07_BT_July 2022

Infant Care
By: Dr Hemlatha Subramaniam
Paediatrician
Pantai Hospital Sungai Petani
TAKE NOTE!
Nappy changes should
occur at regular intervals
(where clinically
appropriate) to avoid
irritation to the perineal
skin environment.
There are variations in a diapering
routine based on skin care regimen and
diaper type. Nevertheless, it is important
to develop a consistent routine and do it
the same way every time.
Choose the right
diaper size
Disposable nappies are preferred as
they offer various diaper sizes to better
fit a child as they grow. Some kids
might need a larger diaper earlier, or
they might stay in the same size longer
than expected. Parents will need to
experiment a bit until they find the
right brand and size.
As a rule of thumb, diapers should
accommodate a kid’s waist with plenty
for the tabs to grip on to. When
fastened correctly, parents should be
able to fit a finger between the waist
and the baby without too much effort.
Ensure the diapers are snug around
the legs.
Leg ruffles are
essential
Even if they look cute on your little one,
the ruffles around diaper leg holes are
not a fashion element – they are there
to keep poop and pee inside the diaper,
preventing them from leaking down
the legs. Ensure the leg ruffles are
visible on the outside and not tucked
inside the diaper around the legs.
Keep your supplies
ready
The key to changing a kid without fuss,
whether inside the home or outside the
home, is having all the supplies on hand
and easily accessible. Nothing makes
baby-changing more awful than having
to stop in the middle to search for wipes.
Be cautious when using
a changing table
While changing tables ensure that an
adult doesn’t have to kneel and stoop
to change a kid, there’s a huge risk
to it: elevating the baby to a height
could potentially lead to a disastrous
fall. One hand should always be kept
on the kid if a belt isn’t available. If
the belt is available, use it, but remain
super vigilant.
Clean private areas
properly
For a baby girl, clean her vulva by
wiping front to back. The idea is to
remove excrement from the vulva,
which will help prevent urinary tract
infections. For little boys, you can just
wipe their penises with disposable wet
wipes or cotton balls. Do not try to pull
the foreskin if they are uncircumcised.
On the other hand, great care should
also be taken when wiping a freshly
circumcised penis.
Here are some essential items for
thorough cleaning
• Cotton balls or soft disposable
towels with warm water are the
preferred cleansing method
• A pH-neutral cleanser may be used if
stools are dry and difficult to remove
• Wipes should be avoided (if
required, they should be free from
alcohol and fragrance)
• Barrier creams should be used on all
neonates at risk of perineal dermatitis
at every nappy change at the first
sign of erythema or skin breakdown.
Dealing with diaper rash
Diaper rash can turn nappy change into
a nightmare. To reduce the discomfort
of your baby’s irritated skin, dab rather
than wipe the skin. You can also
minimise further contact by cleaning
the area with water via a spray bottle
filled with warm water. Make sure that
the baby’s skin is thoroughly dabbed
dry after cleaning.
Diaper rash is very much about
controlling moisture. Fortunately, plenty
of creams and lotions can help manage
the discomfort. Apply an appropriate
amount of barrier cream and leave it on.
Removing the cream between nappy
changes is not necessary. You can just
add another layer of cream to the one
before. Avoid barrier creams containing
plant extracts or fragrances as they can
exacerbate the rash. If the rash persists
or worsens even after using creams,
seek a paediatrician’s opinion.
TAKE NOTE!
Check the perineal area
at each nappy change
to identify perineal
dermatitis and candida
infections early.
62 BabyTalk | July 2022