Checking in with Stand Up Diapering

A work friend emailed me recently and asked for an update on how to stand-up diaper a boy....so here goes!

I wrote my past "stand up diapering" post after potty training my daughter . (And THIS ONE while we were still in the process.)  We are now on to Little Man and so I wanted to update how the process is going with him.  Additionally with Quinn we used disposable diapers.  With Beck we are using cloth diapers, so I feel like I'll have a good handle on the learning process through both methods. 

We started "potty training" Beck from his first days of life.  In a developmentally appropriate fashion we began talking to him about the diaper change.  "Mommy's going to open your diaper.  You have a VERY wet diaper with lots of pee-pee!   Let's put this dry diaper on you and that will feel much better."  (Imagine that being said in a nice baby-talk voice, of course!)  "You are poopy and stinky, Mister!  Mommy's going to clean your bottom with this wipe.  There, that's better!  We'll throw this dirty wipe in the bag and get a nice fresh diaper."

STEP 1-Begin by explaining what is being done during diaper changes and giving the child the vocabulary that goes along with diapering.  From birth to about 10 months we changed him on a changing table (okay, really the top of my dresser, but close enough).  Always using the same spot at home is important to signify "THIS is where diaper changes occur" and to begin to help the child clue in to the schema of diaper changes--location, procedure, vocabulary.  While it's a bit more work to change diapers in the same place every time, it is helpful to the infant to understand they'll be having their diaper changed. 

Eventually around 6 months old my son began to understand what was being done during diaper changes.  He'd reach for the velcro tabs on his diaper as soon as we'd remove his clothing.  He also liked to help hold items for the diaper change--cream, a wipe, etc.  We continued talking with him about the diaper change.

STEP 2- Begin including the child in the diapering/toileting process as soon as possible in a way that is developmentally appropriate.  Initially this begins with having them hold items used for the change. 

At 10 months Beck was able to stand while holding onto something.  At this same time he began to struggle with us to stay still during changes, trying to "alligator roll away".  These are the two signs that it's a good time to begin stand up diapering.  With Beck we began right away in the bathroom.  Since our master bathroom is the bigger one, we designated that our diapering station.  We do have a two story house, but we were fine with taking him upstairs for diapering.  If stairs are an issue, you can always have more than one diapering station on each floor.  I talked about this before in my earlier post, but the Montessori method works to give children authentic opportunities for tasks--this is the whole reason they believe bathrooming should take place--in the bathroom!  So here is our set up in our bathroom:

We keep diapers in the bathroom cabinet in two baskets--one for the fabric inserts and one for the PUL covers.  This works for us using cloth diapers.  We pile the "overnight doublers" in between the two baskets.  A nice benefit to this is that Beck LOVES opening and shutting cabinets, so you'd better believe he'll take any opportunity he can to open and shut these. 
 

We keep cloth wipes and a wetbag (for dirty diapers/wipes) next to a little stool.  I started out placing a small, interesting item on the stool as well, to give Beck something to look at while I changed him (I'll talk more about this later...).  With Quinn we used a similar setup, though we kept a wicker basket with extra disposable diapers, walmart bags (for poop diapers), and cream under the stool.  Beck's cream is coconut oil in a glass jar, so I keep it out of kiddo reach. 
The stool is used for Beck to hold onto during changes.  At the lab school where I learned to stand up diaper we used a small chair for the teacher to sit in and the child actually supported themself on the teacher's leg.  I have also used the toilet when we've been at someone else's bathroom.  Usually I just throw a towel over the closed toilet so Beck doesn't germify his hands by touching all over it.  If it's just one time I'll be doing it, I often just wash his hands really well after he holds onto the toilet.

STEP 3- Once the child is able to support their weight assisted, begin standing diaper changes in the restroom in a "diapering station." 

Of course the first few times you do this the child wants to sit down, crawl away, etc.  Be patient--of course no new task happens automatically the first time.  Think of it as a process.  Like eating--your child didn't figure out how to eat the first time you approached his mouth with a spoon.....If your child tries to walk/crawl away, gently say, "Stand here for a diaper change!" and help his body back to the stool.  You may have to do this repeatedly.  It helps initially to put a book or small toy on the stool that the child will want to look at.  Continue using the vocabulary and explaining the process as you change the diaper.   After a few changes your child will understand what to do.  Beck was very interested with the wipes container, so it worked well to let him open and close that as I changed his diaper.

wetbag and now he's moved on to wanting to zip/unzip it.  He also loves when I put a little dab of diaper cream on his finger and ask him to put it on his bottom. 

