Diaper Hygiene

It is important to wash diapers thoroughly; any traces of ammonia will irritate your baby's skin, and fecal bacteria could cause infection. Strong detergents could also irritate your baby's skin, so start by using soap flakes and test a new detergent with a single diaper that you use and then isolate. Watch for irritation. If no irritation develops, you may use that detergent. There is no need to boil diapers unless they are very stained or have become rather gray; just use hot water for both rinsing and washing.

Washing Routine

Establishing a routine of washing will make life easier, especially if you try to wash the diapers in large loads. To do this, of course, you will need a large supply of diapers - at least 24. You'll use 8-12 diapers a day for a newborn, so two dozen diapers means diaper washing every two or three days. The more diapers you have, the less often you have to do the wash.

Choose a diaper pail with a locking lid, and make sure that the pail is small enough to lift when it is full of wet diapers. Many pails have a special compartment for a deodorizing disk, a useful feature. Make sure, however, that the disks you use are nontoxic; small children have been known to eat them because they smell good. You will also want to use a plastic garbage bag to line the pail. Diaper services provide deodorizers and bags.

When you change a diaper, put wet diapers in the lined pail. Shake feces off soiled diapers into the toilet, flush, and put the diaper in the pail. When you are ready to do the wash, dump the diapers into the machine and add detergent. (If you are using soap flakes, they must go in first.) Let machine fill with hot water and then add bleach if you wish. Bleach makes the diapers whiter, but it weakens the fabric and may irritate the baby's skin. Test a sample diaper on the baby before using bleach on the whole load.

Run the full cycle and then run the machine again with just hot water to rinse thoroughly. Diapers should be dried thoroughly in a tumble dryer. Avoid fabric softeners, since they will make the cloth less absorbent.

Plastic pants will become hard and unusable if you wash them in water that is either too hot or too cold. Wash them in warm water with a little dishwashing liquid, then pat them dry and let them air before using. If they do become hard, you can soften them in a tumble dryer with a load of towels.

Diaper Rash

If urine is left too long in a diaper or on the skin, it is broken down to ammonia by bacteria from your baby's stools. The ammonia then irritates and burns the skin, and this is the most common cause of diaper rash. A mild diaper rash will appear as small red dots on your baby's bottom, but if it becomes more serious, you will see an inflamed area of broken skin and possibly pusfilled spots. The bacteria that produce ammonia dermatitis (diaper rash) thrive in an alkaline medium. Breastfed babies are less prone to diaper rash than bottlefed babies. If you follow the guidelines given (right), you will minimize the possibility of diaper rash. Not all skin conditions occurring in the diaper area are true diaper rash. It is important to identify a rash correctly so that you can take appropriate action.

If, despite your precautions, your baby develops a sore bottom, check the chart below to see if she needs treatment. If not, then continue your preventive measures (except for the use of barrier cream), as well as the following:

• Change your baby's diaper more often.
• Use a disposable pad inside a cloth diaper for extra absorbency at night, especially if your baby sleeps through the night.
• Once your baby has diaper rash it is important that her skin be aired between diaper changes for at least 15-20 minutes.