406 – Diapering and Pottying

Episode Intro and Overview 0:00

So to recap, the stuff that you'll need for diapering and pottying are probably some disposable diapers, some cloth diaper insides and outsides, if you're using cloth, a diaper pail, Some diaper creams, and then some potting training supplies, especially a potter seat adapter. That's one of my faves. Hi, you're listening to Season 4 of the Baby Manual Podcast, the podcast that helps new parents all over the world navigate the everyday challenges that arise when you have a young baby. This season will help you decide which pregnancy, baby, and toddler items you actually need and which ones are a waste of time and money.

I'm pulling on the knowledge of hundreds of thousands of new parents around the world, other pediatricians, doctor moms, the Academy of Pediatrics, breaking pediatric news sites, all to give you the best information and recommendations that I can, because I know how overwhelming it can be. I am your host, a pediatrician, mom, and author, Dr. Carol Keim. Hello, welcome to this week's episode of the Baby Manual Podcast. We're going to be talking all about diapering and potty training, which is something I'm really passionate about because, oh man, in America, we potter train very late compared to the rest of world, and we go through so, so many diapers.

And gosh, it just feels really, really hard on the earth to me. So let's talk a little bit about the different options for diapering and for potting training. So for diapering, now a lot of us will start off with disposable diapers, and I do recommend having some disposable ones on hand when your baby is very young.

Disposable Diapers and Newborn Wipes 1:32

So, for the first week of life, they're having about one poop and pee for about however many days of age they are or more. So we want to have at least one pee and poop on that first day, at last two on the second day and so on. And then around a week of aged, they start peeing and pooping every time that they eat, which is typically eight to 12 times per 24 hours. You're going to go through a lot of diapers starting around the week age. diapers are one of those things that at baby showers a lot of people like to bring because they know that you're going to use them and you can go through quite a few and At the very beginning when your baby is very very young and waking up multiple times a night to eat It can be really hard to give yourself any extra work.

And so disposable diapers are very convenient during that period of time. So the newborn size ones are the typical ones that you would want. There's a lot of different brands of diapers. My personal favorite is actually Pampers because I just feel like I see less rashes with those. have less of the smells that other ones have. Most diapers do have some scent to them to help mask the smell of pee and poop so that they don't just smell bad all the time. But if you want to go with one that's unscented, there are a lot of really good companies like Honest Diapers that have just as unscented, you know, and organic and all that.

They do tend to be more expensive though. The other thing I really like about Pampers is that they have a strip on the outside that's yellow and it turns blue when it gets pee on it. And it only reacts to pee. It doesn't react to just being wet. So if your baby poops, it's not gonna turn blue. Say if it is just wet from water or whatever, that doesn' make the strip change color. So that's really nice because then you can just take a look at the outside of the diaper and you'll know if your baby has peed or not.

And it also makes it really easy at beginning to count the number of times your babies pees per 24 hours because you do need to be tracking that for the first couple of weeks just because your pediatrician is going to ask you at appointments how many times are they peeing and pooping. That's a good indication of how much your child is eating. I like water wipes in terms of wipes, or even just a washcloth with water. But you're gonna probably use one for each time that your baby poops. And sometimes more than one, but when they're real little, and the first couple of pooks are Meconium, you might need a couple, because those tend to be really sticky.

The Meconeum poop, it sort of looks like silicone caulk, And it sticks in that same sort way. There's not really much that's that consistency, But when you go to wipe it, Yeah, it just kind of spreads a bit for the first couple of wipes and then it'll eventually come off. Once your baby starts having transitional stools between the meconium and regular poops, then they get softer and softer, and easier to wipe up. And then around the time that your milk fully comes in, or even for formula Fred babies, that's around day three to five, the poop starts to transition further into eventually becoming a yellow, seedy poop.

which kind of looks like cottage cheese with mustard mixed into it or turmeric. It's this like, it's yellow with these little white pieces in it and that is a normal baby poop. So those are very easy to wipe and again, you just like one or two wipes each time with that. In terms of diaper pails, there's a few different options for diaper pales and the top two, I would say, if you're doing disposable diapers, the diaper genie is really good. What that does is it has this long roll of a plastic garbage bag that goes inside of it.

And each time you put a diaper in, it twists closed, and that seals off that diaper, in the little twist. The diaper genie has the least smell, I would say, for the disposable diapers, because of that twist feature. When you take the diapers out, its like a roll of sausages. or like a long link of sausages. Each diaper is wound in there. So that helps a lot. But really any trash can is fine as long as you empty it often enough.