So at a year Beck could--stand for diaper changes, remove his own diaper, clean his body with a wipe and put it in the wetbag.  He also waved his hand at any poopy diaper and said, "YUCK!" to which I'd reply "poop goes in the potty" while I dumped it in (off his cloth diaper). 

Now at 16 months we are on to more tasks!  As soon as he figures out the past skill,  I know he's ready for another step in the toileting process.  I love stand up diapering because it allows the child to participate in toileting in an active, developmentally appropriate way, instead of being a passive observer just laying there watching me do all the work.  This method is also very empowering for the child--they are so proud to be able to complete these tasks on their own!

Here's Beck getting a diaper:

Putting it under the table:
(ignore the snotty nose....he was straight from nap.)

I always do a "shirt roll" before starting the procedure.  This keeps clothing out of the way and is good to teach them so that when they use the toilet they don't pee on their shirt.  Initially I do the rolling, but as they start using the toilet I provide modeling for them to do it themselves. 

Right now Beck is working on removing his own pants.  I often get the top down over his bootie, then he takes it from there.  We sing (tune: London Bridges) Beck's pants are falling down, falling down, falling down....alll the way down!"  (Look how proud of himself he is!!)

Then he takes off his diaper and hands it to me.  With Quinn I had her put it in the trashcan herself.  With Beck I need to put the used insert in the wetbag and we toss the cover in the shower to be rinsed in bathwater after the kids bathe. 

Getting a wipe to "clean his body."

Putting his wipe in the wetbag.

STEP 4-Include the toilet when applicable. 
At 16 months Beck has obviously noticed the toilet.  He wants to come in and look at it whenever anyone else is using it.  He wants to flush it and he wants to play with toilet paper.  These are cues he's ready to START learning about the toilet.   I choose to use the actual toilets for training.  For me this makes more sense than the little potties.  I don't want to have to teach the skill once on a little potty and then teach it again when it's time to move to a big potty.  Also little potties aren't accessible everywhere.  We use a potty seat and a stepstool.  Beck loves snapping on the potty seat (Q did, too, at this same age!).  Right now I am setting him on the potty.  Q totally climbed on like a mountain woman herself at this age, but Beck isn't quite as agile.  Typically he just sits for a second-- I am showing him how to tear off a little piece of toilet paper and "clean his body" and then he throws it between his legs into the water.  We will refine and expand on these skills over time, but for now he's learning the logistics--and later when he's actually concentrating on the act of peeing, he will already know how to use toilet paper, clean his body, and flush--so he will only have to focus on that one skill--peeing.  Additionally whenever we know he's pooping we take him to the toilet and set him on.  Often he ends up pooping in the potty.  We don't make too big of a deal about it--just say, "Poop goes in the potty!" and he gets to flush it down.  He sits on the potty in the morning, before nap, and before evening bath, then anytime we catch him pooping.  Again, we don't make a big deal out of any part of it--we just treat it like a normal part of our routine.  If he resists, I help him if I can, and if not we just let it go until next time.  The Older Infants classroom I worked in at the lab school used this exact same procedure and all of the kids sat on the potty, tore tp, "cleaned" and flushed at each diaper change, then washed their hands, with help (again, don't wash their hands FOR THEM....teach the steps and let them do what they can, expanding as you go!)  Very rarely did someone not want to, and if so, it was calmly accepted without making a big deal of it. 

Beck is currently working on putting his own pants back on--right now I hold them open and he steps into them (instead of me putting his lets in).  He's also working on removing his own shoes and socks and rolling down his shirt after a diaper change.  When he has a poopy diaper (such as in the morning when he wakes up) I dump it in the potty while he watches, saying "Poop goes in the potty!" and he flushes it.

