HEALTH, SAFETY, AND NUTRITION FOR THE

YOUNG CHILD

9 CHAPTER NINE: PHYSICAL WELLNESS,

DIAPER CHANGING AND TOILET TRAINING
Kelly McKown

Chapter 9 Learning Objectives

By the end of this chapter, you should be able to:

 Discuss physical activity recommendations for young children.

 Describe the steps to properly change a diaper to prevent the spread of disease.
 Describe strategies for toilet training.

INTRODUCTION
Healthy active living includes eating healthy foods, staying physically active, and getting enough rest. Developing
healthy habits starts in early childhood. Eating well and being physically active helps a child continue to grow
and learn.[1]

HEALTHY ACTIVE LIVING

Research tells us that the way young children eat, move, and sleep can impact their weight now and in the future.
Early childhood is an ideal time to start healthy habits before unhealthy patterns are set.[2]

Many children in the United States do not follow the recommendations of the Dietary Guidelines for Americans.
According to the CDC, on average, children consume too much fat, saturated fat, and sodium and not enough
fruits, vegetables, or calcium. Children obtain 33%-35% of their calories from fat and 12%-13% from saturated
fat (above the recommended levels of 30% and 10%, respectively). Only 16% of children ages 6-11 years meet
the recommendation for total fat intake; only 9% of children meet the recommendation for saturated fat intake.[3]

Young children depend on parents, caregivers, and others to provide environments that foster and shape healthy
habits. Early care and education programs have a responsibility to promote growth and development, make
healthy foods available, and provide safe spaces for active play. Staff can help children and families by
encouraging and modeling healthy eating and physical activity at the center and by providing suggestions for
small, healthy steps at home.[4]
Physical Activity

Good activity habits begin early in children’s lives. As early as infancy, adults can help children grow lifelong
healthy play habits. Children learn from adults, they should model being active and participate with children when
possible.

Infants should spend a lot of time on the floor (and out of equipment that limits mobility). This time allows them
to reach, and kick so they can reach important milestones like crawling and sitting up.

Even very active toddlers need environments that support movement and activity and intentional opportunities to
be physically active. Things like dancing, jumping, and taking walks are great ways to keep them moving.[8]

Iron Deficiency

Iron deficiency anemia is the most common cause of anemia in the United States.[40] This condition occurs when
an iron-deprived body cannot produce enough hemoglobin, a protein in red blood cells that transports oxygen
throughout the body. The inadequate supply of hemoglobin for new blood cells results in anemia. Iron-deficiency
anemia causes a number of problems including weakness, pale skin, shortness of breath, and irritability. It can
also result in intellectual, behavioral, or motor problems.

In infants and toddlers, iron-deficiency anemia can occur as young children are weaned from iron-rich foods, such
as breast milk and iron-fortified formula. They begin to eat solid foods that may not provide enough of this
nutrient. As a result, their iron stores become diminished at a time when this nutrient is critical for brain growth
and development.

Diaper Changing

Changing diapers in an infant classroom is a time when disease can be spread. The proper steps must be followed
to prevent the spread of disease: Changing Diapers in Child Care

Diaper changing areas should be smooth and nonporous (such as a plastic-covered pad), have a raised edge to
prevent children from falling, be near a sink, be out of reach from children, and away from food preparation
areas.[34]

The following diaper changing procedure should be posted in the changing area and followed to protect the health
and safety of children and staff:

Step 1: Before bringing the child to the diaper changing area, perform hand hygiene (including putting on gloves,
if using) and bring supplies to the diaper changing area, and place a disposable liner on the changing area.

Step 2: Carry/bring the child to the changing table/surface, keeping soiled clothing away from you and any
surfaces you cannot easily clean and sanitize after the change. Always keep a hand on the child.

Step 3: Remove the soiled diaper and clothing without contaminating any surface not already in contact with
stool or urine. Put soiled diaper in covered waste container. Put any soiled clothing in a plastic bag that is securely
closed to give to family.

Step 4: Clean the child’s diaper area with disposable wipes and place soiled wipes into a covered waste container.

Step 5: Removed the disposable liner and gloves and place in waste container
Step 6: Use facial tissue to apply any creams or ointments. Slide clean diaper under the child and fasten it and
dress the child.

Step 6: Wash the child’s hands and return the child to a supervised area.

Step 7: Clean and disinfect the diaper-changing surface and any equipment or supplies that were touched (and
any other area child soiled before changed).

Step 8: Perform hand hygiene and record the diaper change, diaper contents, and/or any problems.

Caregivers/teachers should never leave a child unattended on a table or countertop. A safety strap or harness
should not be used on the diaper changing table/surface.[35]

Toilet Training

Signs of Toilet Training Readiness and Tips

If Using Potty Chairs

Due to being hard to clean and disinfect, potty chairs are not ideal in a child care environment. If they are used,
they should be used in the bathroom only. After each use:

· Empty contents immediately into the toilet

· Rinse with water and dump water into the toilet

· Wash with soap and water (with a paper towel) and empty soapy water into the toilet

· Rinse again and empty into the toilet

· Spray with bleach solution

· Air dry

· Wash and disinfect sink

· Wash hands (child and adult)[36]