Diaper Pails and What You Don't Need 5:50

For cloth diapers, we'll get there in a second. I like it different diaper pail. Things that you don't need for diapering, you do need a wipe warmer. And what I've seen actually lately is that wipe warmers can even cause mold to grow on the wipes. Yeah, it's not a great idea. I mean, whether the pipes are warm or not, by the time you get it out of the warmer and onto your baby's bottom, It's still gonna be wet and it still going to be a little bit cold. So it doesn't really make it any more comfortable for them.

If you're worried about the temperature of it, you can always just pull the wipe out at room temperature and hold it between your hands for a second before you use it and that'll warm it up for second. But you really don't need that. And another cute thing that I see a lot of people get at baby showers but isn't really necessary is a PPTP, which is just a little cover for baby boys that goes over their penis so that they don' pee on you during the diaper change. Just a heads up, boys and girls both pee during diaper changes very often and poop during What I would usually suggest is just to have a washcloth nearby or burp cloth, something that you can put over them if it's coming out quickly.

Or if you look in my book, The Baby Manual, I have diagram of this diaper trick, which is where you put the next diaper underneath your baby before opening the first one. And so if they do start peeing and pooping when that diaper is taken off, it just goes right onto the Also, when you first go to open your baby's diaper, I say every time, loosen the sides and open it a little bit and see if they're peeing and pooping. And if there are, just hold it closed with your hand, flop it back into place, wait a few more seconds, check if you're done, and then once they are done you can go ahead and change them.

So yeah, you don't need any special devices to catch the pee and poo. A washcloth works or the diaper itself works. For cloth diapering. One thing I love about cloth diapering is that it is easier on the environment and there are some really good cloth dipering services. I don't know if they're available everywhere, but if you can find one, the way that those work is you just collect all of the dirty diapers for a week in a diaper pail and then on whatever day of the week you have your service, you just leave the bag of dirty diapers out in front of your house, and then they pick it up and they drop off a clean bag for the diaper insides for you to use, then take those to their facility and wash them for.

It's extremely convenient if that's an option in your area. I highly recommend that. If you're washing your own cloth diapers, one thing to be aware of is that you can't use fabric softener because softner will make the diapers water resistant,

Cloth Diapering Basics and Supplies 8:35

which kind of defeats the purpose of having a diaper on. So, and you also, with clothed diapers you, can use anything petroleum based because those also will coat the diaper and make it waterproof. You don't want those. you need a cream that would work so that they can. The diaper will maintain its integrity. I'll get to creams in just a second. So the way that cloth diapers work, there's an outside part and an inside part. The outside the cute part that has the snaps on it now, and you put the inside, which is technically the diaper, in that.

And so those inside diaper parts are typically layers of cotton that are sewn together or bamboo. A lot of them are trifold, where the middle section is thick fabric and the two sides are thinner fabric. You fold it into thirds and then put that on the outside of the There are a lot of different options for the cloth diaper outsides, but a lotta them are essentially very similar, where they have multiple rows of snaps. It can be really intimidating to look at at first, But once you realize the lower snaps are for size of the diaper, so you just have one row of snap that's gonna be always closed, and then the higher row that goes along the waistline is for tightness of diaper.

snap the two sides onto whichever of those snaps is the right side. And those are really nice because they grow with your baby. It's just you might need to get a size small and size medium of diapers because when the babies are very young for the first one to three months, those regular cloth diapers can be really, really bulky. You might just size up in clothing or at least in pants size if you're having those really The best diaper pail that I found for cloth diapering is the Ooby Diaper Pail.

I'll put a link for that one. And what I love about that on is you just put bag on the inside. There's like a little arm that holds the bag for you. Then you close the top and there's a sliding part that slides open to put the diaper in. When you slide it closed, it seals and it doesn't smell. It smells inside, of course, but it it does make the room smell, which is really nice. And also there's a lock on the top, which is really, it's really just like a latch, like I catch that you can turn to the lock position so that when you have a toddler in the house, they don't go and just start opening and closing the diaper pail and reaching in like they like to do.

So that lock is. Yes, so I love the ubi diaper pails. Things that you don't necessarily need for cloth diapering are the petroleum based ointments, which I usually recommend for regular disposable diapers because they tend to be the best at fighting diaper rashes. But for a cloth dipering, remember petroleum is the enemy. So for diaper creams, starting off with those petroleum ones, Vaseline and Aquaphor are my two basic recommendations for just about every normal diaper rash, and also to prevent diaper rashes.

