Home › Newborn & Baby Care

Diaper (Nappy) Changing and Skin Care for Newborns

How often to change, how to prevent nappy rash and keep skin healthy.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

In the first weeks a newborn may need eight to twelve nappy changes a day. Frequent changes keep the skin dry and protected, and what you find in the nappy is also one of the best everyday clues that your baby is feeding well.

How to change a nappy

• Wash your hands and gather everything first: a clean nappy, warm water and cotton wool or fragrance-free wipes, barrier cream if you use it, and a changing mat.
• Lay your baby on a flat, safe surface and keep one hand on them at all times. Never leave a baby alone on a changing table, bed or sofa, even for a second.
• Wipe away the worst of any poo with the front of the nappy, then clean with warm water and cotton wool. For girls, always wipe from front to back.
• For boys, clean around the penis and testicles and into the creases. Do not pull back the foreskin, because it separates on its own over several years.
• Pat the skin dry and, if you can, let your baby kick without a nappy for a few minutes before putting on a fresh one.
• Fasten the nappy snugly, leaving room for two fingers at the waist, and fold the front below the umbilical stump until it falls off.

In the first month, many health services suggest plain warm water and cotton wool rather than wipes. After that, fragrance-free wipes are fine.

What to expect in the nappy

• Days 1 to 3: the first poos (meconium) are thick, sticky and black or dark green. This is normal.
• Days 3 to 5: poo turns greener, then yellow-brown or mustard yellow as milk comes in.
• Breastfed babies usually have loose, yellow, seedy poo. After the first few weeks, some exclusively breastfed babies go several days between poos, which can be normal. Formula-fed babies tend to have firmer, tan-yellow poo.
• Wet nappies increase day by day. From about day five, most babies have at least six heavy, wet nappies in 24 hours. Fewer than this can mean your baby is not getting enough milk, so ask for advice.

Call a doctor or midwife if you see

• Pale, white or clay-coloured poo, which can be a sign of a liver or bile duct problem and needs same-day medical advice
• Red poo or black poo after the first few days, or any blood in the poo
• Very few wet nappies, dark or strong-smelling urine, or orange or brick-red crystals in the nappy after the first days
• Frequent watery poo, especially with vomiting or a fever, because newborns can become dehydrated quickly

Preventing and treating nappy rash

Nappy rash is very common. It is usually caused by wetness, friction and contact with urine and poo, and shows up as red, sore skin in the nappy area that may look shiny or patchy.

• Change wet and dirty nappies promptly, ideally at every feed in the early weeks.
• Clean gently with warm water and pat dry rather than rubbing.
• Apply a thin layer of barrier cream, such as a zinc oxide or petroleum jelly based product, at each change if the skin looks red.
• Give nappy-free time on a towel whenever you can.
• Avoid talcum powder, which can be breathed in, and skip perfumed wipes, bubble bath and harsh soaps.
• Wash cloth nappies in fragrance-free detergent and rinse them well.

A rash that stays bright red despite good care, or that has small red spots spreading beyond the main patch or sits deep in the skin folds, can be a yeast (thrush) infection. This needs an antifungal cream, so ask your pharmacist, doctor or health visitor.

Other newborn skin

• Baby acne: small red or white spots on the face in the first weeks, caused by hormones. Wash with water only and do not squeeze the spots or use creams.
• Milia: tiny white dots on the nose and cheeks that clear without treatment.
• Cradle cap: yellowish, greasy scales on the scalp. Gently massage in a little plain oil or emollient, leave it on for a short while, then brush softly and wash. See a doctor if it spreads or looks inflamed.
• Peeling skin in the first weeks is normal. If skin is very dry, red or itchy, ask your doctor about eczema.
• Heat rash: tiny red bumps in skin folds or where your baby is overdressed. Dress your baby in light layers and keep the room comfortably cool.

Everyday skin care

• Use water only for the first month, then a small amount of mild, fragrance-free wash if needed.
• Skip lotions, oils and powders unless a health professional suggests an emollient for dry skin.
• Wash baby clothes and bedding in fragrance-free detergent and avoid fabric softener if the skin is sensitive.
• Keep young babies out of direct sun and use shade, loose clothing and a wide-brimmed hat. Ask your doctor about sunscreen for small areas if shade is not possible.

When to see a doctor

See a doctor if a rash is spreading, blistered, weeping or bleeding, if it comes with a fever, or if your baby seems unwell. A temperature of 38 °C (100.4 °F) or higher in a baby under three months needs urgent medical attention.

Where to check current advice

Guidance differs a little between countries, so check the latest advice from your own health service: the NHS in the UK, the HSE in Ireland, the CDC and the American Academy of Pediatrics in the US, the Canadian Paediatric Society in Canada, or the Raising Children Network in Australia.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.