The Double DIaper - A Little Off-Topic

Alright, this is way off-topic, I know!

The cutie-bug needed to have surgery last week, and as a result he will have a catheter for a period of two weeks.  Lucky for us, he gets to spend this time at home.  Unlucky for us, we have to take care of the catheter!  Well, that's not really a big deal.  The hard part is taking care of the diapers while the catheter is in place.

We were told to "double diaper" until the catheter is removed.  It took us several days to really figure out what the heck we were doing.  In the meantime we got very little information that was helpful on how to double diaper.  I've decided that there should be a "double diapering tutorial" online.  Since I couldn't find one, I am making it!

Double diapering basically allows for the diaper area of your child to remain completely dry and clean inside of an "inner diaper" while all the urine is absorbed by an "outer diaper."   Here's how it works:

• After doing any clean-up or maintenance required for your baby, you place one diaper on the child that has a hole in it, strategically positioned over the catheter site.
• You gently pull the catheter through the hole of the "inner diaper."
• You place a larger, very absorbent, "outer diaper" over top, making sure the catheter is placed to drain into the center padded area. 

This isn't really that difficult once you get the hang of it, but I sure do wish I'd been given some more "helpful hints" in the beginning! So here are step by step instructions to create your double diapering system:

• Prepare by having two sets of diapers when you get home
• A box of disposable diapers the next size up from normal. For instance, my son wears size 1, so I bought a box of size 2.  We used Pampers Swaddlers Sensitive.  We went through about 30 of these in two weeks.
• A box of "super absorbancy" disposable diapers, like the overnights, the two sizes up from your normal size.  Since I couldn't find these in size 3, I ended up using a diaper three sizes up from normal, and that has worked just fine for us.  We used Huggies Overnights.  We went through about 45 of these in two weeks.
• Some people prefer cloth diapers - I use cloth diapers normally.  I want to be clear that while this process sort of works with cloth diapers it really becomes a sopping mess very quickly.  
• You have to have the waterproof barrier between the inner and outer diaper.
• You have to cut a hole and seal the edge of the hole on the inside diaper.
• You need to have a super absorbent outer diaper that wicks away the dampness from the inner diaper.
• We DID try this.  It was a sopping nightmare and I recommend just going with sposies for the duration of your double-diapering adventure.

• Prepare a diaper changing area.  When you have to change a double diaper, especially on your own without help, you'll want a comfy place for the child with something to amuse them.  We placed a changing pad in front of the mirror on my dresser.  We also left a couple of toys there to keep the little hands busy.
• Make sure you have wipes ready.
• Make sure you have a clean washcloth to pat dry.
• Make sure you have the double diaper ready (see next step, about the "batch")
• Make sure you have neosporin, or any other medicines prescribed by your doctor on hand
• It helps to have an extra pad under the baby's bottom so that you can swap it out for a fresh one each time.  The catheter will leak on your changing pad during the diaper change.

• Prepare a "batch" of double diapers instead of doing them one at a time.  It makes things allot easier when you never have to scramble to put one of these together.  My doctor told me not to worry about it ahead of time, but I wish I had created a good stash before the surgery.  It would have been one less thing to worry about when we got home.  

To create your double diapers:

• Grab a handful of your inner diapers (the one size ups), and an equal number of outer diapers (the two size ups).  I do about 5 at a time, every couple days.  It takes a while to do them.
• Gather some medical tape and a good pair of scissors. 
• Get something to do this on, because it makes a bit of a mess.  I use a pillow case.  It's easy to shake off and then throw in the wash.

 

• Take each of your inner diapers and open them up the way you would if you were about to diaper your child.  Then fold the diaper in half lengthwise.  
• Noting where on the diaper the catheter would be, make a horizontal cut.  You'll notice I do this high on the front because my child is a boy.  Also, I was told to cut a cross shape, I find that this single cut works better.

This is the point where things get messy.  You will notice fibers coming out of the diaper.  These little sandy pieces may actually be chemical components that turn to gel when they get wet.  If you don't seal the edges this stuff will get all over your baby, and render the "keep dry" effect of the double diaper useless.  It's especially frustrating when you've been told not to bathe your baby!  

So you want to seal the edges!

 

• Using medical tape (the cloth works better than the paper), tape the cut edges of the diaper closed, leaving a hole.  See the diagram below.

1. Place the tape on one side (I start on the outside.)  Try not to let the tape touch the open edges before you are ready, or else the fibers will make the tape not stick.
2. Use a finger to push the tape through the hole.  Place the finger on the not sticky side, this way you are pushing the tape against the edge it is meant to cover, and not getting fibers on the tacky side from the opposite cut edge.
3. Tape down the other side (For me this is the inside.). Continue steps 1-3 working around the hole until there are no more exposed edges.
4. Tape down any sticky spots or loose tape on the inside.  You don't want it to stick to baby.
5. Finished Product Front (see the arrows to identify each piece of tape and direction I taped in)
6. Finished Product Back (see the arrows to identify the tape and direction, including the piece that covers a sticky spot)

• To make things easy on yourself, go ahead and assemble the double diaper by opening your "outer diaper" and then placing the "inner diaper" inside.  
• Fold the double diaper back up, and you have a diaper ready to stack!

If possible just change the outer diaper!  Our physician's instructions were to change the inner diaper only when it was soiled or damp, otherwise twice per day when we medicated the site.  Changing the outer diaper is just like normal, except that there is a diaper inside instead of a baby bottom.  When you need to change the inner diaper:

• Open the outer diaper and remove it.
• Open the inner diaper and carefully pull the catheter back inside.
• If the inner diaper is dirty (poo) be sure to put a wipe between the catheter and the soiled area.
• Clean any soiled areas with wipes & remove the inner diaper.  Then dry by patting gently with a clean washcloth.
• The catheter should be hanging down, and probably dripping, on the extra pad you can replace after each diaper change. 
• If there are any surgery incisions you want to avoid using wipes there because they can cause stinging.  Instead use a damp washcloth.
• Apply any ointments or medicines to the baby's surgical and/or catheter site as directed by physician.
• Open the new double diaper, leaving both diapers together.
• Place the double diaper under baby's heiny.
• Gently pull the catheter through the sealed hole of the inner diaper.
• Close up the inner diaper. 
• Double-check the placement of the catheter (you don't want it poking out to drip down baby's leg) and then seal up the outer diaper.

Viola!  You are now a pro!

I hope this was useful for you!  Please leave a comment and let me know if it helped you, or if there is anything you think should be added.