Difficult Diaper Changes?

Dear Dr. Rene,

I am the mother of twin (Boy and Girl) 20-month-olds. Since about the age of eight months, changing diapers and clothes has been very difficult. Both children move about during this process, which is normal, but they really scream and fight, and they are really strong, and I have a really difficult time changing diapers and clothes. I have tried giving them toys and little things as distractions, but that works for one day and then they are no longer interested. This also affects their childcare provider and she complains to me about how difficult it is.


I remember these difficult moments well.

There are lots of ideas for things to try. The answer is to try each, see how it goes, and use it as long as it lasts.

  • Before you start, be sure you have all your supplies gathered and ready to go.
  • When you know they need a change, set a timer for one minute and say, “when the timer rings, it is time to change your diaper.” For some children, this works surprisingly well. It takes you out of the argument.
  • In calm, firm language remind them to, “lay down,” and, “stay still.”
  • Some parents suggest that if laying down is the difficult part, try changing them standing up. I have heard of parents that have them stand in the bathtub or just on the outside of it holding onto the edge. Others suggest that the child leans against a wall. I did this just once and thought it was a nightmare, but others swear by it. My guess is this is a controversial approach. Maybe we needed more practice.
  • Provide distractions such as small toys or books. Better yet take a small bag and gather interesting objects from around the house. Go for things that your child doesn’t often see or have access to such as a kitchen whisk, a sand timer, small calculator, clean sponge or toe separators. Stash this bag next to your diaper changing area. When it’s time to change a diaper, hand the child one thing from the bag, lay them down and change them as fast as you can. When the change is over, the object goes right back in the bag. Rotate through items overtime.
  • You might give them related jobs as a distraction. This means making them the wipe holder or the diaper folder.
  • You might spend a few minutes before each diaper change giving a doll baby a diaper change together. Talk about how the baby is still and lays down. After each time, thank the doll baby for being cooperative.
  • You might distract them by singing a familiar song with lots of expression or a song with movements. Once you start the song, continue to sing as you change their diaper.
  • You might distract them with interactive word play like, “where’s your nose?” and, “where’s your ears?”
  • When they do cooperate, even if it’s only through distraction, be sure to give descriptive praise. This means to describe their behavior and label such as, “you were so still for a diaper, that was helpful!” To learn more about descriptive praise view: http://www.youtube.com/watch?v=rn2Ddh16xIY.

I hope something on this list is helpful.

Please comment below if you have other helpful ideas!

Sincerely, Dr. Rene

Increase Interest in Potty Training

>Are you thinking about potty training in the near future? Have you been at it a while but stalled in the process? Is your child “just not interested”? These tips may help.

*Let Them Observe*
If you are at all comfortable with the idea, let them observe. Children learn best through modeling and taking them in with you provides this opportunity. Let them watch and answer any questions they have. By all means, if this is uncomfortable don’t do it.

*Talk Them Through*
Talking them through the process can start while you are still changing diapers. You can talk about how they poop and pee and you can label bodyparts. You can talk about how someday they will go on the potty. When they observe you in the bathroom, you can talk about all that you are doing includng flushing and washing. Once you are making the transition you can add language about “that feeling in their tummy that means they need to go.”

*Read the Books & Watch the Videos*
There are many good potty training books and videos on the market. The idea is to casually mix in the books with your other story times and the videos with your viewing time.

*Change All Diapers In or Just Outside the Bathroom*
Stop changing diapers all over the house. The first benefit is that children who hadn’t already may start associating the bathroom with going potty. The second benefit is that children who just don’t want to stop playing to go potty have to whether they make it or not. This goes for when you are out running errands as well, find a bathroom.

*Dump or Hold Over Their Potty*
This idea also helps children to make the potty connection. Whenever you change a poopie diaper walk with the child into the bathroom and dump the poop into their potty saying “the poop goes in the potty” and then flush or clean as you would have. If it is a wet diaper, you can just hold the diaper over their potty saying “the peepee goes in the potty.” I know this may create an extra step but may be helpful in the process.

*Sit and Relax*
Some children are too nervous to have success if the push is to “sit and try.” If this is the case, it may be best to shift the focus to “sit and relax,” sit together and talk or sing or read books or put on finger plays.

*Presenting the Potty OR Making It Their Own*
This means make the initial presenting of the potty fun. Maybe take a special shopping trip to pick out a potty or let them help choose which potty seat they like. If the potty is already out, you’ve been trying for a while already or they have older siblings, have a potty decorating day. You might let them put stickers on the (cleaned) lid or make a poster for the wall behind the potty, something to celebrate that the potty is now theirs.

*Descriptive Praise*
Descriptive praise works to build intrinsic motivation for behavior. In the case of potty training it sounds like, “You knew you had to go!” “You got there so fast!” and “Look, you put your poop right in the potty!” You are describing back their behavior, focused on effort and progress. This helps to give them ownership of the process.

*Underwear as an Under Layer*
For some children, diapers and pull-ups may work too well. Because these products are so absorbent children may not recognize that they are wet. If this seems to be the case, you might have them wear underwear under their pull-up or diaper. This way they get wet just not the floor.

*Take a Tour of Potties*
Start pointing out potties everywhere you go. Talk about how there are potties in restaurants, stores and in other people’s homes. If there is time, you might visit the potties. We took the tour at relatives’ and close family friends’ houses.

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