MAY I CHANGE YOUR DIAPER PLEASE?
Imagine you are sitting patiently in your doctors waiting room, with a group of 10 strangers, when suddenly a doctor and a nurse burst through the doors, deep in personal chit chat, walk straight toward you, grab you under your shoulders and without saying a word, hoist you over his shoulders and carry you to the exam room.
Once in the exam room, he plops you on the table and propels your legs in the air to remove your pants, all the while, still deep in conversation with the nurse.
He conducts a very personal and intrusive exam, using cold instruments, commenting on the color of your skin to the nurse, murmuring about potential issues and never once checking in with you or even glancing your way.
Suddenly his cell phone rings and without hesitating, he answers it, and begins talking on the phone while you lay there, pant-less, exposed, vulnerable, confused and embarrassed. You don’t think that protesting is an option because he is a doctor after all, so you just lay there, as your dignity and self respect slowly disappear into a deep suppression of feelings.
When the exam is over, he hoists your legs back in the air, awkwardly pushes your pants back on and grabs you behind the neck to pull you up into a sitting position. He lifts you again, drapes you over his shoulder and walks back to the waiting room, where he plops you back down in your seat, not saying a word, turns and vanishes again behind a door. All the while still on that phone call.
How would you feel about this? How would you feel about yourself? What kind of decisions would you be making about your value as a person? Realistically, would this ever happen between two adults? No way!
Sadly, this is what most diapers changes are like for babies and toddlers. They lack respect, connection, tenderness and consideration for how they feel during this very private and intimate process. An adult would not stand for that level of disrespect and cold interaction but children, especially babies, do not know to ask for anything different. They rely on us to set examples, follow our lead and soak in all the messages that come along with being treated this way.
Diaper changes are the first opportunity children experience someone else touching their body. This is an important and valuable opportunity to teach them that their bodies, especially the most private areas, deserve honor and respect.
May I check your diaper please?
When I approach a child in my care to change their diaper, I do so with a gentle stride and a calm demeanor. I place my hand on their back and sweetly ask “May I check your diaper? Then I patiently wait 7 to 10 seconds giving them time to register the question (terry time) and respond before I do anything. Some children will say “yes or no” others will shift their bottom out as a non verbal, “sure” and I will then brace their body with one hand, so they do not feel off balance, and gently pull the diaper out to peer in. If I see the diaper is in good shape and does not need changing I will gently release the diaper, stable their body if they have shifted and say “Thank you, looks good.” I will always, always say thank you.
May I change your diaper please?
When a diaper is due for a change, I ask in a way that communicates to the child that it is their choice. Their body, their choice. Most children will allow a diaper change when you ask with respect and kindness because they feel honored, safe and valued and want more than anything to be in partnership with you.
When a child says “no” and it is necessary to change it, I always honor the no by responding “I hear you, you aren’t ready. I can come back in a few minutes and ask again.” When I return my verbiage will be different. “I am back, it is time to change your diaper now, are you ready?” If a child says no again I will honor the “no” once more by saying “You still aren’t ready, I understand, hmmm, I am worried if the pee or poop stays in your diaper much longer it may give you a rash and I want to keep your skin safe so it is time now,. but I will do it quickly so you can come right back to what you are doing.” More respect and acknowledgement of them and their perspective. You are building partnership and modeling respectful behavior in relationships.
This would be the moment most caregivers pick up the child and carry them, against their will, to the diaper changing table, quickly and forcefully move their body around to change the diaper then, put them back on the ground in a hurry. Much like the doctor did to you in the beginning of this post.
Rather than do this, I stick with respect and offer the child choices to choose from that both end in them getting a diaper change. “Would you like to walk to the diaper station or would you like me to carry you?” This is a crucial moment for the child, you, your relationship and future diaper changes because still, you are honoring the child’s perspective and this detail is not going to be lost on them. In fact, they are taking it all in, making notes on what respect feels like. You are planting some serious and powerful seeds in these moments.
Would you like to walk or would you like me to carry you?
The power of choice is important for all of us. When we feel like we don’t have a choice or aren’t in control we feel anxious and this often leads to feelings of lack and then depression. The Whole Brain Child goes into the importance and power of giving your children, even babies, choice in a grand a glorious way. I recommend reading it but only if you enjoy having life changing experiences!
In my experience, most children will choose walking to the diaper station because it’s the closest thing to them feeling in control as it gets at this point. They have already told you “no” twice and yet still you are pressing on with this pesky interruption. As soon as they say “walk” I celebrate and honor their choice. “Great!” I say. If they choose to walk but then are not in fact walking I will then support them by gently turning their body towards the table and give a gentle assist of movement. I am basically lovingly saying “this is happening now.” If they resist moving and plant their feet or throw their body down, I will say (and this is a gem that you will use often) “Ah, I heard you say you wanted to walk but now you are choosing to stay still so you are telling me you want me to carry you, I would be happy to.” and I then bend down, still with love and kindness, pick up their body and carry them to the changing table.