What I like about those is that they form a barrier, so when your baby pees and poops the next time, it doesn't get onto their skin. The way that diaper rashes happen is from friction and moisture. And so it can happen at any time. Most babies will at some point have a diaper rash. So don't feel bad if it happens to your baby. It's a very normal and common thing to happen. If you use wipes after your baby poops, I would suggest putting on a thin layer of diaper cream after that, and that can really help to prevent diaper rashes.

Diaper Rash Creams and Treatments 12:22

There's also A&D ointment, which is petroleum-based, it has vitamins A and D in it, those are things that help heal skin as well. That one has a pretty strong smell to it. It's one that I I sort of think of it as a slightly medicated ointment versus the Vaseline and Aquaphor. Vasoline is just regular petroleum, like white petroleum and aquaphor is petroleum that also has lanolin in it, so it's a little more moisturizing and healing. But some babies can be allergic to aquapor and some baby's are allergic A and D oinment.

So the basic white, petroleum or vaseline is a really good option for if you have sensitive skin or if anyone in your family has allergies, asthma or eczema. Those are risk factors that your baby might have an allergy to something topical like that. So the plain old Vaseline is great. The zinc oxide-based ointments are the next most common type of oints that people use. Those were the white ones. Zinc oxide is like a white powder, so the diaper cream itself is white and it can get on all kinds of things.

They can make a mess when you're using it, so just be careful to keep it just on their booty. The most common brand here in the US is Desitin for that one. And I would go with the regular Desutin. I find that the extra strength one, for whatever reason, seems to cause more rashes. is tending to get a lot of diaper rashes. It could just be an irritation from the cream that you're using. They could be the brand of diapers. You could try changing brands of diapers. But also for a regular irritant diaper rash, if you just switch off between a petroleum and a zinc oxide one, that's a really good way to treat that.

it should be treated within two or three diaper changes. If your baby has a diaper rush that lasting longer than that, you might want to go with some medicated creams. But just quick before we get to those, calendula cream and other ones that are calendular is made from marigolds and it's natural anti-inflammatory. A lot of those are beeswax based as well and those can be really helpful for when you're cloth diapering instead of a petroleum based one. But you can also use zinc oxide creams with cloth diapers.

So the calendula creams, I'm listing them third just because they are less effective than the petroleum-based ones for everyday use, but they can be helpful. Also, another thing that can help with diaper rashes is to try to let it dry out because, like I said, moisture and friction are the two things that cause diaper rash. So after diaper changes, if As your baby gets older, when they're not peeing and pooping with every time that they eat, you can try just leaving the diaper off for a little bit of time or leaving it open until, if you use a wipe, like leave the diaper open, until their skin has dried off and then close it up.

So if your baby's diaper rash is not healing after like two to three diaper changes or getting worse, or if it's been a couple of days, like if its getting a little bit better and then it gets worse again, those are all reasons to think that it might be colonized with something. And that's also very, very common. because we have yeast that lives on our skin and bacteria that live on your skin normally. That's a normal thing. So when the diaper rash starts to happen and the skin gets broken down, sometimes the yeast or the bacteria can get in there and cause a little bit of an infection and that will make it, the regular diaper creams just not really work.

I suggest having some on hand that you can buy over the counter. but really the best treatment for those are going to be prescription creams. Ones that you should have on hand before your baby is born are Clotrimazole or Myconazol or Turbinafine. Those are all anti-fungal creams, they're sold over the counter in the US either by that name or by brand names or they are sold by what they do, and they're called things like jock itch cream or athlete's foot cream, or ringworm cream. Ringworm is actually a fungal infection of the skin.

So all of those creams are safe to use in the diaper area. They should never go inside the vagina for baby girls, only on the outside, but those are all safe-to-use on skin in a diaper. And those can help with the fungle ones. The reason to think that your baby's diaper rash is colonized with the yeast or fungus is, which is the same thing by the way, is you'll see an area of rash and then around it you will see these tiny little dots that are called satellite lesions. And so when the outside the edges of it, you see all these little dots of rash.

That's the reason to think it's a yeast or fungal infection and one of those anti-fungal creams should help. You can also use apple cider vinegar mixed one-to-one with water or white vinegar, those again mixed, one to one with, water and dab that on three times a day or use the anti fungel cream three-times-a-day. Vinegar is a natural anti fungi. And actually, if you go back to the third season of Baby Manual podcast, there's There's an episode where I talk a lot about other different natural anti-fungal things that you can do.

