elevating child care

How To Love A Diaper Change

Call me sensitive, but I once saw a diaper change that made me cry. In fact, I can cry just thinking about it. It was a scene from a film about the The Pikler Institute, the highly respected orphanage in Budapest, Hungary, founded by pediatrician and infant expert Dr. Emmi Pikler. The camera focuses on a 3-week-old new arrival being welcomed with a diaper change. We hear the caregiver speaking slowly and see her gentle touches. The subtitles read, “Now I will lift your legs. I will move the diaper under you”.  She pauses after she explains each action, giving the infant a few moments to respond and anticipate what will happen next.  Several minutes later, the delicate task completed, the caregiver says quietly to the tiny, trusting person, “I think you will like it here.” 

Diaper changes are built for intimacy. And all we need to turn diapering from a difficult, dreaded chore into a mutually gratifying experience is to change our perception, to appreciate the moment as an opportunity for developing a closer partnership with our child. Remembering to slow down, to include our baby instead of distracting him, ask for his assistance, use gentle “asking hands” instead of busy, efficient ones can literally transform a mundane task into a time of mutual enrichment. 

It will not always be easy. Toddlers test. That’s what they are supposed to do. A toddler has failed if he makes life too easy for us. Here are some ideas for making the most of diaper changes with our infants and toddlers: 

Set the tone with a respectful beginning. I’m amazed when parents stop a child in his tracks to open the back of his pants without warning, or say, “Ew, smelly! Someone needs a diaper change!” It’s all I can do to refrain from asking, “Would you like to be treated that way? If you passed gas in public would we be waving our hands, holding our noses and grabbing at your pants?” 

Children don’t like to be interrupted when they are playing, and most diaper changes can be postponed until there is a lull in an infant or toddler’s activity. Wait for a break in your child’s play and then say discreetly, “Please let me check your diaper now”.  Then, “We’re going to change your diaper.” If the child walks, you might give the option, “Would you like to walk to the changing table or shall I carry you?” If he resists, you may be able to give him the choice of a bit more time. “I see you’re still playing. In five minutes we will change your diaper.”Toddlers crave autonomy and are more amenable to cooperation when we respect their need to make some decisions. 

Give undivided, unplugged attention. Embrace this time together, and your baby will, too.  Release yourself from other concerns to focus for these few minutes on your child. Slow down. Even the youngest infants sense our hurry or distraction, and it makes them tense and resistant, rather than willing participants. Our slow, gentle touch breeds trust. 

If the child seems distracted, acknowledge it and wait. “You hear that loud siren. I hear it, too. Now, it seems to have passed. Are you ready for me to unsnap your pajama?” Or, “You’re crying. Did I lie you down too quickly? Do you need me to hold you for a moment before we start? 

Ask for your baby’s assistance. Remind yourself to pay attention to the whole person, not just his lower half. Don’t do anything without telling him first. Not only are we treating him with respect by telling him what is happening, we are encouraging him to absorb language with all his senses (the cold wipes, the sound of the snaps on his pajamas). 

You will find joy in your baby’s responsiveness. He soon shows you he can place his hands through a sleeve, contract his abdominal muscles to help you lift his bottom, hold the diaper and the diaper cream. When diapering time is finished and we ask, “Are you ready for me to pick you up?” our baby will learn to extend his arms to us in reply. Surprisingly, even the youngest infants respond when we ask to pick them up by preparing their muscles for a change in altitude and position. 

Be flexible. Stay open to new possibilities. When infants become mobile, they need us to adjust to their needs as best we can. A baby might wish to roll to his tummy to be wiped, or be in an all fours crawling position. The toddler may need to stand and be changed on a pad on the floor.  Continue to ask for cooperation, but compromise and allow the child to do things his way if you can make it work.   

Imagine new ways your child might be able to be more participatory. Invite him to wipe himself, put on his own cream, take his diaper on or off. Children of all ages want to be trusted to do things for themselves whenever possible. If you keep your mind open to all the possibilities, you will be surprised by all your baby can do. 

Remember, your goal is partnership. Are all diaper changes smooth and easy? No way! A securely attached child tests us…often.  Sometimes we start off on the wrong foot, the baby is too tired (or we are) and the whole thing is a disastrous mess. Forget about feeling connected — we may not even like our baby in that moment.  These are normal bumps in the road. Best to embrace those, too, and acknowledge to our child, “Wow, that was a tough one together, wasn’t it?” 

