Diaperchange Today's early childhood development question deals with the dreaded morning diaper change. (Is anybody else tortured daily by this like I am?)

Mazzy HATES to be changed right after she wakes up. If I take her directly from the crib to the changing table, she breaks into hysterics and wraps her arms around my neck so tightly that I fear she might strangle me if I do not back away from the A&D Ointment immediately. (She is freakishly strong.)

Most of the time, I can wait for her to settle down before I attempt the change, but about once a week (even though we use extra absorbent nighttime diapers), Mazzy wakes up COMPLETELY SOAKED through her PJs.

Somehow being drenched in her own urine does not seem to bother her (FYI – this does not run in the family), which would be fine if she did not insist I hold her in such a way that the wetness starts to seep into my own clothing. The only Mazzy-approved substitute for being held is to be transferred into our bed— not exactly my favorite place for a living urine receptacle. 

So instead, she screams and cries and tries repeatedly to fling herself off the changing table while I do my best to catch her, stay dry and count the days until the invention of the diaper-changing-robot. It's an issue we've dealt with for as long as I can remember.

Then the question below arrived in my inbox. Why didn't I think of asking Dr. B?

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Dear Dr. B,

My two year old son throws a fit when I try to change his diaper and jammies first thing in the morning. Which maybe wouldn't be such a big deal if he wasn't always pee-soaked. (The kid drinks like a fish.) Even when I manage to get the diaper and clothes off, he tries to put them back on. Why does he love his full diaper and wet clothes? And how can I make this easier on both of us?

Thanks,
AK

Dear AK,

Most children have difficulty transitioning from one thing to the next and the transition from sleep to waking up is no exception. Mornings can be especially challenging because children are expected to make transitions much more quickly and we often don’t have the luxury of time to be patient with uncooperative behavior.

Children who resist diaper changing in the morning are most likely trying to tell us, “I’m tired,” “Stop rushing me,” or “I’m not ready yet,” while children who resist diaper changing throughout the day may become upset because it interrupts something fun they were doing or because they are trying to avoid a negative experience.

Below are 9 strategies you can try to make "the morning diaper change" easier.

Tips for Resolving the Pee-Soaked, Leaky Diaper Problem

1) Change Diaper Size or Type: Pee-soaked and leaky diapers may be the result of diapers that are too small or not absorbent enough. You may want to try getting a bigger diaper size, using a diaper insert that soaks up additional urine, and trying different kinds of extra absorbent nighttime diapers.

2) Reduce Liquid Intake: He may be drinking too much before bed. Try to reduce his liquid intake 2 to 3 hours before bedtime. You can try giving him more liquid earlier to reduce the likelihood that he will want to drink as much later on. Or try gradually filling his cup with less liquid at night, keeping him more occupied in activities before bed, and taking longer and longer to refill his cup when he asks by distracting him with other comforting bedtime items (e.g., special stuffed animal, blankie, or cold teething toy).

3) Try an Extra Diaper Change at Night: If you dare to wake a sleeping baby, consider changing him while he’s asleep. Some children are deep sleepers and can be changed at night without them waking up. Try changing him before you go to bed to free him up for additional wetness in the morning.

Tips for Making the Transition Easier

4) Give It Time: The easiest solution to morning diaper changing meltdowns is probably to simply wait 15 to 20 minutes before changing (even if he is soaked) to give your son some time to wake up, realize that he is indeed soaked, and time to prepare himself to be changed. You can also try to change your morning schedule to devote more time to diaper changing and dressing so that you can be more patient and flexible during the process. Also, be prepared with everything you need before you start to make the process as efficient as possible. If resistance occurs at other times during the day, try to change him at natural breaks between activities or give him some advanced notice or warning instead of interrupting his play or other enjoyable tasks. Avoid changing him abruptly or unexpectedly.

5) Change Locations: Some behaviors become associated with specific places and routines. Children also exhibit challenging behaviors during changing because they are distracted by other things in the room that you may be unaware of such as toys, lights, or sounds. Try moving to the bathroom or a less distracting quiet place to minimize distractions and attempt to break the negative cycle of uncooperative behavior.

6) Create a Distraction: Diaper changing is often easier when children are distracted by something positive such as a funny made-up diaper changing song, a countdown so they know when it will be over, or a special toy they can play with while you are changing.

Tips for Making Diaper Changing More Enjoyable

7) Set a Positive and Fun Tone: Diaper changing can be viewed as a disgusting chore or as an intimate time between you and your child where you are able to meet his basic needs in a fun and positive way. Children can usually sense when you are trying to rush through a task to get it over with or truly enjoy the task and want your child to enjoy it too. If you pretend to enjoy diaper changing, your child may start to enjoy it as well. Use positive language, put on fun music, be silly and animated, and use humor and make-believe (such as talking clothes or diaper peek-a-boo) to send the message that diaper changing is fun.

8) Encourage Participation: Try to get your child engaged in the process by helping pull wipes out of the container, picking between two items of clothing, and pulling his shirt over his head. By giving your child more control and assisting him toward increased independence, you will improve his interest and cooperation in the process.

9) Create Something to Look Forward to: It may be easier for your child to endure getting his diaper changed if he knows something good is coming right after. You can tell him you have a special surprise for him when you finish or you can use “first, then” or “when, then” statements. For example say, “first diaper, then play with (favorite item or activity)” or “When you finish changing, then you’ll have time to play.” It may take him a few days to understand this concept and to trust that he will get the desired item or activity but stick it out and make sure you follow through.

Hope this helps!
— Dr. B