The prescription anti fungal that we use for diaper rashes is Nystatin. And that one also is a very safe anti fungi medication for babies and just locally acting and can be given topically. It can applied topicaly three times per day. That's just one that would need to ask your doctor for a prescription for. When your baby has a yeast diaper rash, you wanna also use regular diaper cream in between the times that you're doing the anti-fungal cream because that's only gonna be three times per day and your babies probably gonna to be using their diaper a lot more than three time per a day.

So all of the other diaper changes you should use one of those first two elements that I mentioned, either petroleum based or zinc oxide based. The antibacterial ointments. So bacterial colonization in the diaper area looks like pimples, like individual boils or pimple in skin that are typically red around the edge and then you might see a head in middle of it that's white or yellowish in color. And typically there's just like one or a few of those. It's not generally involving like the whole diaper rash area.

You might just see like 1 or 2 of in there. You can use something over the counter like Basitracin or Neosporin. Those are antibacterial ointments that you can put onto there, also three times per day. But the best one is the prescription strength one, which is muperosin oinment. And your doctor could prescribe that if there are boils in the area that are recurrent. Muperosine will treat MRSA, which is the type of staph that is resistant to most antibiotics. And so that can be really helpful for if your baby's having like multiple occurrences of boils in their diaper area.

Also, when you're treating your Baby for something like that with meprosin ointment, because it's happening multiple times. You also should treat anybody who changes the baby's diaper with that same ointment under their nails three times per day and inside the nose because that's where it likes to live. So you can So for any caregivers in the house, you can use that same tube of ointment that you're putting on your baby's bottom. Just put a tiny bit under each of your nails and inside of you nose every time that change that baby diaper.

Probably a good idea to change them, use the oinment, wash your hands, and then apply it to yourself if you are able to. To make it less likely to recur. Another thing I really like for diaper creams but that is not really necessary is a diaper cream spatula. And I ended up using that with both of my children just because I have decently short nails but I still get diaper under the nails every time I apply it. So I liked having that spatula because then it just doesn't get on your fingers. And you can just wipe that off with a wipe afterwards.

You don't have to like wash it every time. Just wipe it off. It's real easy to apply to the baby's skin and it also helps it to spread around really nicely.

Potty Training and Elimination Communication 20:38

So, I'll link the silicone diaper cream spatula that I like for that. For potty training, okay, so I do have an earlier episode about potting training and elimination communication and early potter training or pot training from birth or diaper free method. It has a lot of names. I like the name elimination, communication because really At any age, teaching a baby to use the potty is a communication between the baby and you. The parent has to know when the babies about to go potting and the babys signals that somehow and then the parent had to signal back to the Baby that they're going to be taken to pot.

to be able to go. So you can listen to that earlier episode about how to do it exactly, but things that are really helpful for potty training and for early elimination communication are a potter chair for each room. So, one that sits on the floor that you can dump into the toilet after they go on it, those are nice because typically your baby can sit on with their feet touching the floors and so they feel really stable on them. The downside with that is that, you do have to wash it out each time you use it.

So it's a little bit of extra work to then dump that into a toilet and then wash that out. What I ended up using with my children was just a potty seat adapter, and I found that to be a lot easier. And I'll link the one that I like. There's a, a lotta different options for these, but the ones that are completely flat are only really good for toddlers, for preschool age children. They're not great for babies. The ones that are a little bit shaped, like that one that I'll link for you, those can help to hold the baby in place a bit easier so that they don't tip side to side or front to back, and they're a lot more stable on there.

And so it's a whole lot easier when your baby is little and you're doing that. So yeah, I would say you can start as early as the time that the start having the discoordinates tooling, which is typically around six weeks of age. Up until that point, babies are peeing and pooping with every diaper change. And then after that, they're only poop-ing a few times per day and typically pee every time that they eat. So while there is a whole episode about this and also a section in my book, The Baby Manual About This, I'll just tell you real quick with elimination communication, the easy catches, easy way to start with it.

Is to put the baby onto the party every time they are done eating so you use your party phrase something like let's go party and then you bring them there and put them on the potty after they've eaten. If you have a baby that immediately pees and poops every time you open their diaper, that's a really easy catch. You can just open her diaper in the bathroom over the toilet and use the phrase and put them on the potty. And that can be a real easy way to catch it. Then the other really catch is when they wake up.