As Ruth Anne Hammond explains in her insightful new book, Respecting Babies: A New Look At Magda Gerber’s RIE Approach, “If [a parent] is usually slow, gentle, and attentive, an occasional lapse is emotionally manageable for the child, and may even be helpful in the process of learning that her parent is human.“ 

Diapering is not just about getting a job done, or having a clean baby. Our hands are a baby’s introduction to the world. If they touch slowly, gently, and “ask” a child for cooperation rather than demand it, we are rewarded with a relationship bound in trust, respect and the inexorable knowledge of our importance to each other. 

“One generally finds that infants are the most content and cheerful in the hands of mothers who move with ceremonious slowness.” –Dr. Emmi Pikler

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43 Responses to “How To Love A Diaper Change”

  1. avatar The Mama says:

    This is a tough one. I’ve really been working on it though. Thanks so much for the tips!!!

    • avatar janet says:

      Hi Mama!

      There will be rough patches. Hang in there and keep acknowledging the difficulties, rather than resorting to distraction to get things done. Tell your baby that you are counting on him (her?) to help. It will make you feel more connected and honest, even if it’s not always fun.

      Sometimes, if diapering hasn’t been going well, the child feels our dread before we even start. Try to let go of the past and start fresh and positive about the experience each time. And then, just let it be what it is. Don’t worry or get disappointed if it doesn’t go well!

      Please keep me posted!

  2. avatar Roseann Murphy says:

    What a beautiful representation of the diaper changing technique! I can picture the routine. Thank you for focusing on participation rather than distraction. Thank you for mentioning the embarassing actions sometimes used to bring attention to the need for diaper change.
    As parents it is so easy to forget how it feels to have something “done to you” rather than to be an active participant.

    I look forward to each and every one of these articles. They are informative, supportive and filled with love.

    Using this routine is a loving interchange between the child and the parent. Thank you again.

  3. avatar Joyce LaRonde says:

    Actually, my LO did once draw attention to my “breaking wind”. She started coughing, fanning her nose, and said, “Ewie, mommy! Stinky.” My in-laws were thrilled…

    • avatar janet says:

      Yes, we can count on children to be wonderfully authentic, can’t we?

  4. I know exactly what you are saying! The first time I went to the Pikler Institute in 2004 I was blown away by the care and respect that adults showed to the children. The next time I went back in 2006 I was lucky enough to purchase the Bathing the Baby DVD and book and every time I see the opening sequence it brings tears to my eyes as the care and respect shown for this infant is so strong, yet so gentle.
    I’ve been working on videoing diapering sequences here in New Zealand with my colleagues and we are learning so much from the experience.
    Thank you for writing such a great blog. I look forward to meeting you next month at the RIE Conference.
    Katherine Bussey

    • avatar janet says:

      Hi Katherine!

      Thanks! Great to get your shout-out from New Zealand. Funny, because none of the longterm RIE associates that I spoke to could remember which video included the diapering sequence I was talking about. We all saw it so many years ago. Is it in Bathing the Baby?

      I would love to see your videos sometime. And I can’t wait to meet you at the RIE Conference!

  5. I think the one you are talking about probably comes from Lóczy, a place to grow. The documentary by Bernard Martino. Is it the scene where the brand new baby comes to the Institute and is very upset and stressed and the way in which the nurse cares for the baby is so caring and sensitive and it reminded me like she is surrounding the baby with protection and is so welcoming.
    Bathing the Baby is another video. It is SUCH a heart-warming video to watch. Have you seen it before? If not let me know and I will bring it with me to the States. I am going to be visiting for a couple of months while I do PITC training.
    Polly has talked about the fantastic work you are doing and I look forward to meeting you too!

  6. avatar Jamie says:

    Since birth, we have done narrated diaper changes with our girl. Now she is 11 months old and diaper changes have become a battle as she wants to roll, wiggle, crawl, etc rather than do the change. Distraction doesn’t help for very long and I feel wrong doing it. I hadn’t thought to ask her to help me and I will try that later today. Are there other suggestions for an extremely mobile baby?

    • avatar janet says:

      Jamie, it sounds like your daughter is right on schedule. Wouldn’t it be odd to have total compliance from a baby who is (as she should be) excited about developing motor skills and a will of her own?

