Childminders and Nappy Changing

[OliPocket]

Quick question for all you lovely childminders......how often would you change a child's nappy? 18 months old and with CM from 8am to 4.30pm. I change my DS at 7 when he gets up and then drop him off at 8am. Recently my CM has only changed him twice during the day and last week he had a very bad nappy rash from being left in a dirty nappy. She said she couldn't smell a poo and so wasn't sure how long he'd been in the soiled nappy for. I want to talk to her about changing/checking his nappy more frequently but just wanted to canvas opinion before I speak to her.

Each child is different. For some approx 4 hrs would be ok in a nappy, if not soiled.

I had children today 8-6 and one had 3 changes and another with a more sensitive bottom had 6 changes. They all get changed immediately if I notice the are wet or soiled and they are all changed before they go for a sleep.

Just speak to your CM and explain what works for your child and how she can fit it into her routine.

Depending on the quality & type of the nappies usually every 2-3 hours, though modern disposables can cope with longer unless the child does very big wees. I check the 'feel' to see if wet/poo even if no pong regularly but would change after 3 hours even if dry as they get a bit sweaty & unpleasant. If a child has, or is prone to, nappy rash every 2 hours. I care for an 18m old girl who arrives at 7.30 and leaves at 4 - so similar to you. I change her around 9 after the school run when I get her dressed, around lunch and around 3, just before the final school run but more if needed

Thanks for your replies. I think it's a case of checking more often rather than just changing for the sake of it. I was a bit upset about it on Friday but have waited till I calmed down to speak to her because she is lovely and I don't want her to feel like I'm having a go. I know this could have happened while my DS was with me. I change him about as often as you ChildrenAtHeart but I guess if I didn't smell him, I might have left him too. Thanks again, I'll have a gentle chat with her tomorrow.

Just about to type what TSC said. It's not the frequency of the changes but the checking for poo that's important.

If this were me, I'd definitely want to know.

Children are all different and some have more sensitive skin than others. If your childminder needs to check your son more often, then you just need to tell her. She certainly shouldn't be offended.

The most sensitive child I looked after had to be changed immediately, cleaned with soap and water, carefully dried with a towel, then have talc applied. That was her home routine and, if I left it for a few minutes (in the car, for example), she would get a horrible rash. It took a lot of discussion with Mum and trial and error before we worked out a routine that was workable, and ensure that the baby had no rash.

Please don't get upset or worry about it. I wouldn't be annoyed at being told and I shouldn't think she will either.

Thanks everyone. Thing is, I don't change him that much more often and he's not had a nappy rash since he was a newborn. I probably change him 3 times, maybe 4 in that period of time. I sometimes do before and after nap but only because I think he'll sleep better in a dry nappy and I need my 2 hours peace!

I'll mention it to her tomorrow. She is a very experienced CM and can be a bit sensitive about stuff but I really want to stay with her so will tread lightly. Thanks again for your replies....really helpful.

Nursery (and residential care) guidelines are max 3 hours. I would expect changes scheduled for mid morning, after lunch, and mid afternoon, plus whenever soiled.

I would assume the guidelines held true for childminders as it's a professional care environment.

Btw I'm temping at the moment and my timings are common across all the settings I've worked in...

my 22mths old gets changed when with me 7-8am when gets dressed, midday before nap and then again at 6/6.30pm for bath unless he poos he obv gets changed more which he invariably does in a clean nappy!!

Childminder changes roughly same as me as thats what I said I do

nursery does 10am ish, 2pm ish and then 4pm ish (I cant see point in 4pm one if done at 2pm and alot of time I collect at 4,30pm and manage to catch them before its done and say oh dont worry)

Purple - any link to those guidelines?

All children are different, some poo causes nappy rash faster than others I find.

TSC, my main experience is in adults with LD's, so it's a case of "change every 3-4 hours" and "you're going to be given 4 pads per day per person because that's how often people excrete"

I think nurseries just go with it as best practice tbh!

I'll have a google, nick, my info was verbal during training so might be company specific and just happened to coincide in the firms i worked for iyswim.

Considering disposable nappies take 10yrs to rot in a landfill, I think 2 changes a day is more than adequate!!
As a CM I change mine before lunch, then before home time. (poos changed in between of course).
I think what the OPs CM sounds the same?

www.nhs.uk/conditions/pregnancy-and-baby/pages/nappies.aspx#close

NHS guidance for parents. I'm having trouble finding the right search terms, will keep trying...

www.google.com/url?sa=t&rct=j&q=elderly+continence+guidelines+uk&source=web&cd=5&ved=0CGkQFjAE&url=www.publications.doh.gov.uk/pdfs/continenceservices.pdf&ei=FNPoT968Eoea-wbd3eixAw&usg=AFQjCNFvaAs2WAMt9jD3ii2Ho23eJ5ItCg

Page 9 for pads per day according to Trust

I have three children in nappies 4 days a week. I used to change mid morning, after lunch, after nap and before they went home and if they did a poo inbetween. I spent most my day changing nappies and decided that I was over doing it. I was concerned parents would complain that their child wasn't being changed frequently enough.

Now, with experience and confidence I only change nappies twice a day (or more if they are soiled). It is sufficient for the children I care for.

Roughly
8am when up
12.30 before nap at 1
3pm when wake from nap
7pm before bed

So actually If I knew you had just changed before drop of I might not have changed ( although you change an hour earlier so might add a 10am change)

Same as above, they last all night whilst asleep so 4 ish hours in day seems ok. They get changed as soon as I notice they have pooed though.

Just mention he is extra sensitive and you would appreciate if they could try and change him every x amount of hours

I think toddler changes are different from baby changes though in that toddler bladders will hold larger wees for longer so they have a dry nappy for longer periods than babies who will do small wees very frequently.

I looked after 3 children yesterday all aged around 2.

Child 1 (25 m) - poo nappy 11.00, nappy dry at nap at 12.30 so changed her when she woke up at 1.30, another poo at 5.00pm went home in that nappy at 6.30.

Child 2 (22 m) only with me for 3 hours - poo nappy half way through

Child 3 (23 m) with me for 3.5 hours - poo nappy mid morning.

It seems they all save their poos for me! The short stayers only ever arrive with 2 nappies. I think the mums would expect me to change them once in that time, and the other is for the inevitable "poo in a new clean nappy" moment.

Hi, I am a mother of 4 and a regestered childminder of 15 years. I find with good nappeis they dont need changing too often. When they are babies its more often, every three hours unless dirty nappy. Always change dirty nappy straight away, no matter what. Guess what though, I may of made a mistake once or twice in 15 years and not smelt a poo. Sorry, thats life I guess. It must be harder in a nursery where there are about 40 children there. We are just like parents too, human.
I would say, mention it to your childminder, its a shame to get upset over something and have a bad weekend, but they do get nappy rashes even if they are not left in a dirty nappy too. I have my children for 50 hours a week, thats longer than the parents so they dont always understand either. Hope you sorted it in the end. I love my children I look after and I hope I do my job the best I can, they always come first.

I just read my message above and it looks like I left her in a pooey nappy. I didn't - I changed it!