Caring for Our Children (CFOC)

Chapter 5: Facilities, Supplies, Equipment, and Environmental Health

5.4 Space and Equipment in Designated Areas

5.4.2 Diaper Changing Areas

5.4.2.1: Diaper Changing Tables

Content in the standard was modified on 12/20/2022.

Early care and education programs should have at least one diaper changing table per infant group or toddler group. Diaper changing stations should follow the Safety Standard for Baby Changing Products within 16 CFR Part 1235 (effective June 26, 2019), and American Society for Testing and Materials’ (ASTM) F2388-21 Standard Consumer Safety Specification for Baby Changing Products for Domestic Use.1

 

Also, program staff should:

  • Be properly trained on diaper changing procedures and proper cleaning and disinfecting of diapering surfaces. They should clean and disinfect surfaces after each use.
  • Allow enough time for changing diapers.
  • Not allow more than one group or cohort of children to share diaper changing tables and sinks.
  • Not place the diaper changing tables and sinks between two classrooms.
  • Only use the diaper changing table for changing diapers.

Diaper changing tables should be high enough for staff to use comfortably without bending over, and for older toddlers to use stairs if necessary . Staff should actively supervise children during diaper changing. 

RATIONALE

Diaper changing takes time, as does cleaning and disinfecting diaper-changing surfaces. Early care and education programs that follow proper diapering and hand hygiene practices decrease illnesses among children and staff.2 Also, when program staff from different groups use the same diaper changing surface without proper cleaning and disinfecting of surfaces, illnesses may spread more easily among children.

 

Following the Safety Standard for Baby Changing Products decreases injuries to children from normal use as well as misuse or abuse of diaper changing tables. Specifically, it decreases injuries and deaths of children from falling from changing tables, structural or mechanical failure, instability, getting trapped in openings in the table, and suffocation.1

COMMENTS

ADDITIONAL RESOURCES

American Academy of Pediatrics. Virtual Early Education Center. https://veec.aap.org/index.html

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
3.2.1.2 Handling Cloth Diapers
3.2.1.3 Checking For the Need to Change Diapers
3.2.1.4 Diaper Changing Procedure
3.2.2.1 Situations that Require Hand Hygiene
5.2.7.4 Containment of Soiled Diapers
5.4.2.2 Handwashing Sinks for Diaper Changing Areas in Centers
5.4.2.4 Use, Location, and Setup of Diaper Changing Areas
5.4.2.5 Changing Table Requirements
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES

  1. U.S. Consumer Safety Product Commission. Baby changing products business guidance and small entity compliance guide. CPSC.gov Web site. https://www.cpsc.gov/Business--Manufacturing/Business-Education/Business-Guidance/Baby-Changing-Products-Business-Guidance-and-Small-Entity-Compliance-Guide. Accessed September 19, 2022

  2. Collins JP, Shane AL. Infections associated with group childcare. Principles and Practice of Pediatric Infectious Diseases. 2018:25–32.e3. doi: 12 16/B978-0-323-40181-4.00003-7. Epub 2017 Jul 18. PMCID: PMC7152033. Accessed August 3, 2022 

NOTES

Content in the standard was modified on 12/20/2022.