      Adapt to her need to move as much as possible, but also ask for cooperation and give choices when you can, i.e., “Would you like me to wipe you lying on your back or in your crawlling position?” “Hmmm… you want to move, but I need you to stay still to put your diaper on. Can you do that yourself? Well then, I will have to hold you. Sorry, I know you don’t like that.” Be flexible to a point, but don’t be afraid to be firm (before you even get close to losing your temper). Getting upset or annoyed will make things worse and might make testing more interesting for her. “You are wanting to stand. Okay, let’s try putting the diaper on while you are standing” (If she has a safe way to pull up).

      Unfortunately, the days of simple diaper changes are gone, at least for a while, but the important thing is to stay in relationship with your daughter, not distract her. Let it be whatever it is…. “Whoa, that was a struggle! Not so fun today.” Don’t worry if your daughter cries, or doesn’t seem to enjoy the process. Whether the diaper change is easy or difficult, it is always a valuable, relationship building experience. Remember, it is a toddler’s job to resist, and this is only the beginning. Accept it. Embrace it. Enjoy(!) it.

  7. avatar Nev says:

    This is interesting. Thank you for this article. :)

    90% of nappy changes in our house involve singing, talking, asking to move here/up/etc. We’ve always been aware not to make a disgusted face or a stern face that suggests we’d rather do anything else (This is what we did anyway and then we read about it in Why Love Matters and it validated what we did).

    At almost 9 months nappy changes suddenly have turned into tearful events and we’re not sure why that is. Nothing much has changed, she just got older. Any hints, ideas, questions would be greatly appreciated.

    Nev :)

    • avatar janet says:

      Hi Nev! It’s typical for babies to begin to resist diaper changes when they are excited about their developing motor skills and also becoming more independent. This is healthy! In fact, an infant who continued to be placidly compliant during diaper might be a concern. So, knowing that our babies want and need to be participants rather than have things “done” to them, we have to continue to find new ways to include them and also stay flexible (but still engaged) when they resist. Please check out this discussion thread in the community section (I love the title): Diaper Change Time is Chaos http://janetlansbury.com/community/topic.php?id=84

  8. avatar Ayu says:

    I was visiting my workplace (a day care)during my maternity leave with my 3 month old baby when she needed her nappy changed. After telling her, I put her down on the changing table and immediately she spotted the dangling mobile on the ceiling. She had never seen one until that day and it was as if she was hypnotised. I waited for a bit before telling her what I was going to do, but she kept staring at the mobile, passively letting me change her. Usually she would smile and respond to me. It just goes to show that distraction might work, but it isn’t partnership. I wonder what they’d do if I took that mobile away…

    • avatar janet says:

      Ayu, wonderful insight…thanks so much for sharing! A colleague (Lisa Sunbury) and I were in an online discussion the other day about this very subject (on Twitter of all places) with a child care professional. Her point of view was that enjoying the mobile together was a positive way for the adult to engage with the baby on the changing table, while Lisa and I believed it would be a distraction that made engagement and partnership more difficult. Would the administrator of the center be open to hearing your thoughts about the mobile?

      • avatar Ayu says:

        The centre is under new management and I’m currently still on leave.
        I’m not dead against mobiles, I’d just prefer them placed at the play area where children can enjoy it if they choose to. That is also something for me to bring up on our next staff meeting ;)

        • avatar janet says:

          Yes, mobiles are great when babies can choose to enjoy them while they play — when they’re not positioned right above them in a crib or on a changing table. There are such wonderful opportunities for bonding, nurturing, motor skill and language development during an attentive diaper change. Maybe you could approach the staff with some of those thoughts. Good luck! :)

  9. avatar Adi says:

    Thank you so much for this post. We have been struggling with this for several weeks and I have come to dread diaper changes. My 10 month old son cries and struggles to roll away. I am excited to try this new approach first thing in the morning! I know it may not go well at first, but the way I was doing it before (distracting, hurrying) was just making it worse.

  10. avatar Skyfire says:

    I came across this idea a few weeks ago and started trying to implement it with my 9 month old girl. My older daughter was very passive and cooperative, but my little one is very wiggly and wants to crawl away and do something else.