So waking up from naps, waking in in morning, those are times when babies usually have to pot as well. Those three easy catches are a good way start. For bigger kids who are potty training, you might want to get a step stool so that they can get up onto the toilet and use that potting seat adapter. And they even make ones that are a potter adapter plus stepstool in one. So I really like those ones if you have a toddler and you're starting and want wait until toddler had to pot a train. I can link that one for you.

When your baby is doing well with the pottying and starting to not need diapers all the time, which my sort of unofficial checkpoint for my kids was if I open their diaper and it's dry and they go on the party and I put that same dry diaper back on and then I've put it on three times, I think, okay, maybe they're ready to start transitioning into underwear. The thing is, a lot of underwear, especially the padded underwear for babies that are potty training, are pretty big. They start usually size 3T from what I've seen.

So to find smaller underwear than that, there's this great website called Tiny Undies, and we'll link that too. And they have as small as six months size. That's really great because, yeah, when you have just these big baggy underwear that's not going to be very helpful for baby's doing elimination communication. So again, more info on all of this in my book and also in previous episodes of the podcast. Things that you don't necessarily need for potty training, you do not need a floor pot that sits in the bathroom.

I said have one for each room and what I mean for that is rooms that your hanging out in because if your baby has to go urgently and it's going to take too long to get them to the bathrooms, then you may just want one say like in a living room, in kitchen, whatever. But if you're in the bathroom already, you might as well just use a potty seat adapter and have them go straight into the toilet. I feel like that's a lot easier. If you are starting later with the potting training, like age two to four like we usually do in U.S.

is when typically we start with potter training. then sometimes it is nice to have one in the bathroom because then they can go at the same time as you and learn from seeing the adult use the potty. And also just a quick reminder, with baby boys, when you're doing potter training, you want to start with them sitting on the toilet. They'll learn to stand eventually. You don't need to ever teach them that. The can figure it out on their own. When baby boy starts standing to pee, a lot of times we'll start withholding poop at same and they become constipated and it can be a problem.

Having them sit on the potty every time while you're teaching them is the best advice I can give you. And then sticker charts are fairly commonly suggested for potter training. I don't love them. Unless your kid loves stickers and the sticker itself is a reward, then maybe. But for the most part, some delayed gratification for doing something that is natural anyway. I mean, babies don't want to sit in their own waste. So it feels good to use a potty. It feels to get that stuff out of your body and not have to set in it.

That alone is enough of a reward for most children. If you're starting very late, like after age four, then maybe a sticker chart might be helpful. When you're doing things like that and giving rewards for pottying, again, it can backfire. It can cause too much pressure on the child because they want that reward. That's also why we usually don't recommend giving food as rewards. For potter training, because it could be really stressful for the children because the only way they can get that special food treat is by potting in the pot.

So that extra pressure can make it harder for them to go. Because it's really hard to pee and poop when you are nervous. So, and then also make sure that you never ever punish your child for accidents if they pee or poop in their pants or in the diaper while you're training. They're not doing it maliciously. It's not intentional. it's an accident. So make sure that you don't ever punish your child for that. All right. I hope this was all really helpful for diapering and potty training. because really it is so much better on the environment.

And also, one great thing about cloth diapering with early potty training is that the cloth diapers stay wet and they feel more wet than the disposable ones do when they pee. So like with disposables, the pee tends to soak in and it wicks away. which is nice for preventing rashes, but not as conducive to potty training because then there's less motivation, I guess, to not be sitting in a wet diaper. Whereas with the cloth diapers, they get cold when they got wet and so the child can feel it right away.

Wrap-Up and Resources 28:28

And so those can be really helpful to do together. Awesome. So next time we're going to be talking about stuff that you should bring when you're out and about travel stuff, portable stuff what to put in the diaper bag, all that kind of stuff. Thanks for joining me. Have a great day. So to recap, the stuff that you'll need for diapering and pottying are probably some disposable diapers, some cloth diaper insides and outsides, if you're using cloth, a diaper pail, Some diaper creams, and then some potting training supplies, especially a potter seat adapter.

That's one of my faves. Thanks for listening. Remember all of the links from this episode are in the show notes and you can always go to my linktree which is l-i-n-k-t-r dot e-e slash d- r- k- e i- m. If you know anybody who is pregnant or has a little baby, tell them about this show. Maybe they would like to listen to this podcast. They might find something helpful in here. And if you know any friends who are pregnant and want to get them something for their baby shower, I would definitely recommend my book, The Baby Manual.

It's meant to be all inclusive. Really, all the questions that arise in the first year of your baby's life are in that book. So Baby manual is also linked in The Show Notes and on my link tree. Have a wonderful day.