Describe routine physical care needs for children in relation to: nappy changing, toilet training, washing and bath time, skin, teeth and hair, meal times

Qualification: NCFE CACHE Level 3 Diploma for the Early Years Educator
Unit: Unit 1.3: Support physical care routines for children
Learning outcome: Understand the physical care needs of children
Assessment criteria: Describe routine physical care needs for children in relation to: nappy changing, toilet training, washing and bath time, skin, teeth and hair, meal times

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Routine physical care for children generally includes nappy changing, toilet training, washing and bathing, skin/teeth/hair care and feeding. Depending on the child’s age, stage of development and skills, some or all of these tasks may be performed by a parent or caregiver; however, if a child is capable of performing tasks themselves, independence should be encouraged.

Here we will focus on the basic steps involved in each of these task categories.

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Nappy changing

Babies and young children require frequent nappy changes to ensure that they remain clean, healthy and comfortable.

Changing a nappy involves the following steps:

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  1. Begin by washing hands and ensuring that you have all the resources that you will need close to hand, including baby wipes, cotton wool, warm water, a fresh nappy, creams etc.
  2. The baby is placed on a changing mat, ideally at floor level, to prevent the risk of falling.
  3. The carer removes the dirty nappy – the nappy itself can be used to clean the baby’s bottom, particularly if they have had a poo.
  4. The baby’s bottom and other areas that were enclosed by the nappy can then be cleaned thoroughly with alcohol-free baby wipes or cotton wool and warm water. Care should be taken to ensure that the areas inside skin folds are cleaned. Girls should be cleaned from front to back to reduce the risk of infection.
  5. The dirty nappy should be handled hygienically. If using disposable nappies, they should be folded up and placed in a nappy sack before being disposed of in the appropriate refuse bin. Cloth/Terry’s nappies will need to be stored hygienically before they are soaked/washed.
  6. If required, creams should be applied before fitting the fresh nappy. The nappy should be secured tight enough not to fall off but loose enough so that the baby is comfortable.

Depending on the parent/carer’s wishes and preferences, either cloth or disposable nappies may be used – it is important to respect their choice. Cloth nappies can work out cheaper over the long term; however, disposable nappies can be more convenient.

Toilet training

As a child gets older, they should be supported to move away from nappies and use the toilet. There is no perfect age to begin toilet training – every child is different, and you should wait until there are signs that the child is ready – however, the ages of two and two-and-a-half may be used as a general guideline.

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Signs that a child understands when they need the toilet and are developing bladder/bowel control include:

  • They tell you when their nappy is wet/dirty or whilst they are peeing/pooing
  • They tell you before peeing/pooing or become fidgety
  • There is at least an hour’s gap between wetting
  • They are able to understand basic concepts of toileting and can follow basic instructions

To begin potty training, you should discuss with the child what the potty is for and how it is used. It should also be visible to them at all times so they can use it if needed. You may also show them how to use it and encourage them to sit on it if they need the toilet or at regular intervals, such as when they wake up or after meals. Similarly, if a toilet will be used rather than a potty, then the carer should explain how to use it and shown how to sit on it. They will also need to be taught how to adjust their clothing to use the toilet (e.g. pulling pants/trousers down etc.)

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Carers should praise the child when they use the potty but not make a fuss if they have an accident because this can make the child become anxious about toileting. Some parents/carers may use pull-ups or training pants as a child becomes more accustomed to toileting independently.

For children with disabilities that may make toilet training more difficult, further support may be needed, but it is important that this skill is still encouraged. Further advice and information about this can be found on the Contact charity website.

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Washing and bathtime

Handwashing is one of the most important ways to prevent the spread of infection and illness.

Children should wash their hands several times a day, including after using the toilet, eating or preparing food, and playing outdoors. Faces should be washed with a soft cloth, particularly after meals.

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Some practitioners, such as nannies or au pairs, may be required to carry out bathing and showering activities – this should be in collaboration with parents and carers.

To reduce the risk of accidents, it is essential that all activities are risk assessed – this will reduce the likelihood of incidents such as scalding, drowning and slips/falls.

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Babies will be fully dependent on their carers for their washing and bathing needs; however, as a child gets older, they should be encouraged to become more independent in these tasks.

Skin, teeth and hair care

The skin is the largest organ in the human body, and it plays a vital role in protecting us from the outside world.

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Every day, our skin comes into contact with bacteria, allergens and other potentially harmful substances. In most cases, our skin does an excellent job of keeping these substances out. However, sometimes the barrier is breached, and we can end up with an infection or other problems.

Good skincare can help to reduce the likelihood of this happening. For example, using a barrier cream can help to prevent nappy rash, while applying suncream can protect delicate skin from sunburn.

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And as discussed above, keeping skin clean by regularly washing and bathing reduces the spread of pathogens.

Similarly, hair care is also important. This can include washing hair as part of the bathing routine and brushing and combing. Some practitioners may also be responsible for styling a child’s hair.

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It is essential for early years practitioners to be able to spot head lice/nits. When it is identified, practitioners should inform the child’s parents/carers and the parents/carers of other children in the setting so that treatment can be applied. When informing parents/carers about an outbreak of headlice, the child should not be named to protect their confidentiality.

Oral health is also an important healthcare task that should be promoted because tooth decay is an epidemic amongst young children in the UK and is entirely preventable.

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Teeth brushing techniques can be demonstrated, and discussions can take place about oral hygiene with both children and parents/carers. This can also be tied in with healthy and nutritional eating guidance.

Meal times

Meal times are an important part of the day for young children. Not only do they provide a chance to refuel after a busy morning of playing, but they also offer an opportunity to socialize and learn new skills.

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One of the most important things that children can learn at meal time is good hygiene. Washing hands before eating helps to prevent the spread of illness, and it’s important for adults to model this behaviour.

In addition, meals should be tailored to meet each child’s individual dietary needs. Some children may need to avoid certain foods for medical reasons, while others may have religious or cultural preferences. Regardless of the individual circumstances, it’s important that all children have access to nutritious and enjoyable meals.

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Lastly, meal times should be a time for children to develop independence. Encourage them to try new tastes, and supervise them as they learn to use utensils and pour their own drinks.

By creating a positive mealtime environment, parents/carers and practitioners can help their children develop healthy habits that will last a lifetime.

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The role of the Early Years practitioner in relation to these activities is explored in the next section.

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