Some children will start walking once you begin to pick them up and some will wiggle around making it very challenging to move them. If I have a wiggle worm, I pull them tight and say “I’m holding you tight because I want to keep you safe. You are moving so much I do not want you to fall” More love and kindness.
The key in these moments is to avoid engaging in this resistant behavior. Your only job is to steady the course, no matter what attempt at distraction your little throws your way. This is a stellar opportunity to practice acceptance of all choices. Whatever the child does, accept it, take it in an adapt but steady the course. This diaper change Is happening buddy.
Why is steadying the course so important?
It’s crucial actually. The child wants you to steady the course. Even though they are making it hard for you, they are testing your relationship. They are tracking the following outcomes:
Can I trust this person to follow through?
Does this person care enough about me not to give up on me?
Did they mean it when they said they didn’t want me to get a rash?
Am I worth all this hassle?
Who is in charge here? Me or them?
When you steady the course, and don’t let them pull you into their distraction tactics they feel loved by you. When you let them distract you or wear you down and/or abandon mission, they question your commitment to them and you become untrustworthy.
May I pick you up?
So, we are finally at the table, the child chose to walk, now you are both standing at the table and it’s time to pick them up and lay them down. Here is another opportunity to model respect “May I pick you up?”
Typically they will raise their hands to say yes. Asking if you can pick them up not only models more respect but allows them to prepare their body to be picked up. As soon as you ask the question, “may I pick you up?” their brain communicates to their body to flex the necessary muscles to prepare to be picked up. This enables your child to feel strong and participate when you pick them up. Grabbing a child to pick them up, without warning, is shocking and scary. Asking and waiting until you have their attention and permission. will support them physically, mentally and will build more trust between you both.
Now, the child is in your arms, gently and lovingly lay them down supporting their head and entire body until they are laying comfortably.
It’s time to connect
Once the child is laying comfortably, I take a breath, lay my hand gently on their belly, look into their eyes, smile sweetly and ask “Are you ready?” I wait for them to respond and then begin the diaper change.
First: Ask them to help while you remove their bottoms. “Will you please lift your legs in the air so I can remove your bottoms?” then watch as they gleefully shoot their legs in the air. Gently pull the band down from their waist and lovingly remove from both legs. Stay connected and say “Thank you, that was so helpful!” Stay present and tell them you are going to take off their diaper now. Unlatch diaper velcro and open diaper then ask for participation. “Will you lift both your legs in the air please?” When they do, remove the diaper from under their body. Stay connected, make eye contact and acknowledge their assistance. “Thank You, that was very helpful.”
Second: Tell them what you are doing next. “I am going to use this wipe to clean your body. It may be a little cold.” then gently wipe them and, if necessary to hold their legs up, do it with a gentle, respectful grip. Think of the doctor who threw your body around during that exam and ask yourself how you would have wanted him to move your body? What would have made you feel respected and safe and do that to the child.
Third: Hold the new diaper and show it to them. “I am going to put this fresh diaper on you now, will you please lift your legs up again?” They are usually thrilled to assist you in this way and legs go flying in the air. “Thank you! That is so helpful.” Then slide the diaper under their bottom and ask them to please lower their legs back down. If it is necessary to move the diaper, or their body to center, make sure to tell them or ask for more help. “Will you please move your hips (gently touch the hip) a little towards me?” (motion in the direction you are referring to) then, when they do, more celebration. “Thank you! Now I am closing your diaper.”
Fourth: Hold up the bottoms and say “Will you please left your legs again?” When they do, “Thank you!” begin slipping the bottoms back over their legs and gently slide them up their legs. “When you reach the hips ask them, “will you please lift your hips up?” and when they do, slide their pants up and say. “All done, that was so helpful!” Then ask them if they are ready to be picked up and when they respond by lifting their hands and flexing their abdomen you will know they have said yes! Lift them gently, place them down lovingly and thank them for all their help.
Commitment to respectful diaper changes will create a beautiful relationship between you and the children you care for. They will rarely resist having a diaper change because the experience will be so rich in connection and we crave connection above everything. Avoid giving children electronics to distract them during a diaper change. You will be teaching them to check out when someone is touching them. Avoid commenting on how their poop smells or how much they pooped. It is embarrassing and disrespectful to make fun of how a child’s body creates smelly or gross things. They may interpret it too mean they are gross or smelly. Stay neutral, matter of fact, no big deal, all in a days work.
Stay present with your little one when changing a diaper. Stay off the phone and avoid interruption until the diaper change is complete. Make eye contact as much as possible and talk with them about the details. They love you, they trust you. This is a beautiful time to honor them, teach them and model kindness.