The logistics--reviewed. 
--I've found it works well to turn the diaper inside out before putting it on a standing child.  Then I double check all the holes--waist and both legs to make sure the diaper is on straight.  If you are nervous about getting the diaper back on, just fasten it however you can quickly and you can always make adjustments afterward.  Verbally explain to the child what you are doing!  "Mommy needs to tighten up these tabs so your diaper doesn't fall off!" 

-When wiping poop you can lift first one leg and clean that side, then lift the other and get the rest. 

-Just like your child....the first few times are going to be awkward, but you'll get the hang of it!  Promise!  I worked in a school of 40+ teachers and all of us had to learn it--there wasn't anyone who was not able to do it after a week or so.  Just be patient and relax!

So.....in review.....I Love the stand up diapering/Montessori diaper changing method because it allows toilet training (potty training) to be a process that is refined as a child grows--allowing them to be an active participant in each stage as they are able--and it doesn't require a radical, sudden learning curve where a child is asked to master the entire process in a couple of days.  It is slow, it's simple, it's NOT A BIG DEAL, it's routine, and it is pleasant (well, as pleasant as poop can be....). 

I'll try to remember to stay current with some updates on the process as we continue it with Beck!!

Stand-up diapering....the long version. But SO worth it hanging in there for.

When I finished grad school about 5 years ago I took at job at a college lab preschool. The school was used as a teaching model and practicum site for early childhood/child development college students. It was a preschool that ran 2 programs in the same building--a traditional preschool that served infants through preK--and also a Montessori program also serving infants but including kindergarten, as well. I was hired to work in the traditional model, primarily in the 2 year old classroom.

As part of my orientation (I LOVE their model for orientation), I had to spend several hours observing each of the other classes through the two-way glass (and I could listen by wearing some headphones that connected to a microphone in the classroom....it was an awesome set up!). The Montessori program, especially at the infant and toddler levels, instantly amazed me! I was so shocked to see 1 year olds setting their own tables, using silverware, regular cups, and NAPKINS!!! This was just the beginning of my journey....

The toddler class I taught in followed a more traditional philosophy, but it was still highly influenced by Montessori methods. One that was immediately foreign to me was stand-up diapering. When I first observed teachers in the infant and toddler classrooms diapering standing up, I wondered what in the world they were doing....and then when I heard this was the ONLY way any child able to stand could be changed, I was a little nervous whether I'd be able to do it...and why in the world anyone would WANT to do that.

I remained a critic for only a couple of days.  It was easier to master than I had thought. My co-teachers gave me great tips (and I learned a few lessons the hard way.) I quickly saw the reasoning and value behind stand-up diapering....first in the toddler classroom where our children were mastering potty-training, and then later, when I took on some extra hours in the older infant classroom and saw the pre-potty-training stages.

First off, in the Montessori method, there is no such thing as potty training a child over a couple of days, over a weekend, or even over a week. Like most aspects of child development, procedures and skills are taught gradually and methodically--giving the child as much responsibility as they are developmentally ready to handle at each point of their physical, emotional and cognitive (mental) growth.

So....the first step begins even with tiny infants when caregivers explain what they are doing as they change diapers. They explain to the child what's in their diaper (pee or poop) so the infant begins to make a connection that there is a difference...important later on when a child needs to be able to discern if they need to pee or poop in the potty. They may also begin to let the infant hold the diaper or a wipe and hand it to them when they are ready for it.

When a child is able to stand up with help (ie: holding onto something), they are ready to begin stand-up diapering. For us, that was around 10 months with Quinn (our daughter) and Beck (our son). You can tell it's time when they start the "alligator roll." If you've had a baby you know what I mean! The second you start diapering he tries to roll away from me and fight getting changed. I cringe anytime I see a parent in a battle with an "alligator baby" during a diaper change, and I cringe even more when I hear parents tell me they have to spank their child (or use some other form of punishment) to make them lay still to get their diaper changed. Alligator rolling combined with leg strength to stand (with support) equals time for the world of stand-up diapering!!

In a classroom setting, the teacher would sit in a small chair and put the child between her legs, with the child holding onto one leg of teacher to assist with standing (this was in the 2 year old classroom). In the infant classroom the child supported himself on a low changing table that was about 2 feet off the ground (of course....Montessori is all about child-sized furniture!!).
At home we bought two very cheap stools from Ikea (they kinda look like nightstands) for around $12. We kept one upstairs and one downstairs in the bathrooms.

