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					                          Step 1:                                                  Step 2:                                                Step 3:                                                      Step 4:
                          Get Organized                                            Carry the child                                        Clean the child’s                                            Remove the
                          Before you bring the                                     to the changing                                        diaper area                                                  soiled diaper
                          child to the diaper
                          changing area, wash
                                                                                   table                                                                                                               Remove the soiled
                                                                                                                                                                                                       diaper without
                          your hands, gather                                                                                                                                                           contaminating any
                          and bring what you                                                                                                                                                           surface not already in
                          will need to the diaper                                                                                                                                                      contact with stool or
                          changing table:                                                                                                                                                              urine.
Non-absorbent paper liner large enough to cover        Keep soiled child clothing away from you and any         Place the child on the diaper change surface and            Fold the soiled surface of the diaper inward
the changing surface from the child’s shoulders to     surfaces you cannot easily clean and sanitize            unfasted the diaper but leave the soiled diaper
                                                       after the diaper change.                                                                                             Put soiled disposable diapers in a covered, plastic-
beyond the child’s feet                                                                                         under the child                                             lined, hands-free covered waste-can. If reusable cloth
Fresh diaper and clean clothes - as needed              Always keep a hand on the child                         If safety pins are used, close each pin immediately         diapers are used, put the soiled cloth diaper and its
                                                        If a child’s feet cannot be kept out of the diaper or                                                               contents (without emptying or rinsing) in a plastic bag
Wipes for cleaning the child’s genitalia and                                                                    once it is removed and keep pins out of the child’s
                                                                                                                                                                            or into a plastic-lined, hands-free covered container to
buttocks removed from the container -- so you do        from contact with soiled skin during the changing       reach. Never hold the pins in your mouth.                   give to parents or laundry service.
not touch the container during diaper changing          process, remove the child’s shoes and socks so          Lift the child’s legs as needed to use disposable           Remove gloves using the proper technique and put
                                                        the child does not contaminate these surfaces with             wipes to clean the skin on the child’s genitalia
Wipes for cleaning child and provider hands (see                                                                                                                            soiled gloves into a plastic-lined, hands-free covered
                                                        stool or urine during the diaper changing                      and buttocks. Remove stool and urine from            waste-can
Step 4)
                                                        Put soiled clothes in a plastic bag and securely tie           front to back and use a fresh wipe each time.        Use a disposable wipe to clean the caregiver’s hands
A plastic bag for soiled clothes                        the plastic bag to send the soiled clothes home                Put the soiled wipes into the soiled diaper          and another disposable wipe to clean the child’s
Disposable gloves, (put gloves on before handling                                                                      or directly into a plastic-lined, hands-free         hands, discard soiled wipes into the plastic-lined,
soiled clothing or diapers                                                                                      covered waste-can.                                          hands-free covered waste-can
Diaper cream (when needed/appropriate) removed                                                                                                                              Check for spills under the child. If there are any, use
from the container onto facial or toilet tissue read                                                                                                                        the paper that extends under the child’s feet to fold
to apply to child’s skin                                                         Diapering Procedure                                                                        over the disposable paper so a fresh, unsoiled paper
                                                                                                                                                                            surface is now under the child’s buttocks

                          Step 5:                                                  Step 6:                                                 Step 7:                                                     Step 8:
                          Put on a clean                                           Wash the child’s                                        Clean and                                                   Wash your
                          diaper and dress                                         hands                                                   disinfect the                                               hands
                          the child                                                and return the child to a                               diaper-changing                                             then record the diaper
                                                                                   supervised area.                                                                                                    change in the child’s
                                                                                                                                           surface
                                                                                                                                                                                                       daily log.



Slide a fresh diaper under the child                    Use soap and running water, no less than 60             Dispose of the disposable paper liner used on the           In the daily log, record what was in the diaper and
Use a facial or toilet tissue to apply any necessary    degress F and no more than 120 degrees F, at a          diaper changing surface in a plastic-lined, hands-                any problems (like loose stool, unusual odor,
diaper creams, discarding the tissue in a covered,      skin to wash the child’s hands                          free covered waste-can                                            blood in the stool or skin irritation). Report
plastic-lined, hands-free covered waste-can             If a child is too heavy to hold for handwashing         Clean any visible soil from the changing surface                  any problems or observation as necessary

Take notice and plan to report any skin problems        or cannot stand at the sink, use the three-towel        with detergent and water, then rinse the surface
such as redness, skin cracks or bleeding                method for handwashing procedure:                       with water
Fasten the diaper. If pins are used, place your             Wipe the child’s hands with a damp paper            Wet the entire changing surface with the
hand between the child and the diaper when                  towel moistened with a drop of liquid soap          disinfectant solution (e.g. bleach and water
inserting the pin                                           Wipe the child’s hands with a paper towel wet       solution mixed fresh daily) leave bleach/water
                                                                                                                solution on the diaper changing surface for 2             Fore information about health and safety in child care,
                                                            with clear water
                                                                                                                minutes. May leave to air dry or wipe dry after the       contact Healthy Child Care Iowa at 1-800-383-3826
                                                            Dry the child’s hands with a paper towel            2 minute surface dwell time                               or visit the Web site at www.idph.state.ia.us/hcci.
                                                                                                                Put away the spray bottles of detergent, water and        Reference: Caring for Our Children, Second Edition,
                                                                                                                disinfectant                                              (2002) American Academy of Pediatrics.

                                                                                                                                                                          Photos courtesy of Healthy Child Care North Carolina

				
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