How to Change Teen Diapers

Diapers are a part of everyday life for many people with disabilities or other physiological issues. It is important to be prepared and efficient when changing a teen's diaper as they may be easily embarrassed by the process. Knowing your position options and understanding how to use your supplies will make everything go much smoother. Try your best to preserve the teen’s privacy and give them as much control over the process as you can.

Part 1

Part 1 of 4:

Getting Ready

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1
Look for signs of wet or soiled diapers. Watch for indications that they need a diaper change. In the case of soiling accidents, it is usually easy to smell or sometimes hear, and you may have noticed they were standing in an obvious “soiling” position. Visible wetness, sagging or bulging, skin irritation, and discomfort or restlessness are other signs that it may be time to change the diaper.^{[1]
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- How often this occurs will depend on several factors (the person's health, etc.). However, plan on changing (or assisting if needed) a teen's diaper about every 4 to 6 hours (for high-quality absorbent products).^{[2]
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- If possible, remind them to change themselves if they can do so. Create a changing schedule and adjust it as necessary for additional dirty diapers.
2
Do a discreet verbal or physical check. With more independent teens, you can ask them if they need help with a diaper change. If they are less independent, you may need to do a visual check. Quickly peek inside the back and front of the diaper to see if it is wet or soiled.^{[3]
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- They may resist your need to check if they need a diaper change, so be sensitive to their feelings. Respect their privacy and dignity as you check.
- Consider developing a code phrase, such as: “Do you need a break?” or “It doesn't smell like roses here. Do you need to get some fresh air?”
- Prepare to change or have them change the diaper as soon as possible. Delays in a cheaper diaper can contribute to the development of urinary tract infections, skin irritation, and rashes.^{[4]
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3
Go to a changing area. If you are in a home setting, head into the restroom area or a room with extra space. If you are “out and about,” it gets a bit more challenging. Go to a public restroom and head into an extra-large stall, an accessible stall, or a separate family restroom, if one is available. The space must be clean and big enough for your teen to potentially lie on the floor, if needed.^{[5]
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Research source} Sometimes you may find a restroom with an extra-large changing table.
- If you're around other people, say, “Excuse us for a moment, we’ll be right back,” and leave it at that.
- If you have options, choose the bathroom stall with extra handrails and/or purse shelves (for changing supplies).^{[6]
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Always lock the bathroom door behind you. If people are standing outside of the bathroom area, feel free to ask them to give you some space as well. Likewise, if you are in a public space, use hushed tones when completing the change. Do not complain aloud, or you will further frazzle and embarrass the teenager.^{[7]
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5
Set up the supplies. If you are out, you should carry a sturdy diaper bag that contains the following: diapers, disposable underpads, wipes, barrier skin cream, a pair of gloves, and hand sanitizer. Unpack these items and place them nearby for the changing process.^{[8]
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Research source} If the teenager can, you might ask them to assist by holding the wipes or the fresh diaper.
- A disposable underpad is just one of many options to provide a barrier between the teen and the changing surface. You can also use a folded shower curtain, a waterproof picnic blanket, or a homemade padded changing mattress covered in soft vinyl.
- It's easy to forget or run out of a necessary item. Do a quick inventory of your diaper bag before heading out to ensure you have everything you need.
- If you're in a public restroom and can't set out the items, leave them in the bag and pull them out as needed. The fewer supplies that are contaminated with germs, the better.
If you need to move something to make additional room on the floor in a room, do so. Pay attention to the temperature as well. You do not want the room to be too hot or too cold, as it will make the changing process all the more uncomfortable. Adjust the thermostat if you can, and if it is necessary.
7
Prepare for the changing position. How you do this depends on how mobile your teen is. Standing would be the easiest, but if your teen cannot stand up or has soiled the diaper heavily, you will need to set up the room for a lying-down change.
- For a laying-down change, place an underpad on the ground or bed.^{[9]
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  Research source} If a changing table is available, clean the plastic cover with a disinfecting wipe.
- For a seated change, place the underpad on a chair seat or bench. If they’re seated on the toilet, place the pad on the ground around the base of the toilet.^{[10]
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- For a standing change, place the underpad on the ground with reach access to a wall, if needed for support.

