Prime times – Intimate care and nappy changing

Prime times of the day make the best of routine opportunities to promote emotional attunement with the child and to create opportunities for learning while attending Gan Kinneret Nursery Limited. Children’s privacy is maintained during nappy changing and toileting, balanced with safeguarding considerations. Nappy changing times are key times in the day for being close, promoting security, communication, exploration and learning.

Babies

Babies and young children are usually changed within sight or hearing of other staff, while always maintaining their dignity and privacy.
Where the layout of the setting makes this difficult, the setting manager completes a risk assessment and puts alternative arrangements in place.
Key persons have a list of personalised changing or checking times for the babies and toddlers in their care.
Key persons carry out changing for the babies in their key groups wherever possible; back-up key persons change them if the key person is absent.
Nappy changing areas are warm and comfortable, with no bright lights shining down into babies’ eyes.
Mobiles or other interesting objects are available to capture the baby’s attention.
Each baby has their own basket to hand containing nappies and wipes, and possibly a special toy for changing time.
Staff put on aprons before changing starts and prepare the area. Gloves are always worn when dealing with soiled nappies.
All staff are familiar with hygiene procedures and carry them out consistently when changing nappies.
Key persons ensure nappy changing is relaxed and a happy time for babies.
Key persons never turn their back on a child or leave them unattended on a changing mat.
Key persons are gentle and allow time to communicate with the baby, talking and responding to the baby’s sounds. They allow time for play and familiar rituals such as gently tickling tummies or toes.
Key persons avoid pulling faces or making negative comments about the nappy contents.
Key persons do not make inappropriate comments about babies’ genitals, nor attempt to pull back a baby boy’s foreskin unless genuinely required for hygiene reasons.

Nappy changing records

Key persons record when the baby was changed and whether the baby passed a stool, noting anything unusual, such as hard and shiny, very soft and runny, or unusual colour.
If a baby does not pass a stool, strains, or passes hard, shiny stools, parents and carers are informed as the baby may be constipated and the feed may need adjusting.
Unusual stool colour is noted and may be linked to food eaten. A black, green or very white stool indicates a problem and the child should be taken to the doctor.
Exceptionally soft, watery stools may indicate diarrhoea; strict hygiene is followed to clean the changing area and prevent infection. Parents are informed and may be required to collect the child if further symptoms occur.
Any sore bottoms are noted and discussed with parents or carers. A plan is agreed to help heal the soreness, which may include use of nappy cream or periods without a nappy, in line with the medicine administration procedure where medicated creams are used.

Young children, intimate care and toileting

Wherever possible, key persons undertake changing for young children in their key groups; back-up key persons change them if the key person is absent.
Young children from around two years may move into pull-ups when they are comfortable with this and parents or carers agree.
Changing areas are warm and appropriately located, with safe places to lay young children if needed. Mobiles or other objects of interest may be used to focus attention.
If children refuse to lie down, they may be changed while standing, provided they can still be effectively cleaned.
Each young child has their own basket to hand with nappies or pull-ups and wipes.
Key persons ensure that nappy changing is relaxed and used to promote independence.
Young children are encouraged to take an interest in using the toilet. They may sit and talk with a friend using the toilet.
Children are encouraged to wash their hands, with soap and paper towels readily available. Time is allowed for a little play as they explore water and soap.
Anti-bacterial liquid soap is not used with young children, as ordinary soap and water is effective.
Key persons are gentle and avoid pulling faces or making negative comments about nappy contents.
Wipes or cotton wool and water are used to clean the child. Where cultural practices involve washing and drying with towels, staff work with parents and carers to make reasonable adjustments, while still promoting good hygiene and reducing cross-infection risk.
Key persons do not make inappropriate comments about young children’s genitals.
Procedures for sore bottoms are the same as for babies.
Older children use the toilet when needed and are encouraged to be independent.
Staff do not wipe older children’s bottoms unless there is a genuine need or the child requests help.
Key persons are responsible for changing where possible. Back-up key persons take over in their absence; where other staff are involved, they are properly briefed so that all children’s needs continue to be met.
Parents and carers are encouraged to provide enough changes of clothes for ‘accidents’ during potty training.
Any spare clothes held by the setting are gender neutral, clean, in good condition and in a range of sizes.
Leaving young children in wet or soiled nappies or pull-ups may constitute neglect and is a disciplinary matter.
Nappy changing always takes place in an appropriate, designated area – not in play areas or next to snack tables. Where room layout restricts options, a suitable area is agreed that maintains the child’s dignity and good hygiene practice.