands with a premoistened towelette instead. NEVER leave a child alone on the diapering table.
  15. Wash the child's hands under running water.
  16. Diaper and dress the child.
  17. Disinfect the diapering surface immediately after you finish diapering the child. (See section on “Cleaning and Disinfection” later in this chapter.)
  18. Return the child to the activity area.
  19. Clean and disinfect:
    • The diapering area,
    • all equipment or supplies that were touched, and
    • soiled crib or cot, if needed.
  20. Wash your hands under running water.
Note: This information is not intended to take the place of your state's or locality's child care regulations and laws. In every case, the laws and regulations of the city, county, and state in which the child care facility is located must be carefully followed even if they differ from these recommendations.

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