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I work in a daycare. It's a chain of daycare centers staffed mostly by seasoned and educated professionals. I've been told by my boss and colleagues that we should change diapers regularly even if there is nothing in the diaper at all. For example, before a daytime nap or before a meal. I've been intending to ask them what their reasoning is, but I'm now doing some research online first.

My initial assumption prior to this advice was that there would be no reason to change the diaper unless there is urine or excrement in it. Or perhaps, unless it's hot and the child is very sweaty.

I guess my assumption may well be wrong, and therefore I'm asking this question.

I guess it could be something with comfort. Do diapers get less comfortable as they are worn, even if the child doesn't urinate or defecate? Or do they risk irritating the skin?

I'm primarily taking about disposable diapers, as cloth diapers are virtually never used in my part of the world.

I have searched the web for this question, and I have been unable to find anything that really answers the question.

  • Can you point to a recommendation somewhere that says that even perfectly clean diapers should be changed? I've never heard that, and I'd be interested to see the rationale. My guess is that the recommendation is that diapers should be changed regularly even if they're not obviously messy (i.e. urine may not be easily noticeable, but that doesn't mean the diaper is still actually clean after several hours). – Rose Hartman Sep 13 '17 at 15:45
  • @RoseHartman I work in a kindergarten. My boss and all my coworkers practice this. It's a large chain of kindergartens with seasoned professionals working there. I've been intending to ask them what their reasoning is, but I'm now doing some research online first. – Revetahw Sep 13 '17 at 15:48
  • Thanks, the edits definitely clarify the situation. It's possible this is just established practice in your organization; there may be no genuine need for it. – Rose Hartman Sep 13 '17 at 16:01
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    I would guess liability or quality control. Large companies are often very concerned with verifying minimum performance, by having a time based system there is less chance a employee's judgment of a diaper is disputed by a client, and little chance of a child being left in a dirty diaper too long. Also in the US "kindergarten" is 5-6 year olds, which seems old for diapers. – user26011 Sep 13 '17 at 16:01
  • @notstoreboughtdirt This is not in the US, and we speak another language than English. It's for ages 1-6. What's a good word for it in English? – Revetahw Sep 13 '17 at 20:24
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I was intrigued by your question. I wondered how much diaper changing had changed since I practiced Pediatrics (as an FP).

I googled as well. I can't find a source that remotely suggested the practice, so I will say that it appears to be physiologically unnecessary.

The American Academy of Pediatrics says nothing about that on it's baby care/diaper change page. I even watched this video to see if I was missing something. (I was not.)

If I had to guess, I would say that @not store bought dirt is correct and this is a policy intended to prevent any child from being overlooked for a diaper change. It also guarantees eyes on the individual child at least every so often. As a mom, I checked the diapers often, and as a doc, I would be a bit concerned if a baby was dry for more than a few hours, but I wouldn't expect this to be a reason for the policy in your establishment.

Because today's disposable diapers are more absorbent, I'd expect the opposite question: how often do I have to change diapers that are wet? But I have never heard of changing a dry diaper.

Again, I would keep track of output. In the highly unlikely scenario that a diaper stayed dry for 12 hours, I might change it, "just because".

  • +1 for good research and good suggestions. – Revetahw Sep 13 '17 at 17:07
  • This will vary some based on the age of a child. For a 6 month old or younger, I think my advise is better. ( Voted +1 for this ) – Mister Positive Sep 13 '17 at 17:24
  • I'm glad you're happy with your answer, and thanks for the upvote. But may I ask why you think your advice is better? This is not a challenge; l want to learn where I can. – anongoodnurse Sep 13 '17 at 17:27
  • Because a child at that age ( 6 months or younger ) will urinate at least 20 times a day. So by changing every 2 - 3 hours the child is usually not sitting in a fully soaked diaper. – Mister Positive Sep 13 '17 at 17:39
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    @MisterPositive - Ah, I understand. But my answer didn't address that issue; only that of changing a dry diaper. But, point taken. :) – anongoodnurse Sep 13 '17 at 17:52
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My suspicion is that it is not linked to health, but instead linked to ensuring you check the child's diapers on a regular basis, and proving to the parents that you are.

Your kindergarten/daycare may operate differently from mine, but the daycare we used for the first few years (which was a large center) did something similar; diapers were changed every 2 hours, and a notation was made on a chart we were given at the end of the day as to what was in it (so we could track their health). We also could tell how often diapers were changed by how often we needed to restock the diaper caddy.

As such, it is indicative that you are checking properly (and not just marking on the chart without actually doing the work) that the diaper is actually changed.

  • +1, this makes sense. We also register digitally when diapers are changed, and parents can access this information. – Revetahw Sep 13 '17 at 21:55
  • This makes sense. It seems like it is to ensure everyone is being changed regularly, even if it isn't necessary for everyone at the time. – Bronco Sep 14 '17 at 17:27
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I agree with others--I am not aware of any reason to change a dry diaper, and guess that it may be a "better safe than sorry" policy at your company.

However, I also worked as a caregiver in a daycare, and have personally experienced situations where I couldn't visually tell that the diaper was wet, but could feel a textural difference when I touched the diaper's inner surface. Even assuming that the staff follows handwashing procedures carefully, I can understand why a company would want to limit situations where their caregivers might touch the surface of a dirty diaper--so maybe that is their reasoning.

