Changing a nappy.

Before you start

Get everything within arm's reach first — clean nappy, cotton wool or a soft cloth, clean warm water, a towel, a change of clothes, and a bag for the dirty one. Never leave your baby alone on a raised surface, not even for a second. Newborns roll sooner than anyone expects them to. If you have to walk away, take the baby with you or put them on the floor.

1. Set up first Clean nappy, cotton wool or cloth, warm water, towel, spare clothes. Within reach, before you start.
2. Wash your hands Before and after. Every single change.
3. Open and lift Hold both ankles in one hand and lift gently, never yank the legs. Use the front of the old nappy to wipe the worst away, then fold it under.
4. Clean front to back Always, for boys and girls. It keeps stool away from the urinary opening. For girls do not open or clean inside the labia; for boys do not pull the foreskin back.
5. Dry completely The step everybody skips. A nappy going on damp skin is how rash starts. Pat dry, then give a minute of air if you can.
6. New nappy on, snug not tight Two fingers should slide under the waistband. If the cord stump is still on, fold the waistband down below it.

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Preventing nappy rash

Nappy rash is caused by skin sitting against wet. Almost everything that prevents it comes down to less time wet and more time dry.

• Change often: a newborn may need it every two to three hours, and straight after any stool.
• Dry properly before the new nappy goes on. Pat, do not rub.
• Air time. A few minutes on a towel with no nappy at all, once or twice a day, does more than any cream.
• A barrier cream: zinc oxide or petroleum jelly, on clean dry skin if the area gets red.
• Plain water and cotton wool for newborns. If you use wipes, choose fragrance-free and alcohol-free ones.
• Avoid talcum powder. It cakes in the creases and babies can breathe it in.

What the nappy tells you in the first week

Nappies are the main way you know feeding is going well, which is why the ward asks about them constantly.

Breastfed babies may stool at every feed or, after the first weeks, go several days without one — soft stool when it comes is what matters, not the frequency. A brick-red or orange dust in the nappy in the first days is usually urate crystals and is common, but tell us if it continues past day three.

Common questions