It's important to have all your supplies ready at hand. We kept a basket under the stool with diapers, wipes, bags for dirty diapers, and diaper cream.

Before changing the dirty diaper, we would get the new diaper and unfold it and actually turn it inside out, so that once it's placed on the child the leg flaps (that contain the pee) are not tucked under.

At this first stage the child is encouraged to help with removing clothing--ie: show them how to loop their fingers in the waistband of their pants and use a downward motion. We often sang the song "Quinny's pants are falling down, falling down, falling down." to the tune of London Bridges.

The child is also asked if they have pee or poop (even if they don't have the words to answer yet.) The caregiver checks, and notifies the child. If it's a pee diaper the child can be taught to remove it themselves. We started teaching Quinn how to open the tapes on her diaper. If it's a poopy diaper, the child needs to learn that the caregiver removes it, so it doesn't get everywhere! It's important to teach the child to differentiate between poop and pee because when they are starting to use the toilet they need to know if they are peeing or pooping. Seems simple to us, but initially kids don't know the difference. They will be taught that if you need to poop sometimes you might need to sit a little longer, and you wipe differently, etc. Also distinguishing between pee and poop is helpful later on, as you can encourage the child to come to you immediately for a change if they have poop.

The child can be in charge of getting a bag for the dirty diaper. They can also be taught how to open the wipes and take them out one at a time, handing them to the caregiver. Of course all of these skills are introduced one at a time, with lots of practice for each skill. For a pee diaper the child is asked to "clean your body" first (use a wipe on themself). The caregiver can follow up with a second wipe, if needed. If it's a poopy diaper, the caregiver cleans first, and the child can have a turn when the caregiver's finished.

People always freak out the most when they hear about stand-up diapering when it's a poopy diaper. I actually learned it's much easier standing than doing it laying. First off, often it doesn't get smashed all over the place onto the child's body because the child layed on their bottom. The poop stays more solid, making for easier clean up. The child can either lean forward, over the leg of the caregiver, or one of the child's legs can be lifted to access all the areas that need wiped. The child can switch over to holding onto the caregiver's other leg if the caregiver needs to wipe the front of the child.

For my two, we used the stool, so we were actually behind them when we changed her. Initially we had to work with on remaining standing--they'd want to sit back down and crawl away. We would let them take the wipes out or put a small toy or book on the stool top to keep interest (for about a month, until they figured out what was going on and had no problem remaining standing).

The caregiver explains what they are doing as they help remove clothing, clean the child's body, and help the child redress.

Another facet of this method is that once the child starts standing, diapering is relocated to ONLY occurring in the bathroom. This is for obvious reasons--the place where we take care of toileting needs is in the bathroom. We kept our "changing stool" in the bathroom. We also purchased a small toilet seat (that fits on the bigger one) and stool, so she could begin to learn about using the toilet. In our school's program parents were encouraged not to place little toilets in any other locations (living room, etc.), because children need to learn to go to the bathroom to handle all toileting needs. It's important to diaper in the bathroom (ding--one of those early "pre-potty" steps that leads along the path to potty training....) to help the child make the connection that potty stuff happens in the bathroom! I think one of the first reasons many parents resist stand up diapering is because it's a little more work--you can't just change the child right where you happen to be...you have to get up and go into the bathroom every time. But it'll pay off....it will....it will! If you are saying, "But our bathroom is too small to fit a stool in there," you can use the toilet to support the standing child. Close the lid and wipe down surfaces that will be touched with a clorox wipe, or throw a towel over the closed lid so the child touches that, instead. You can also use a child-sized chair or even a door frame to support your standing kiddo.

We started out by letting Q explore the toilet--flushing many times, opening and shutting the lid, and unrolling the toilet paper. We didn't allow her to put her hands in the water, though. We taught her that it was "yuck." We showed her how to climb up and sit on the seat. So, for a couple months after every diaper change we encouraged her to sit on the potty for a second. She didn't do anything....just sat for a couple seconds. This was fine! She was learning some important skills--how to get on the toilet, primarily. So, to recap, every time we changed her diaper, it was ALWAYS in a restroom. And if we were at home, we always encouraged her to climb up and sit on the potty after a diaper change.