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I too have never located data to back up the approach. That said, it is policy where I come from (USA) that our daycares seem to have a policy to change every 2 hrs. When I inquired I was told it's state regulations. When I looked up our state regulations (they are online) it says that nowhere. In fact, they only state diapers are to be checked "often" and changed when wet or soiled.

Once upon a time it may have been hard to tell if a diaper had a little urine in it. Today, the disposables all have a mark on them that fades if even a little wet, so you can tell even before you open the diaper.

So I would check to see if there are posted rules on this according to your governing locale. Here we run by state laws on daycares. I am not sure on other countries if that would be state/province or up higher than that. It likely is posted somewhere. If you can locate that, you may be able to see if it might be a licensing requirement. If it is, then it doesn't matter whether there is a medical source to back it, it must be followed. If that isn't a government rule, then it may be something more like here, where they do it simply to ensure that each child is changed regularly. There may be a concern that a worker, not feeling up to doing 5 diapers every 2 hours (the ratio that is common here for workers per baby), might opt to skip a child who is "only a little wet" and such a policy prevents that as all children are changed, end of story.

A friend of mine who is an early childhood development specialist who assists daycares to set up their rules, policies, training says she always recommends the 2 hour changes for this reason. It leaves no room for "judgement calls". Her explanation is that it is more to avoid human error than anything else.

  • Ah, the wonders of new technology. Yes it has been quite a few years since I have regularly changed disposable diapers--a visual indicator would have saved me a number of potentially yucky hand tests. – magerber Sep 14 '17 at 17:15
  • @magerber It didn't always save me. You can only see it with pants down, so if you try to do a quick peek down the back instead of removing pants, you get no favors out of that disappearing ink. ;) – threetimes Sep 14 '17 at 18:06
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I have no research to back this up but I'm going to go out on a limb and say it could mostly likely be for two reasons.

  1. CYB (cover your booty) purposes, as in prevention of parents making potential claims that you are not properly caring for their child. Seeing a fresh diaper on a child may give some parents peace of mind that despite how busy the daycare gets, your kid is getting individual level attention. It may also give the caretaker a chance to check the area for rashes or other problems to inform the parents as quickly as possible to ensure they get seen by a doctor.

  2. Maybe (a very strong maybe) it helps get the child into a routine. Perhaps as the child begins to understand what is happening, they will start to sub-consciously time their bowel movements or urination around the scheduled changing time. Again, not backed by research but it could be something.

  • #1, I believe, is the right answer, so +1. And you were the first to come up with it in comments, so my answer concludes only what you already said. As to #2... I don't know. Babies do have a tendency to urinate when cool air hits their privates, so the result is peeing into a new diaper :( or, if a boy, worse (All parents of baby boys learn this, usually the hard way!). I don't know about training them, though. Surely Pavlov might know. – anongoodnurse Sep 14 '17 at 15:31
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    @anongoodnurse So I wonder what would happen if cool air goes over the privates while simultaneously dunking a hand in warm water? – SomeShinyObject Sep 15 '17 at 2:11
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In general if you're not sure, change it every 2 to 3 hours while your child is awake, especially if your child is under 6 months old. If they are sleeping, change it when they wake up unless they soil the diaper.

While awake, a child's natural movements will corrupt the diaper's original ability to stay in place comfortably and may cause a rash.

Babies urinate approximately 20 times a day for the first several months of their lives. It would get incredibly expensive and exhausting if you tried to change your baby’s diaper every time. You do want to change him/her every 2 to 3 hours, but it is not necessary to wake a baby to change a wet diaper. However, the acid content of a bowel movement may irritate your child’s skin and should be changed as soon as possible once your baby is awake."

American Pregnancy Org

I don't think you will find a "sourced" answer as to when to change a clean diaper, so better safe than sorry.

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    This question is not about how often to change diapers. It's about reasoning for changing diapers even if there's nothing in them. Are you saying that there's no reason to? – Revetahw Sep 13 '17 at 16:11
  • @Revetahw Answer updated. – Mister Positive Sep 13 '17 at 16:23
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    There is nothing in your link to support the need to change every 2-3 hours, sorry. – anongoodnurse Sep 13 '17 at 16:30
  • @anongoodnurse Nope, not directly. I was hoping for an answer from you that is better than mine. ;-) – Mister Positive Sep 13 '17 at 16:31
  • I was not the DV, however. – anongoodnurse Sep 13 '17 at 16:37
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If there's nothing in it there's no need to change it.

I have a 6 month old son. We only change his diaper if there is something in it (wet or solid). Changing it when it doesn't need to be changed is a waste... diapers are expensive.

On the other hand, I have a 2 year old daughter who is potty training. She has red hair and fair complexion, so she has very sensitive skin. We don't put her in a diaper because they give her rashes. But if we did, we would have to change it whenever it was even a little wet. But once again, if there was nothing in it there would be no need to change it.

http://tlt.psu.edu/plagiarism/student-tutorial/citations/

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    Not the DV here, but on a question like this, a source would be nice. – anongoodnurse Sep 13 '17 at 17:04
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    Bronco, I like your sense of humor. ;) Interestingly, Penn State is where I did my residency. – anongoodnurse Sep 14 '17 at 0:30

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