    Still, I kept at it, asking her to come back and please be still for me, watching her to see what she wanted to do. Today we had a really good experience. She loves to chew on the diaper cream tube. I told her I needed to get some out to use on her, and she held up the cap end so I could get to it while she was still holding it, and she didn’t have to wiggle after it. When I put on her sleeper, I saw that she wanted to sit up, so we did the snaps with her in a seated position, and she intently watched. It occurred to me that she couldn’t really see that process lying on her back.

    I don’t think I’ll ever forget that moment: the expression on her face, the stillness in her body as she watched with such interest.

    • avatar janet says:

      Oh, thank you so much for sharing this wonderful story. I love the discovery about her seeing the process better in a seated postion…and your flexibity…and respect…and such insightful observations.

  11. avatar Niki Buchan says:

    What a brilliant description of how we should respect even the youngest child!!! I have always seen this as valuable one on one contact time but have many times wanted to cry when I observe the nappy changing routines in some early years settings…..for the opposite reasons you wanted to cry watching the movie! I have also always asked a child’s permission before I try and wipe their nose….same respect. I would like to post this on my site.

  12. avatar leyla says:

    Janet, is there a link to the video or similar videos?

    Thanks!!
    Best,
    Leyla :)

  13. Thank you so much! This is particularly timely with my 10 month old(very wiggly) son. He often stands while I get his diaper on, and it is always an adventure. I so appreciate the RIE changing times.

  14. Thanks for sharing this! We recently shared a post called “It’s Not Just a Diaper Change” which is about the very same thing and how to make it a special time between you and your baby. We’ve even included a few techniques for those active babies on their way to toddlerhood. Hope your readers will enjoy too. http://theeducatorsspinonit.blogspot.com/2012/02/baby-time-its-not-just-diaper-change.html

  15. avatar Genevieve says:

    Janet, this is such an important and well needed post. Thank you for taking the time to write it so beautifully.

    • avatar janet says:

      Oh, thank you for your kind, supportive words, Genevieve.

  16. avatar theresa gianna says:

    i’m expecting my first in a matter of weeks, and have really been enjoying your website.
    what are your thoughts on EC (Elimination Communication)? i’ve seen it mentioned in the occasional article, but never expounded upon. it seems that EC could also be a respectful way to help babies with their elimination needs, especially if you communicated with them about it throughout the process. do you have any tips for that?

    • avatar janet says:

      Thanks, Theresa. I’m am not a proponent of EC, so this is not the place to look for tips. I think it can be done respectfully, but I believe it is totally unnecessary. There’s a long discussion about EC between parents and educators that might interest you… It’s here on my community forum: http://janetlansbury.com/community/topic.php?id=23

      • avatar theresa gianna says:

        thanks for pointing me over to that discussion! it was very interesting and helpful.

        on a general note, i’m really glad i found your website. the utmost respect with which you treat children is so inspiring. at times it struck me as “over the top”, but then i realized sadly that that’s something i’ve absorbed from our society and its failure to acknowledge the whole personhood of infants and children (a generalization, but something that holds true in my experience). i’ll definitely be returning to your posts when my little one arrives, and as he/she grows. =)

        • avatar janet says:

          Thanks, Theresa! Honestly? It seemed “over the top” to me at first, too. Now I can’t imagine treating an infant any other way.

  17. avatar Sarah says:

    I know this is an older article, but I just wanted to drop a thank you! I’ve been struggling for a couple months with my baby’s erratic sleep and screaming diaper changes. One night as I was so frustrated because her bedtime diaper change got her so worked up that I had an even harder time getting her to sleep… I turned to Google and found this!

    I have changed my approach to diaper changes with my sweet daughter and for 3 days have not had one battle on the changing table, whereas before it was a battle at EVERY change.

    I explained it to my mother, and her response was a lot like mine at first: “Really?” But it has made such a wonderful difference.

    Thank you again!

    • avatar janet says:

      Sara, thank you so much for sharing this success story!

  18. avatar Brianne Strong says:

    Janet,
    Do you have any videos of a good diaper change, even if it’s just with a doll? I’d like to show one to my husband.

  19. avatar Andrea says:

    Thank you for this. We do our best to be respectful to our little one. She will tell us when she is going poo or has made it. She will lead the way to her changing table or lay on the floor (I have back problems). Of course se tests us and we try to relax her. Thanks again.

