Chapter 5: Facilities, Supplies, Equipment, and Environmental Health
5.4 Space and Equipment in Designated Areas
5.4.2 Diaper Changing Areas
18.104.22.168: Changing Table Requirements
Changing tables should meet the following requirements:
- Have impervious, nonabsorbent, smooth surfaces that do not trap soil and are easily disinfected;
- Be sturdy and stable to prevent tipping over;
- Be at a convenient height for use by caregivers/teachers (between twenty-eight and thirty-two inches high);
- Be equipped with railings or barriers that extend at least six inches above the change surface.
RATIONALEThis standard is designed to prevent disease transmission and falls and to provide safety measures during diapering. Commercial diaper change tables vary as much as ten inches in height. Many standard-height thirty-six inch counters are used as the diaper change area. When a railing or barrier is attached, shorter staff members cannot change diapers without standing on a step.
Back injury is a common occupational injury for caregivers/teachers (3,5). Using changing tables that are sized for caregiver/teacher comfort and convenience can help prevent back injury (1,3-4). Railings of two inches or less in height have been observed in some diaper change areas and when combined with a moisture-impervious diaper changing pad approximately one inch thick, render the railing ineffective. A change table height of twenty-eight inches to thirty-two inches (standard table height) plus a six-inch barrier will reduce back strain on staff members and provide a safe barrier to prevent children from falling off the changing table.
Data from the U.S. Consumer Product Safety Commission (CPSC) show that falls are a serious hazard associated with infant changing tables (2). Safety straps on changing tables are provided to prevent falls but they trap soil and they are not easily disinfected. Therefore, diaper changing tables should not have safety straps.
COMMENTSAn impervious surface is defined as a smooth surface that does not absorb liquid or retain soil. While changing a child, the adult must hold onto the child at all times.
The activity of diaper changing presents an opportunity for adult interaction with the child whose diaper is being changed.
TYPE OF FACILITYCenter, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
- Aronson, S. S. 1999. The ideal diaper changing station. Child Care Info Exch 130:92.
- U.S. Consumer Product Safety Commission (CPSC). 1997. The safe nursery. Washington, DC: CPSC. http://www.cpsc.gov/cpscpub/pubs/202.pdf.
- ASTM International. 2008. ASTM F2388-08. Baby changing tables for domestic use. West Conshohocken, PA: ASTM.
- Gratz, R., A. Claffey, P. King, G. Scheuer. 2002. The physical demands and ergonomics of working with young children. Early Child Devel Care 172:531-37.
- Fiene, R. 2002. 13 indicators of quality child care: Research update. Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. http://aspe.hhs.gov/basic-report/13-indicators-quality-child-care.