18 months seems really young to most people, but this is actually a great age (for some children it occurs even sooner....) because they are first starting to notice the toilet and what goes on with it--and that parents are using it. Once the child first shows interest/curiosity is the perfect time to add toilet skills to the "potty training" schema. Sometimes waiting until the child is older (2 or over) actually skips past the window of interest (and also coincides with the "NO" phase, which does not help acquire toilet skills!)

Sometimes we knew times of the day Q would always seem to pee. We tried to take her to sit on the potty before she peed/pooped in her diaper, and occasionally we'd get her there in time and she'd pee in the potty. We'd make a big deal and clap and say, "yeaaaa!"

After a while of just sitting and practicing, Q peed in the potty a few times and started making the connection. A little bit after she turned 2 years old, we started encouraging her to sit on the potty and "push out your pee" every little bit during the day. From that point on she did great and was fully potty trained shortly after her 2nd birthday.  Same thing for our son.

From a teaching standpoint I was shocked how easily ALL of our children potty trained using this method--even the boys, which many people argue are so much tougher. I love that potty training was never an "issue" or an "obstacle" or even a frustration. It was just part of our every day routine.

As a mom I loved that I could change diapers anywhere easily--no changing table needed. In the truck--easy! Standing up on the seat worked great. In public restrooms--no problem, she often just held onto my legs and I bent over and helped her (or him). I also loved that it wasn't ME CHANGING HER.....the older and more capable she got, the more she was expected (and excitedly willing) to do because that was just the way we had always done things.

I could go on and on about how great I think stand-up diapering is. And also how important it is to teach toileting just like any other skill--in small pieces as the child is able to do more.  We would never say to a child "This is the weekend you are going to learn to eat.  We are not leaving this house until you learn to eat."  Yet often this is done with potty training....

Both of my kiddos moved along the process so smoothly and with no resistance.  I saw the same thing in the infant and toddler classrooms where I taught.  The only "things" with stand up diapering is that you have to be committed to following the same procedure every time and give as much of the process over to the child as they are ready for....if you can do those...you've got it made!

**Updated....read more about our diapering journey at THIS POST.It has a step-by-step breakdown with pictures of our Little Man and stand-up diapering.  :)

Ribbon toy

I made Beck a new toy to hold during diaper changes. I keep a few toys in his diaper basket for him to explore while we change/dress him. I used a wooden ring and tied red ribbons around it. I used a lighter to seal the ends from freying. He loves it!!!
This toy stimulates his motor skills as he grabs it and brings it to his mouth. It also encourages his visual perception with the different patterns (dots, stripes, etc.). Additionally he can explore different textures between the various ribbon types.

Potty Training Book

I'm sorry, but there are a lot of hokey potty books out there for toddlers, in my opinion. Plus most of them have WAY too many words for most toddlers to listen to. I LOVE this book! It goes through a variety of animals that live at the zoo and how they poop (in a toddler-appropriate manner, of course!). My little one has recently gotten very interested in the dog poop in the yard and announces each instance of it, so this book was perfect for her! And...if you have taken your kids to the zoo, you know the poop is just about the most interesting item there! Forget the tigers and bears, check out that pile of dung! :)

At the end of the book it has a little boy sitting on the potty and talks about how people poop in the potty. Q loves saying "Poop in poppy" and pointing out the "flush," stool (as in step)," and toilet paper.

We got this at the library, of course!!

More self care...shoes and standing diaper changes

As we are starting to give Q more responsibility in her self care, I have added a "shoe shelf" to her bedroom. We have an area where we keep all of her diapering items as well as shoes and socks on shelves. Her many pairs of shoes are stored in a small basket, but I wanted to start allowing her to put her shoes away when she undressed for nap or bedtime. For very young children, baskets aren't always the greatest methods for putting their own items away. In this case, if we asked her to get a pair of shoes out, she isn't quite able to find a matching pair and would get distracted by too many choices. When it was time to put them away, throwing them in a basket would also be difficult for her because she would be soooo tempted to play with all of them. She's a shoe girl! Also, another thing about baskets for storing items is that often times it's not a neat storage solution but rather a "dumping place." Think about the baskets you have in your home and whether they are neat and organized, allowing you to see every item inside (the visual is Sooooooo important for little ones who cannot yet categorize items to know everything that will be in that basket, even down at the bottom....you know that if it's a shoe basket, your red shoes will be down there at the bottom because, after all, they are shoes! Little ones can't yet put items into compartments like that and if they can't see the red shoes, to them they aren't there.) Obviously this is a skill they acquire more and more over time, but initially it's usually best to provide storage that allows for all items to be seen.