  20. avatar MelissaS says:

    Thanks, this is a good article. Do you have a recommendation when it comes to getting in the car seat and going places? My 19mo old has been resisting the car seat since he was about a year old (the same time he started walking). He arches his back and throws a fit. I ask him to get in his seat and tell him we need to go and sometimes he does go on his own but about 80% of the time he fights it. I feel bad because he gets so upset and we do acknowledge his feelings and sometimes that helps, but it is really hard. He pretty much does not like to be restrained at all. So going to the grocery store and out to dinner can be a real challenge sometimes. At home he likes to climb on everything and taking him outside to play he just wants to take off down the street. I realize he has a big desire within to explore the world this way and I don’t want to crush that. Do you have any suggestions for us?

    • avatar janet says:

      Hi Melissa! Yes, I have suggestions.. Don’t be afraid to insist and face your boy’s healthy feelings of resistance. If you are calm and confident and you acknowledge his feelings (“Oh, I know how much you hate being in the carseat! It is such a drag to be stuck in that seat!”), he will be all right. Very few children this age like to be confined… But I would limit this confinement to car seats and holding your hand when you are near cars. I would go for take-out rather than restaurants at this point in time. I would also try to do grocery shopping while your boy stays at home with a friend or relative, whenever possible. Here’s a post I wrote about carseats: http://www.janetlansbury.com/2012/01/car-seat-tantrums-handled-with-respect/

      • avatar MelissaS says:

        Thank you Janet! My husband and I have said we just can’t do a lot of time out of the house with him at restaurants. You confirmed that.

  21. avatar Alexandra says:

    Hi Janet thank you so much for this article! This is truly a godsend as I’m currently facing the “dreaded diaper change”. This has given me a new perspective on how to approach this! I truly enjoy reading your articles. My 8 month old son is very very busy and I feel so bad sometimes that I’m trying to make him conform to be more relaxed (like me) resulting in us both becoming very impatient.

    • avatar janet says:

      These kinds of insights will serve you and your boy very well, Alexandra: “I’m trying to make him conform to be more relaxed (like me) resulting in us both becoming very impatient.” Thanks for sharing!

  22. avatar Annelie says:

    Read this post again as I really need it these days. I am trying to do this with my son, who is 21 months, but right now I fail too often… we are both starting to dread the diaper change and general “dressing” moment.
    He just needs a LOT of time now to do things himself, or to become ready to accept that I do it for him, which is perfectly normal and healthy, but sometimes does not go well with getting to work on time, or going to bed at a reasonable time.
    I tend to become very impatient, but am starting to find ways of distracting myself, while being there for him (getting dressed at the same time as him for example, so that I leave him more time to get ready to be dressed, while I don’t get frustrated waiting – or reading while he eats – so that I don’t push him to eat, but am there if he needs my help for something).
    It is working, but there are always bumps… thanks for helping me with your insights, so that I can make the bumps less frequent!

  23. avatar Julia says:

    Ok, I’m really trying to apply thi wih my 9 months old but I have a question.

    He always poops at 6am, he is usually still tired so he is not very happy with the bowel schedule. He sleeps on a floor bed so when I enter the room he has rolled (he sleeps on his back) and crawled (comando style) outside the bed facing the door.

    I usually change him on his bed trying to make it easier for him to get back to sleep after, if I bring him to the changing table he thinks I misunderstood and I’m trying to get him out of bed and gets nuts.

    My question is, this connection, speaking to him explaining what we are doing and asking for his participation should always be done, also in night diaper changes, because direct interaction gets him fully awake the (selten ocasions) when he is not pissed off.

  24. avatar Helen says:

    Throwing my hands up in the air about a baby who has just got mobile and won’t lie down for a change it had not occurred to me that maybe him rolling over is a way to say please change me that way! Or even standing up. I am reinspired to try and love changes again – both of nappies and ways of doing things :-)!

  25. avatar Ruth Mason says:

    Hi Janet,
    Last week, I began teaching my first parent-infant class in Jerusalem as part of my RIE II training. It’s so exciting and wonderful! I’m giving the moms a handout each week, translated into Hebrew. I want next week’s to be about diapering. How would you feel if I translated this piece of yours into Hebrew – with full acknowledgment and web address, of course.
    Thanks,
    Ruth
    p.s. I have a list of people who are getting summary updates about the class along with a copy of the handout in English. If you are interested in being on this list, let me know.

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