How Often Should I Change My Newborn's Diaper, and How Do I Prevent Diaper Rash?

It's 3 a.m., the baby has just finished feeding, and you're standing over the changing pad wondering whether that diaper really needs changing again so soon. If you've lost count of how many diapers you've gone through today, you're right on track. Newborns go through a lot of them, and each one tells you something useful about how your baby is eating and growing.

In this guide, we'll walk through how often to change your newborn's diaper, how many wet and dirty diapers to expect in the first weeks, how to change one step by step, and how to keep your baby's skin comfortable. We'll also talk about how to set up diaper changes so they're easier on your own healing body, because you matter in this picture too.

How often should I change my newborn's diaper?

Plan on checking your newborn's diaper every couple of hours, and change it any time it's wet or dirty. Child development experts at Pathways.org suggest checking before and after each feed so a soiled diaper doesn't stay on too long, and they say to expect anywhere from 8 to 12 diaper changes a day in the newborn months. The number slowly drops as your baby grows.

At night, you don't need to wake a sleeping baby just to check a diaper that's only a little wet. A dirty diaper is different, though, and it's worth changing right away, because stool sitting against the skin is one of the main causes of diaper rash. The American Academy of Pediatrics (AAP) puts it plainly on HealthyChildren.org: change diapers frequently.

How many wet and dirty diapers should a newborn have?

Your baby's diapers are one of the best everyday clues that she's getting enough milk, and the count changes quickly over the first week. According to the AAP's guidance on HealthyChildren.org, here's what to expect for a breastfed baby:

• Days 1 and 2: one or two dark, sticky, tar-like stools a day. This first stool is called meconium, and it's completely normal.
• Days 3 and 4: at least two stools a day that are starting to turn greenish to yellow.
• Days 5 to 7: at least three to four yellow, loose stools a day with small curds, and six or more wet diapers a day with pale yellow or nearly colorless urine.

Formula-fed babies' stools tend to be yellow or tan with a soft, clay-like texture, so ask your pediatrician what's normal for your baby. If you're watching your milk come in, our article on signs your milk is coming in explains how diaper counts and feeding go hand in hand.

Super-absorbent disposable diapers can make it hard to tell how much your baby has peed. Many newborn diapers now have a wetness strip that changes color, and the AAP mentions these as a helpful way to keep track. Some parents also jot down each diaper in a notes app or a simple log during the first week, which makes it easy to answer when the pediatrician asks.

How do I change a newborn's diaper, step by step?

Changing a diaper gets quicker with practice, and within a week or two most parents can do it half asleep. Here's the routine our doulas use in the homes we support:

1. Get everything ready first. Lay out a clean diaper, wipes or a soft cloth with warm water, diaper cream if you're using it, and a change of clothes. Never leave your baby alone on a changing table, even for a second, and keep one hand on her if you need to reach for something.
2. Open the dirty diaper and wipe from front to back. This is especially important for baby girls, because it keeps stool away from the urethra. Clean gently in all the little creases, including the thigh folds.
3. Lift with care. Gently lift your baby's bottom by her hips or ankles, slide the dirty diaper out, and slip the clean one underneath.
4. Let the skin dry. The AAP recommends patting the skin gently and letting it air-dry before you close the new diaper. A minute of diaper-free time is a good habit, especially if her skin looks a little pink.
5. Add cream if needed. A thick layer of barrier cream, like icing on a cupcake, protects the skin from moisture.
6. Fasten the diaper below the cord. Until the umbilical cord stump falls off, fold the front of the diaper down below it so it stays clean and dry. The AAP says the stump usually dries and falls off by about three weeks of age.
7. Wash your hands and toss the dirty diaper.

For baby boys, it helps to point the penis down before you fasten the diaper, which keeps the leaks to a minimum. Keeping a wipe or cloth over him while you change him will also save you a surprise shower.

What causes diaper rash, and how do I keep it away?

