Nailing Nappy Changes

When it comes to changing nappies it's natural to try and get through the task as quickly and efficiently as possible, especially in long day care where you'll be changing nappies and toileting a lot.

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

Developing positive nappy changing and toileting routines is beneficial as they form a significant part of a child's daily routine in care. As well as meeting a child's physical needs, your actions will also help you build a strong and trusting relationship with a child.

Good experiences on the change table will:

• Provide the opportunity to interact with children and engage in simple play activities
• Teach children about daily routine and cause and effect
• Provide an early opportunity to teach children about self-care through demonstration
• Lead to sharing a sense of achievement gained through learning new skills like washing their hands and dressing themselves

Remember, maintaining correct nappy changing procedures is an important part of the licensing criteria for early childhood services and the Department of Education requires providers to undertake safe and hygienic practices while ensuring children are treated with dignity and respect.

Health, hygiene and safety

Supporting children's health and safety by ensuring nappy change practices are hygienic is an important aspect of high-quality childcare. 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 and the change table with a surface which can be cleaned thoroughly after each change. There should 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, childproof cupboard may be the best way to store these items.

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

Many early childhood centres use a step to enable children to climb up onto a change table which promotes autonomy and also saves educators 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 early childhood education and care professionals can work to ensure toileting and nappy change experiences are positive for children.

The Department of Education encourages a service to apply Te Whariki when reviewing its nappy changing procedure and consider:

• How children can be empowered and involved in the nappy change routine
• How independence can be encouraged
• How reciprocal and responsive relationships can be fostered, through activities such as talking to children about what is happening
• Slowing down and allowing children to take their time so they feel relaxed

In addition, it can help to:

• Use correct vocabulary to describe words associated with nappy changing and toileting
• Allow children to be active participants in the process and encouraging them to help where it is age appropriate
• Be sensitive to the different needs and abilities of children and where possible make small changes to the routine to take these needs into account
• Change nappies when they need to be changed and encourage children to communicate when they need a change
• Talk 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
• Focus on making nappy changes a positive experience for the child by taking into account their comfort and feelings while doing the change
• Encourage families to dress children in clothes which facilitate quick and easy nappy changes
• Refrain from showing displeasure or negativity towards a child who has a dirty nappy

Creating an effective space

Making sure the nappy changing environment is pleasant, well set up, and accessible will have a significant impact on the overall success of nappy changing in your service. Considering how much time educators spend changing nappies, it is worth investing a little time and effort to create a practical 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 children 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 educators 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 children 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 children and will hopefully make it a more bearable experience for the person responsible for doing it too!
 

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References
Positive toileting and nappy changing - Anne Stonehouse
Nga Kupu Oranga Healthy Messages - Department of Education