Download information as a Diapering and Handwashing information sheet ().

Preparing for Diapering

To minimize contamination outside the diaper changing area, prepare for a diaper change before bringing the child to the changing table, by having ready:

• Changing table paper (if used) to cover the table from the child’s shoulders to feet (in case it becomes soiled and must be folded over to create a clean surface during the change)
• Enough wipes for the diaper change (including cleaning the child’s bottom and the child’s and teacher’s hands after taking the soiled diaper away from the child’s skin)
• A clean diaper, plastic bag for soiled clothes and clean clothes (if soiled clothing is anticipated)
• Non-porous gloves (if they will be used), and a dab of diaper cream on a disposable paper towel if cream is being used

Before starting the diaper change, supplies should be removed from their containers and placed either near the diapering surface or on the paper towel or liner on the changing table.

Diapering Procedure

1. Prepare for diapering (as indicated above).
2. Place the child on diapering table. Remove clothing to access diaper. If soiled, place clothes into a plastic bag.
3. Remove soiled diaper and place into a lined, hands-free trash container. (To limit odor, seal in a plastic bag before placing into trash container.)
4. Use wipes to clean child’s bottom from front to back.

Additional Precautions

• The diapering surface must be sanitized after each diaper change with a bleach-water or other approved sanitizing solution (all surfaces must be able to be sanitized- e.g., no quilted pads or safety straps, no containers that are stored on the diapering surface). The bleach-water solution must be allowed to stay on the surface for more than 2 minutes, to kill the germs. So it is best for staff to spray the surface as the last step of the diapering procedure before washing their own hands. After the time lapse, the surface can be dried (no additional handwashing required at this time) or allowed to air dry (and wiped dry if still damp) before use with another child.
• Diapers are disposed of in a hands-free covered can (usually one than has a step pedal that lifts the lid) to prevent further contamination of surfaces.
• Toys that are played with or objects that are touched while children’s diapers are changed must be put aside to be sanitized.
• Note: Both child’s and staff’s hands must be washed after the diapering procedure is complete.

Handwashing Procedure

Children and staff members shall wash their hands using the following method:

1. Check to be sure a clean, disposable paper (or single-use cloth) towel is available.
2. Turn on warm water, no less than 90 degrees F and no more than 120 degrees F, to a comfortable temperature.
3. Moisten hands with water and apply liquid soap to hands.
4. Rub hands together vigorously until a soapy lather appears, and continue for at least 10 seconds. Rub areas between fingers, around nailbeds, under fingernails, jewelry, and back of hands.
5. Rinse hands under running water, no less than 90 degrees F and no more than 120 degrees F, until they are free of soap and dirt. Leave the water running while drying hands.
6. Dry hands with a clean, disposable paper or single-use cloth towel.
7. If taps do not shut off automatically, turn taps off with a disposable paper or single-use cloth towel.
8. If door must be opened to exit handwashing area, open door with disposable paper or single-use cloth towel.
9. Throw disposable paper towel into a lined trash container; or place single-use cloth towels in the laundry hamper. Use hand lotion to prevent chapping of hands, if desired.

Hand Sanitizers

Thorough handwashing with soap and water is always the preferred method of cleaning hands and is required in most situations in childcare.  One opportune time for the use of hand sanitizer in childcare when parents and children (24 months and older) enter the childcare facility. Leaving “germs” at home really does reduce infection rates in childcare and the only way to do this is good hand hygiene before contact with objects and other people.

Please read the national standard from Caring for Our Children for detailed information on the use of hand sanitizers in childcare.

Note: For visibly dirty hands and situations requiring handwashing by the state of Idaho, you may NOT substitute washing with soap and warm water. These times include but are not limited to:  diapering, assisting with toileting, before eating, and food preparation. 

Feel free to contact the Child Care Health Consultant Program or your nurse consultant if you have additional questions.

Additional Resources about Diapering and Handwashing

More information about diapering and handwashing, including a video demonstration, is available from The Centers for Disease Control and Prevention.

From All About the ECERS-R (2003), Cryer, Harms, and Riley, Pact House Publishing (a Kaplan Learning Co.) & Caring for Our Children: The National and Safety Performance Standards for Out-of-Home Care, 2nd edition, American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Childcare (2002) and from All About the ECERS-R, by D. Cryer, T. Harms, and C. Riley (2003).