Most diaper rash is caused by pee and poop sitting against your baby's skin, along with the rubbing of the diaper itself. The AAP calls this the most common type of diaper rash, and it's more likely during bouts of diarrhea or when a baby is teething. A rash that's bright red and worse in the skin folds may be caused by yeast, which is a fungus that naturally lives in the gut. Babies with very sensitive skin can also react to an ingredient in a diaper, wipe or cream.

The good news is that a few simple habits prevent most rashes:

• Change wet and dirty diapers often, and change dirty ones right away.
• Clean gently, and for a sore bottom, rinse with a squirt bottle of warm water in place of rubbing with wipes.
• Pat the skin dry and give your baby some diaper-free time when you can.
• Use a barrier cream at changes to keep moisture off the skin.
• Make sure the diaper isn't too tight, especially overnight, so it doesn't rub against the skin.

If you think a product is irritating your baby's skin, the AAP suggests switching to a different one for about two weeks to see whether the rash improves.

What should I look for in diapers, wipes and diaper cream?

There isn't one right brand, and the ingredients matter more than the name on the package. Here's what to look for, based on the AAP's guidance:

• Wipes: choose wipes that are free of alcohol and fragrance. Plain water on a soft cloth works well too, especially in the first weeks or when your baby has a rash.
• Diaper cream: look for zinc oxide or petrolatum (petroleum jelly). The AAP calls both good choices and says fragrance-free products are best. You don't need to scrub off a layer of paste that isn't soiled, and you can simply add more on top.
• Diapers: pick a size that fits snugly at the waist and legs without leaving red marks. A newborn size with a cutout or fold-down front for the cord stump makes the first weeks easier, and a wetness indicator strip helps you keep count.

Families who use cloth diapers can follow the same skin-care habits. The AAP notes that cloth diapers are less absorbent and need to be changed more often, so plan for a few extra changes each day.

When should I call the pediatrician about a diaper rash or my baby's diapers?

Call your baby's pediatrician if the rash isn't getting better, or is getting worse, after two to three days of home care. The AAP also says to call right away if you see blisters, pus, crusty or weeping sores, a rash that seems very painful, or a rash together with a fever. A bright red rash with red spots around the edges that shows up while your baby is on an antibiotic is often yeast, and it needs your doctor's advice too.

Your baby's diapers can also tell you when to check in about feeding. Call your pediatrician if, after the first week, your baby has fewer than six wet diapers a day, her urine is dark yellow or has red specks, or her stools are still dark instead of yellow and loose. Call too if you see blood in her stool, or if she often misses feeds or sleeps through them. You know your baby best, and it's always fine to call when something doesn't feel right.

How can I make diaper changes easier on my body after birth?

In the first weeks after birth, your body is healing, whether you had a vaginal birth or a cesarean, and all the bending, lifting and stair-climbing that comes with diaper changes adds up fast. A few small changes can protect your recovery:

• Set up more than one changing station. Keep a basket with diapers, wipes, cream and a change of clothes on each floor of your home, so you aren't climbing the stairs every two hours.
• Change at a comfortable height. A changing table or dresser at waist height saves your back and your healing belly, and it's easier than kneeling on the floor.
• Share the night changes. If a partner or family member is home, let them handle the diaper while you focus on feeding and getting back to sleep.

This is exactly the kind of help a postpartum doula brings. When our postpartum doulas come to your home, they set up changing stations where you need them, keep supplies stocked, change and soothe your baby, and make sure you're resting, eating and healing. With overnight newborn care, a doula handles the night diaper changes and settling so you can sleep. If you're curious how night sleep looks in these early weeks, our guide to newborn sleep by week is a good next read, and our article on what a postpartum doula does explains the role in more detail.

Am I doing this right?

You're doing better than you think. Every diaper you change is part of caring for your baby, and those wet and dirty diapers are good news that she's eating and growing. Keep things simple, change often, keep the skin dry and protected, and call your pediatrician when something worries you. Please take care of yourself along the way too, because a mother who's resting and nourished has more to give.

If you'd like a doula in your home to help with diapers, feeding, nights and your own recovery, book a free consultation at milkdoulaco.com for families in Houston, or at milkdoulaco.com/austin for families in Austin, where you can also call or text (512) 880-8845.