Part 2

Part 2 of 4:

Removing the Soiled Diaper

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Many people will also prefer to put on latex gloves at this point. The goal is to prevent the spreading of germs from you to the teen and vice versa.^{[11]
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2
Change in a standing position. This is generally the best option for teens as it is the least stressful and usually the quickest. This position also requires very little space, making it a good choice for small restrooms and other cramped areas. Start by putting an underpad on the ground, ask the teen to stand on the underpad, then pull down their pants until they are bunched around their ankles.^{[12]
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- Release the diaper side-tabs and remove the soiled diaper from the body, taking care not to “spill” any waste from the diaper.
- Wipe the area clean from front to back, ensuring all waste is removed from their skin.
- If the teen needs support standing, they can grab a handrail (if available), use a walker, touch the wall, or grip your shoulders for balance.
- If you think the diaper is heavily soiled, use caution in this position, as it will be easier to get clothing dirty or make a mess in general.
3
Change in a sitting position. This is a changing option in areas where seating is provided (e.g., family restroom benches) or in situations where the teen can lift themselves from a seated position (in a wheelchair, for example), but is not fully capable of standing independently. Start by having the teen sit on a pre-placed underpad. If they are already seated, have them lift up briefly and scoot it under them. Have them raise up again to remove all lower clothing.^{[13]
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- Have them stay seated as you release the diaper side tabs. Ask them to lift up, then pull the diaper down. Wipe the back area, then the front. Pull out the diaper from under them and dispose of it, along with the wipes.
- Be aware that the sitting position requires a degree of upper-body control on the teen's part. They can rest seated directly on the underpad between movements, if needed.
4
Change in a lying down position. This option can make teens feel very vulnerable and potentially embarrassed because they are diapered like a baby in that position. However, for those teens with severely limited mobility or soiling accidents, this is the best option. Starting by helping the teen to the floor, to the changing table (if available), or to the bed (if changing in a room), where they will lie upon the underpad. Remove their lower clothes completely, including plastic pants if they wear those for extra protection. Release the diaper tapes, pulling it loose, but not off.^{[14]
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- Roll your teen onto their side so they’re facing away from you, then pull the soiled diaper toward you from underneath them. If possible, have another person help you hold them in place (so they don’t roll off the bed, for example).
- Clean the person’s diaper area (front and back) with a moist wipe or lukewarm soap and water. You may need to roll them onto their other side to clean all areas thoroughly.
- When removing clothes, look for signs that the diaper has leaked. If they got wet or soiled, replace them with clean ones. This includes dirty plastic pants, which you can also change. Put all wet or dirty clothes in a plastic bag to wash later.

Part 3

Part 3 of 4:

Putting on a New Diaper

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1
Be sure the teen's bottom is clean. Regardless of position, use as many wipes as you need to make them completely clean. If possible, have them help with their own cleaning needs. Use non-irritating wipes or lukewarm water and mild soap for the best results.^{[15]
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- Use wipes that are free of alcohol or added fragrances to reduce skin irritation.
- When you are done with cleaning, place the soiled wipes within the soiled diaper and fold them up for disposal.
- Make sure to wipe the teen from front to back. This prevents the spread of fecal bacteria and is especially important when changing teen girls and transgender boys.
2
Apply skin cream. After you have finished cleaning, rub a zinc-based skin cream around the skin covered by the diaper. This will prevent chafing and rashes, especially for teens who always wear diapers. This is an especially intimate step, so able teens may want to do this themselves.^{[16]
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- You can buy diaper cream in the form of an aerosol can. Your teen may prefer this option since you would not need to use your hands to apply the cream.
- If you see a diaper rash that is dark red or heavily raised, seek medical advice. Long-term rashes can get infected and lead to other health problems.
3
Put on the new diaper and clothing. Grab and unfold the fresh diaper and pull it up between their legs, securing it at both sides by fastening the tapes. Ensure that it's form-fitting without gaps around the legs or waist and that it doesn't impede movement in order to prevent chafing or diaper rash.^{[17]
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Research source} When you're done, put their lower garments back on.
- In the standing position, you'll need to use one hand to hold the diaper in place and another to secure the tabs.
- In the sitting position, you will need to have the teen raise up to place the fresh diaper between their legs and secure it.
- In the laying down position, you will want to keep their knees bent as you place the diaper, releasing them after it is in place, then you secure the tabs.
Place the soiled diaper in the trash or diaper bin.^{[18]
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Research source} Dispose of any wipes that may have fallen on the floor or elsewhere during the process. Look over the area to make sure that it appears the same as it did when you arrived.
When you are finished, it is even more important to wash your hands or use hand sanitizer, even if you wear gloves.^{[19]
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Research source} It is also a good idea to ask the teen to wash their hands as well.
Make sure that you pack everything back up into the diaper bag if you are out in public. It is very easy to forget wipes, for example, in a rush to get out of the restroom. Ask the teen to help you look around by saying, “Do you see anything I’ve missed? Are we good to go?”