So.....we are still going to keep her many pairs of shoes in the basket on one of the higher shelves that only Mommy and Daddy can reach. However, on the bottom shelf I have put two little feet cutouts. I will set out the shoes she will wear that day on the feet and she will go get them from there. When it is time to take them off, we'll teach her to return them to the feet. Older children do great with a shoe rack or even one of the over-the-door shoe pocket systems.....

Older children can also start learning left and right feet and can be taught to put the left foot on the left cutout and same with the right. For now, we will just focus on Q getting each shoe on a foot. Sidenote...this also reinforces the math skill of one-to-one correspondance, an important counting and division skill.

So....onto diapering. We practice stand-up diapering. I know, you can pick your fainted self up off the ground right now. :) I too, was an unbeliever when I first found out about it. I began working at a Montessori who diapered strictly standing once the children could stand assisted. At first I thought it was sheer madness and that I would NEVER master it. Then I worked in a toddler classroom for a year and saw the ease with which these children were potty trained. No "potty training boot camp" no crying from kids or parents....Just calmness and the acquisition of toileting just like any other skill. Little by little.

We started out by buying two cheap wooden stools at Ikea. Plain ole chairs would work, too. We had a spot upstairs and downstairs equipped with a basket of diapers, plastic bags, wipes, and creams. When Q could stand holding onto the chair, we stood her up, we sat on the floor behind her. We removed her pants. Removed her diaper. If it was wet, no problem, just took it off, got out a new one, unfolded it all the way and put it between her legs and refastened the closures. Sometimes at first we had to do a couple readjustments to get it the right tightness. After about 10 times we were experts and could judge the tightness just right the first time. We also made sure the little elastics around her legs were out. Put her pants back on and that was it! If she was poopy, we got out lots of wipes ahead of time and got the plastic bag opened wide and lying beside us and the diaper all opened up and ready to go. Then when we took the diaper off we used it to wipe as much poo as possible. We then used the wipes to clean the back of her, then we lifed her leg enough to get the front. Easy peasy!

As she got bigger, we started including her more and more. Every time we change her we talk about whether she has poop or pee. This is important to know once you start sitting on the toilet so you know how long you'll be there! Not something children acquire automatically, so an important step. We then taught her how to remove her own diaper if it was wet. Somewhere around this time she started becoming mobile, so we had to introduce "wait, please" and teach her how to stay standing at the stool until we are all finished. We started allowing her to open the wipes and hand them to us...of course she always gives way too many, but they're easy to put back....Then we started letting her help take her pants down (by hooking her fingers in the top and gently tugging on her hands) and put them back on (we talk about "one leg, two legs!"). Now she throws her own diapers away and we wash her hands in the sink after. She also gets us a dry diaper before we start the diaper change. As you can see, we keep the dry diapers on a shelf she can reach. We've also started asking her to "clean your bottom" with a wipe after we finish cleaning her. She loves each step and enjoys taking part. She is also learning the steps of using the toilet gradually.

The next steps will include letting her sit on the toilet as soon as her diaper is removed if she wants. If not, okay. We'll let her go nuts with the flushing and put a small amount of toilet paper on the roll for her to experiment with (until she gets it out of her system and learns how the flushing and tp things work)....

Reasons I love Stand-up diapering:
-When she doesn't lay down on a poopy diaper, it doesn't squish all up in her butt cheeks and is MUCh easier to clean up
-She gets to take part and she is learning how to use the toilet step-by-step, which is developmentally appropriate
-she participates in toileting the same way we do on a real toilet--in an upright position
-she is active in participating and not just laying there watching me
-it's great when you are somewhere without a changing table--especially nasty gas stations on road trips!
-we change her standing in the back of the car trunk when we don't have access to a restroom

Be brave...give it a try!!!!