Part 4

Part 4 of 4:

Managing Any Challenges

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1
Stay calm. To relax you both, you might say, “Stay calm. It will all be okay.” Or, “Trust me, we’ve done this many times before.” If a teen refuses to leave for a diaper change, it may also help to set a time limit on resistance, such as, “Okay, I see that you are busy, so we can wait for a bit, but come see me in five minutes.”^{[20]
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- If you feel the need to lash out or say something negative, take a deep breath and count to five. Changing a teenager can be frustrating or awkward, but approaching the situation with anger will only make things more stressful for you both.
2
Empathize. Recognize that your teen may be embarrassed by the diapering process. You can lessen some of these social issues by changing your teen only in private spaces, such as bathrooms. Don’t talk openly about your teen’s diapering needs, and be tactful about telling your teen that it is time for a change.^{[21]
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- Ask the teen for suggestions on improving the process and reducing their anxiety or embarrassment.
- Licensed clinical psychologist Melissa Matos suggests helping your teen accept their diapering by explaining that “all bodies are diverse in shapes and functioning, and that means taking care of your body in a way that makes sense for you and your personal needs. It’s also helpful to challenge messages or biases that are rooted in ableism and marginalization and work to increase more inclusivity of all body types and needs.”^{[22]
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3
Counter physical resistance. A teenager might resist the entire diapering process. If so, be prepared for this challenge by reminding yourself to stay calm and in control.^{[23]
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Go to source} Resist the desire to physically restrain them, as it will only cause more problems in the future.
- Channel the teen’s aggression into the diapering process by asking them to assist with preparing the supplies or the room. You could say, “Look how strong you are. Could you use some of your strength to help me do this? It will go much faster.”
- Tell the teen that you're only trying to help them and set the boundary that it's not okay for them to hurt you in the process. You might say, “I understand that you're frustrated, but hitting me is wrong, and you need to stop.”^{[24]
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- If you feel physically in danger, stop the diapering process and try again after a 15-minute cooldown period.
4
Offer positive reinforcement. If a teen usually resists changing, be sure to offer praise if everything goes smoothly. At the end of the change, you might observe, “Thank you so much for helping out! Did you notice how quickly that went?”^{[25]
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- Offer an incentive for cooperative behavior in the future. For example, say, “If we have a week with no arguments over diaper changes, we'll go out to your favorite restaurant.”
- Change it into a positive situation for both you and your teen. Use the time to talk about anything other than the diaper change.
You may not be able to complete the changing process on your own, especially if your teen physically resists. If this happens, ask your teen for help and then reach out to others, if necessary. For example, when changing at home, you may call out to other family members to help hold your teen in a safe position.^{[26]
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Research source} Choose someone your teen trusts, or ask them who they want to help, if possible. This should be a last resort, as it may violate the teen's privacy.

Expert Q&A

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Question

I'm totally paralyzed from the armpits down and I wear diapers and when we go to the stores my mom changes me on the changing table in the open for babies what should I do about that?

Laura Marusinec, MD
Board Certified Pediatrician
Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.

Laura Marusinec, MD

Board Certified Pediatrician

Expert Answer

Talk to your mom about how it makes you feel. See if there are other options such as private bathrooms. The store clerks may have a private bathroom you can use, or they may know a nearby store that has more privacy. You may even ask your doctor about other options or how to deal with your feelings about your lack of privacy.

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Question

At what age is it appropriate to start teaching my child to change themselves? My daughter is 10 and has full mobility aside from her incontinence. Should I teach her how to change herself or wait a couple of years?

Laura Marusinec, MD
Board Certified Pediatrician
Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.

Laura Marusinec, MD

Board Certified Pediatrician

Expert Answer

It really depends on the child. Talk to her and see if she thinks she is ready. You can start by having her help you with the changing process, and gradually let her do more until she is ready to do it herself. Use positive reinforcement (praise and rewards) if she seems resistant. Show her that by changing herself, she has more independence and freedom. At 10, she may be ready to change herself.

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Tips

It is usually not necessary to double-diaper your teen. Most will only wet through one diaper every few hours.

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Move efficiently when you change a diaper. Teens will often see changes as disruptions to their routine activities and will want to be changed as quickly and discreetly as possible.

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If your teen has frequent heavy wetting accidents or soiling accidents, it is good to add a pair of plastic pants as an extra precaution against leakage. It can also reduce the smell following a diaper-soiling accident.

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Warnings

Do not show signs of disgust when you are changing a teen with a soiled diaper. Changing a baby with a dirty diaper can be a huge challenge for many people, and doing the same on a heavily soiled teenager can be seen as an unbearably large challenge. However, after some time, you will almost get used to doing it, and it will become a daily routine—just like it does if you have a baby.

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Do not punish your teen for needing diaper changes. Doing so is likely to lead to additional accidents and will create negative emotions, which will slow down toilet training if that is an option.

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Teens can have the occasional wetting or soiling accidents during a diaper change, too. You may still need to use a waterproof changing pad or spare towel underneath your teen. Your teen will no doubt be very embarrassed about doing it as it is usually considered very babyish to have an “accident” on the changing table while being diapered. If they can sense the accident before it happens, ask them to warn you before the accident happens.

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Be aware that some people take offense at the very word “diaper” when used in connection with a teenager or adult. Instead, they may prefer the term “briefs.”

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The desire to wear diapers by a teenager can be associated with “paraphilic infantilism.” If you believe this is the case or your teen also suffers from depression or anxiety, you may want to discuss the situation with a medical professional.^{[27]
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